All You Need To Know About… Alcohol


Rating: 5 out of 5.

Risk Of Becoming Addicted

Cocaine, similar to heroin can be extremely addictive. Even after just a few times or become psychologically addicted even sooner. That’s why we give this category 5/5 stars.


Rating: 3 out of 5.

Damage To physical Health

Long-term physical health damage from cocaine is possible, however following harm minimisation techniques, long-term damage can hopefully be minimised. That’s why we rate this category 3/5 stars.


Rating: 5 out of 5.

Damage To Mental Health

The psychological dependence cocaine causes along with cravings for it is one of the main reasons cocaine destroys peoples lives. That’s why we give this category 5/5 stars.


Rating: 4 out of 5.

UK Availability

UK availability for cocaine is common, even more so with crack cocaine. That’s why we give this category 4/5 stars.


Rating: 5 out of 5.

Financial Cost?

The average UK price of cocaine is £46 per gram.

Crack is commonly sold by the rock with £16 buying 0.25g.


Rating: 2 out of 5.

Severity Of Withdrawals?

Withdrawing from cocaine is mostly psychological. With the correct therapies and treatments in place, physical withdrawals should be minimal with help mainly focusing on psychological support. That’s why we rate this category 2/5 stars.


Rating: 5 out of 5.

Treatment Options Available?

Treatment options can include CBT, group/1-2-1 therapy, counselling along with certain non-traditional therapies such as acupuncture and meditation among others. However the user must be ready to engage with treatment and stick with it. That’s why we give this category 5/5 stars as safe treatment options are available for those ready to pursue them.


Rating: 4 out of 5.

Long-Term Recovery Success?

Addiction is a treatable disorder and can be arrested. Some users will lapse or relapse after they complete their detox/rehab, therapy or other associated treatments. However cocaine addicts can live a happy, long, drug free life. That’s why we give this category 4What Are The UK Drug Laws And How Does The Drug Classification System Work?/5 stars as long-term success is possible!

Overall Risk Rating:

Rating: 4 out of 5.

We give alcohol an overall risk-rating of 4/5 stars. Alcohol can be deadly if you become addicted and do not properly go through a managed, safe detox and rehab style program. Also the long-term damage that can be caused from alcohol can also be severe. That is why we rate alcohol as: HIGH RISK.

According to the most recent studies, one person in six has an alcohol problem or alcohol addiction to some degree. This means that millions of UK families are affected by alcoholism and alcohol dependence each and every day. Many do not receive the addiction treatment that they need to live a sober, happy, fulfilling life. Recognising the signs and symptoms of alcohol abuse & dependence is important for family, friends, co-workers, religious leaders, teachers and medical professionals alike. 24% of adults in England and Scotland regularly drink over the Chief Medical Officer’s low-risk guidelines. In the UK in 2018 there were 7,551 alcohol-specific deaths (around 11.9 per 100,000 people). This is the second-highest level since the records began in 200.

Defining Alcoholism

Alcohol addiction, alcohol abuse, binge drinking, alcoholism or alcohol dependence – these are all words that are often used interchangeably. In reality, they are actually quite different.

What is Alcohol Addiction?

We hear a lot about the heroin epidemic and fentanyl but we hear very little in the news about the reality of alcohol addiction. It could be because it’s a legally controlled substance that has caused us to become numbed to it’s dangers as its commonality within society normalises its dangers. Alcoholism and addiction to any substance is a chronic, relapsing disease that will worsen as time goes by, ultimately leading to one of 4 ends: recovery, prison, mentally or physically hospitalised or dead. It’s incredibly common, affecting over 17 million UK citizens each year!

Alcohol addiction is the most severe form of alcohol abuse and involves the inability to manage drinking habits. It is also commonly referred to as alcohol use disorder. If left untreated, can be fatal.

Individuals struggling with alcohol addiction often feel as though they cannot function normally without alcohol. This can lead to a wide range of issues and impact professional goals, personal matters, relationships and overall health. Over time, the serious side effects of consistent alcohol abuse worsens and produces damaging complications.

What Is An Alcohol Unit & How Do I Know If I’m Drinking Too Much? 

One unit is 10ml or 8g of pure alcohol. Because alcoholic drinks come in different strengths and sizes, units are a way to tell how strong your drink is.

It takes an average adult around an hour to process one unit of alcohol so that there’s none left in their bloodstream, although this varies from person to person.

To keep health risks from alcohol to a low level, the UK Chief Medical Officers’ (CMO) low risk drinking guidlines advise it is safest not to drink more than 14 units a week on a regular basis.

If you regularly drink as much as 14 units per week, it’s best to spread your drinking evenly over three or more days.

If you want to cut down the amount you drink, a good way to achieve this is to have several drink-free days each week

Large wine glasses hold 250ml, which is one third of a bottle. It means there can be nearly three units or more in just one glass. So if you have just two or three drinks, you could easily consume a whole bottle of wine – and almost three times the UK Chief Medical Officers’ low risk drinking guidelines – without even realising. Smaller glasses are usually 175ml and some pubs serve 125ml.

Spirits used to be commonly served in 25ml measures, which are one unit of alcohol, many pubs and bars now serve 35ml or 50ml measures.

What is Alcohol Abuse?

Alcohol abuse means that the person may not be physically dependent on alcohol but it is causing problems in their life. Alcohol abuse is one of the early warning signs that a person may be heading towards alcohol dependency because they are drinking more than they should.

What Is Binge Drinking?

The NHS defines binge drinking as “drinking lots of alcohol in a short space of time or drinking to get drunk”.

Because everybody is different, it is not easy to say exactly how many units in one session count as binge drinking. The definition used by the Office of National Statistics for binge drinking is having over 8 units in a single session for men and over 6 units for women.

Of course, people may drink at different speeds or drink over a different amount of time or drink different drinks with varying amounts of alcohol and this definition may not apply to everyone. 

What we can say is that the risks of short-term harms like accidents or injuries increase between two to five times from drinking 5-7 units. This is equivalent to 2-3 pints of beer.

The sorts of things more likely to happen when people drink too much or too quickly on a single occasion include accidents resulting in injury, misjudging risky situations or losing self-control. 

Am I An Alcoholic?

If you have to ask, then you might have a drinking problem. Take our simple assessment here and review the results at the end.


Have you ever felt you should cut down on your drinking?


Have people annoyed you by criticizing your drinking?


Have you ever felt bad or guilty about your drinking?


Have you ever had a drink first thing in the morning to steady your nerves, cure a hangover or to function “normally”?

If you answered ‘Yes’ to two or more of these questions, you should seek professional help. Do not feel ashamed, reaching out for help as early as possible reduces your risk of things such as permanent damage to your body or internal organs, worsening mental health conditions, loss of family, jobs, friends or other forms of responsibility to name just a few. Contact information for your nearest drug and alcohol service can be found on our help & support page here.

Why Is Alcohol Addictive?

Alcohol can be both physically and psychologically addictive. This is not a debate, discussion or theory, it is a fact and it is estimated that approximately 3 million people a year die from alcohol use worldwide. Drinking alcohol occasionally in moderation will not have any long-term negative side effects on your brain chemistry as dopamine levels and endorphins are only elevated for a short amount of time. But when you indulge in long-term heavy drinking, frequent binge drinking and excessive alcohol consumption, it does affect the delicate chemical balance within the brain. Sustained alcohol abuse will lead to permanent changes in the chemical make-up of the brain, resulting in a dependence and addiction to alcohol.

Alcohol is physically addictive because it alters the chemicals in your brain. The brain is a complex organ and normal brain function relies on a delicate balance between neurotransmitters. Drugs and alcohol modify the chemical balance in the brain and interfere with the normal release of neurotransmitters.

Alcohol reacts with the GABA (Gamma-Aminobutyric Acid) receptors in your brain releasing endorphins and increasing dopamine levels that produce feelings of pleasure and euphoria. The desire to recreate these feelings and the fact that your brain associates the sensation of euphoria with drinking creates an increased desire to consume alcohol. When you stop drinking your body continues to crave the alcohol and the feelings of euphoria that go hand in hand with alcohol consumption.

Alcohol typically inhibits the Corticotropin-releasing factor (CRF) in the brain. CRF is a neurochemical that plays a significant role in how the brain deals with stress and when you drink, it inhibits CRF and makes you feel more relaxed and less stressed. Over time the CRF will adjust to compensate for long term alcohol abuse and people suffering from alcohol use disorder will become more stressed when they can’t drink, increasing cravings and reinforcing their dependency on alcohol. Once your body is physically addicted to alcohol you will experience withdrawal symptoms when you suddenly stop drinking.

You can also become psychologically addicted to alcohol and many people with alcohol use disorder drink as a form of self-medication or to alleviate the symptoms of mental health issues or emotional trauma. People who are under a lot of stress at work or unhappy at home will often turn to alcohol to try and make themselves feel better or to cope with their circumstances. But alcohol is never the answer to your problems and many people who drink alcohol to deal with their issues will often become dependent on alcohol just to get through the day and still end up with the original problems that caused you to want to drink in the first place, still being there.

What does this mean, exactly?

It means that addiction is a disease that has major effects on the structure and function of the brain. Like other diseases such as diabetes or cancer, it is very complex but it begins with something simple; pleasure. Often times, people drink to feel good and as a means to escape from reality, even for a short while.

The Pleasure Centre & Addiction

Pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbens, a cluster of nerve cells lying underneath the cerebral cortex aka the brain’s pleasure centre.

The brain registers all pleasures in the same way, whether it’s derived from eating chocolate, exercising, or sex. All drugs of abuse cause a powerful surge of dopamine in the nucleus accumbens. However, there is a big difference between doing things that generate dopamine naturally versus substance-induced dopamine. Certain drugs can release 2 to 10 times the amount of dopamine that natural rewards such as eating and sex do.

You Could Be Addicted To Alcohol If You:

  • Drink alone
  • Try to hide your drinking from friends and family members
  • Increasing legal, work, social or relationship problems
  • Financial troubles increase
  • Keeping alcohol in the car, at work or hidden outside or elsewhere
  • Gulping drinks quickly or always ordering doubles
  • Becoming anxious or irritable if feeling that alcohol may not be available or something will interfere with getting a drink when you originally thought you would
  • Starting the day with a drink in order to feel “normal” & to function fully
  • No longer enjoying activities that were once important you
  • Having blackouts when drinking and not remembering promises made or previous events from the night before.
  • Developing stomach pains or other physical health concerns that could be related to your level of alcohol consumption
  • Developing mental health problems or current mental health conditions worsening as a result of your drinking
  • Failure to stick to responsibilities or commitments or cancelling them at short notice
  • Making excuses, lying or exaggerating situations so that you will be able to carry on drinking

Some signs and symptoms of alcohol dependence and alcoholism are the same:

  • A person that has a strong urge to drink alcohol
  • It may be hard or impossible for a person to quit drinking once they begin
  • More and more alcohol is needed to reach the same “high” or effect that the person drinking wants (this is called a tolerance to alcohol)
  • When a person stops drinking intentionally or because they can’t obtain any alcohol, they begin to have uncomfortable physical symptoms ( AKA withdrawal symptoms)
  • Risky behaviours while drinking, such as unsafe sex, driving while drunk or becoming involved in violence
  • Having seizures or blackouts if you stop drinking abruptly for an extended period of time
  • A lack of interest in previously normal activities 
  • Appearing intoxicated more regularly 
  • Appearing tired, unwell or irritable
  • An inability to say no to alcohol

Signs & Symptoms Of Alcohol Withdrawal

What does withdrawal from alcohol look like?

Symptoms of withdrawal can be mild to life-threatening. This is a physical response from the body’s need to have alcohol.

Physical symptoms of alcohol withdrawal

  • hand tremors (‘the shakes’)
  • sweating
  • nausea
  • visual hallucinations (seeing things that are not actually real)
  • seizures (fits) in the most serious cases
  • Coma
  • Death 

Psychological symptoms of alcohol withdrawal

  • Depression
  • Anxiety
  • Irritability
  • Restlessness
  • Insomnia (difficulty sleeping) 

When a person uses alcohol frequently, their body (and brain) gets used to having it in the body. This is physical dependence.

What Causes Alcohol Withdrawal Symptoms?

Alcohol withdrawal symptoms are caused by the way your brain reacts when you drink heavily. Alcohol affects the area of the brain responsible for what’s known as the ‘fight or flight’ function. This is the way in which our brains respond to danger, either preparing us to either fight or run away. 

When you drink alcohol, the fight or flight response in your brain is suppressed, making you feel relaxed & calm. When you stop drinking, the alcohol gradually leaves your brain as your body processes it. However, if you regularly drink excessively, the alcohol’s effect on your brain’s chemical balance can mean you go straight into fight or flight mode as the alcohol leaves your brain, even when there’s no danger present. 

Withdrawal symptoms, both the psychological (mental) ones e.g. anxiety and the physical ones e.g. the shakes are all caused by your brain going into fight or flight mode. 

The more you drink, the more you’re likely to be affected by withdrawal symptoms. Alcohol withdrawal symptoms are most likely to be experienced by people drinking 8 or more units of alcohol, 5 or more nights a week.

Alcohol & Pregnancy

Experts are still unsure exactly how much – if any – alcohol is completely safe for you to have while you’re pregnant, so the safest approach is not to drink at all while you’re expecting.

Is it safe to drink alcohol when pregnant?

The Chief Medical Officers for the UK recommend that if you’re pregnant or planning to become pregnant, the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum or eliminate them completely.

Drinking in pregnancy can lead to long-term harm to the baby, with the more you drink, the greater the risk.

How does alcohol affect my unborn baby?

When you drink, alcohol passes from your bloodstream through the placenta (umbilical chord) and to your baby.

A baby’s liver is one of the last organs to develop and does not mature until the later/end stages of pregnancy.

Your baby cannot process alcohol as well as you can and too much exposure to alcohol can seriously affect their development and cause serious complications for the baby.

Drinking alcohol, especially in the first 3 months of pregnancy, increases the risk of miscarriage, premature birth and the baby having a low birthweight.

Drinking after the first 3 months of your pregnancy could affect your baby after they’re born.

The risks are greater the more you drink. The effects include learning difficulties and behavioural problems.

Drinking heavily throughout pregnancy can cause your baby to develop a serious condition called foetal alcohol syndrome (FAS).

Symptoms Of FAS include:

  • A head that’s smaller than average
  • Poor growth – they may be smaller than average at birth, grow slowly as they get older, and be shorter than average as an adult
  • Distinctive facial features – such as small eyes, a thin upper lip, and a smooth area between the nose and upper lip, though these may become less noticeable with age
  • Movement & balance problems
  • Learning difficulties – such as problems with thinking, speech, social skills, timekeeping, maths or memory
  • Issues with attention, concentration or hyperactivity
  • Problems with the liver, kidneys, heart or other organs
  • Hearing and vision problems

These problems are permanent, though early treatment and support can help limit their impact on an affected child’s life. Drinking less heavily and even drinking heavily on single occasions, may be associated with lesser forms of FAS. The risk is likely to be greater the more you drink.

Alcohol & Breastfeeding

If you are breastfeeding, the safest approach is not to drink any alcohol.

Anything you eat or drink, including alcohol, can pass to your breast milk. And the level of alcohol in breast milk will rise and fall along with the alcohol in your bloodstream.

Your blood alcohol levels are at their highest between 30 and 60 minutes after drinking alcohol, or 60-90 minutes if you’ve been drinking with a meal. And it takes one to two hours for a unit of alcohol (a small 75ml glass of wine, or half a pint of 4% strength beer) to clear from your bloodstream.

Alcohol & Teenagers

Alcohol consumption in children and teenagers can impact their growth and development. The two videos below will help answer some of the most commonly asked questions that you may have about alcohol in children and teenagers.

Alcohol & Interactions With Other Substances

We asked Professor Paul Wallace, Chief Medical Advisor from Drinkaware why Doctors sometimes tell us not to drink when we take prescription drugs and what happens if we do?

Professor Wallace says the question as to whether you should drink alcohol while on medication depends entirely on what medication you’ve been prescribed.

For some types of medication it’s OK to drink within the UK Chief Medical Officers’ (CMO) low risk drinking guidelines. However, for some, alcohol should be completely avoided.

General advice

Professor Wallace says that:

  • People taking sedative drugs (like diazepam/Valium) or antidepressants (like fluoxetine/Prozac) should avoid alcohol altogether
  • There are some antibiotics which simply do not mix with alcohol – drinking with these will make you sick. But for most commonly prescribed antibiotics, drinking is unlikely to cause problems so long as it is within the low risk alcohol unit guidelines.
  • People taking long-term medications should be careful about drinking, as alcohol can make some drugs less effective and long-term conditions could get worse. Examples of long-term medications include drugs for epilepsy, diabetes or drugs like warfarin to thin the blood.
  • There’s no evidence to prove that alcohol can improve your immune system. The positive effects of a hot drink with alcohol in it (sometimes called a ‘hot toddy’) are more than likely psychological.

How alcohol can interfere with medication

Professor Wallace says there are two main reasons why Doctors advise patients not to drink with some drugs.

  1. “Firstly, because alcohol is a depressant, it affects the way your brain works, numbing your senses so they don’t operate properly,” he says. “Some types of medication also affect the way your brain works and if you’re drinking alcohol there will be a conflict. Alcohol will increase the sedative effects of both, causing sleepiness and dizziness. It could also change the way the brain responds to the medication, making it less effective.” If you’re taking a sedative drug, such as diazepam/Valium, or any other drug that can make you drowsy and you drink alcohol, your reaction times could decrease and you’ll get tired faster. If you’re driving or operating machinery, this can be extremely dangerous.
  2. “Secondly, alcohol can affect the way drugs are absorbed by the body and broken down in the liver,” says Professor Wallace. “If you drink alcohol regularly and especially if you drink excessive amounts, your liver produces more enzymes so that it can get rid of the alcohol more quickly. Those same enzymes might break down the medication you are taking so it no longer has the same effect. An example of this is medications for epilepsy.”

Alcohol and antibiotics

When it comes to antibiotics, Professor Wallace says that the message is slightly different than it is with sedative drugs. The NHS advises that people who choose to drink alcohol when taking most common antibiotics do so within the weekly alcohol unit guidelines

There are antibiotics, like Metronidazole and Tinidazole, which you should not drink alcohol with. Mixing them with alcohol can lead to nausea, vomiting, flushing of the skin, accelerated heart rate or shortness of breath. This is because they can interfere with the breakdown of alcohol, leading to the production of nasty side effects.

There are a wide variety of antibiotics available, penicillin and amoxicillin are the most widely used.

These can have different interactions with alcohol, and, as with any medication, you should always consult your doctor or pharmacist about guidelines regarding consumption.

Statins and alcohol

Statins are drugs which are taken to lower the levels of cholesterol in your blood.  High levels of ‘bad cholesterol’ can increase the risk of developing cardiovascular disease due to fatty deposits building up in your arteries.

According to the NHS, there are no known interactions between statins and alcohol3. However, consumption of statins can occasionally result in an increase in liver enzymes, which if left un-checked can lead to liver damage. It is therefore important for those taking statins to stay within the low risk drinking guidelines (of no more than 14 units per week for both men and women) and to have their liver function tested periodically.

As with any medication, you should always consult your doctor about consumption guidelines.

Can alcohol make you better?

Can alcohol itself ever be a good medicine? Professor Wallace explains how alcohol was once used in medical practice and gives his medical conclusion on alcoholic hot drinks being used as remedies.

“Before the advent of modern anaesthetics, when surgeons were performing operations, they would use alcohol as an anaesthetic, getting their patients drunk before they operated,” he explains. Professor Wallace says the reason for this is because alcohol numbs the brain.

He also explains that many people also feel better after having a ‘hot toddy’ (hot drink with whisky) when they have a cold because alcohol also numbs your senses. A hot toddy can make you feel better but there’s no evidence to suggest that it actually improves your health.

“Nobody should kid themselves that it is going to help you actually get better,” says Professor Wallace.

“You may experience an immediate gain because alcohol has numbed your senses and made you feel less bad for a short time. But you’re deceiving your body and slowing your recovery.”

Alcohol and the immune system

There’s no firm evidence about the effects of alcohol on the immune system, but Professor Wallace thinks it’s probably not a good idea to drink alcohol when you are feeling ill because it is likely to make you feel worse. “Our state of mind can affect the way we respond to illnesses and alcohol is, after all, a depressant,” says Professor Wallace.

Alcohol & Illicit Drugs

The effects of illegal drugs will always be unpredictable since their chemical makeup and extras that get added in when they are being made, makes the ingredients unreliable and often unknown. Generally, when you mix illicit drugs with alcohol, they’re exaggerated in some way, which can result in anything from nausea to heart failure. Best advice is to completely steer clear of illegal drugs, especially with alcohol.

What happens in the body?

Alcohol is a depressant. Combine it with a stimulant, such as cocaine and the two drugs compete with each other. The depressant drug tries to slow the brain/central nervous system down, while the stimulant tries to speed it up – putting your brain/central nervous system under great pressure. Combine alcohol with another depressant drug, heroin for example, and the effect they each have of slowing your central nervous system will be multiplied and you risk your body shutting down altogether.

With no quality control in the world of illegal drugs, you can never be 100% sure of exactly what’s in the substance you’re taking. It could be cut with other cheaper drugs such as tranquilisers or even toxic substances such as drain cleaner or brick dust. Add alcohol into the mix and you’ve got a potentially lethal combination.

If you’re under the influence of drugs, you’re less likely to make carefully considered decisions about how much alcohol you drink or what other substances you take. So you also put yourself at risk of alcohol poisoning and longer-term health effects of alcohol such as heart disease or cancer.

Here are some facts about individual drugs and what can happen when you mix them with alcohol.

Alcohol & Marijuana (Cannabis)

If you use cannabis and alcohol together, the results – both physical and psychological can be unpredictable. Having alcohol in your blood can potentially cause your body to absorb the active ingredient tetrahydrocannabinol (THC) faster. This can lead to the cannabis having a much stronger effect than it would normally have.

Physically, you can experience dizziness, nausea and vomiting. Psychological effects include panic attacks, anxiety or paranoia. Skunk, a term for stronger types of cannabis, can pose even greater risks because it may contain up to three times as much THC than regular Marijuana and in some cases, even greater amounts of THC.

There’s a serious long-term risk to your health too. Cannabis is usually smoked with tobacco, which can cause cancer. Tobacco and alcohol work together to damage the cells of the body, multiplying the damage. Alcohol makes it easier for the mouth and throat to absorb the cancer-causing chemicals in tobacco.

Alcohol & Cocaine

A common but particularly dangerous partnership, alcohol and cocaine together increase the risk of heart attacks, fits and even sudden death. The two drugs interact to produce a highly toxic substance in your liver called cocaethylene. It can increase the depressive effects of alcohol, making your reaction to the cocaine stronger. You’re also more likely to be aggressive with cocaethylene in your system.

Cocaethylene takes longer to get out of your system than either the alcohol or the cocaine alone, subjecting your heart and liver to a longer period of stress. Mixing alcohol and cocaine can be fatal up to 12 hours after you’ve taken it.

Alcohol & Ecstasy (MDMA)

It’s possible that alcohol will deaden the ‘high’ you feel from ecstasy while the drugs are in your system. But the next day, when you “come down”, you’ll feel much worse if you’ve been drinking alcohol. A severe hangover is one of the milder side-effects of combining these drugs though, together they can be deadly!

Ecstasy dehydrates you. So does alcohol. You risk overheating and becoming dangerously dehydrated when you combine the two, especially in hot weather or during summertime. Alcohol is involved in most ecstasy related deaths, many of which are from heatstroke after people have danced for long periods of time in hot clubs without replacing the fluids they’ve lost by drinking water.

As alcohol is a diuretic, which means it makes you urinate a lot more frequently and sweat more, it’s even harder to keep enough fluid in your body when you drink it while on ecstasy. There’s also a greater strain on your liver and kidneys when you combine the two drugs. And as with many other combinations, you’re likely to experience nausea and vomiting.

Alcohol & Amphetamines

The effects of amphetamines, often called speed, are very much like an adrenalin rush. When you take it, your breathing, blood pressure and heart rate shoot up. Like ecstasy, speed can also increase your body temperature and cause dehydration which is then heightened when you add alcohol to the mix. As speed already puts pressure on your heart, if you add alcohol, that pressure can be fatal!

Alcohol can intensify your emotions and make you lose your inhibitions. So can speed. Combine the two and you may end up behaving in a way you seriously regret and make you practice other risky or dangerous tasks that you normally would be totally opposed to.

Under the influence of speed, you may feel more confident or energised, but you can easily become anxious, paranoid or aggressive, particularly when you put alcohol in the mix. You don’t feel the full effects of alcohol until the speed has worn off. Mixing the two means you can drink dangerous amounts without even realising it.

Alcohol, Heroin Or Opioids

Alcohol with opioids is one of the most dangerous combinations of drugs. “Downers” like heroin or opioids slow down your heart rate, blood pressure and breathing. When combined with another downer such as alcohol, you’re basically doubling up and putting yourself at extremely high risk of overdosing and death.

Even small amounts of alcohol seem to lower the amount of heroin/opioids needed to fatally overdose. Around three quarters of people who die from heroin/opioid overdoses have drunk alcohol.

Alcohol & Legal Highs

Previously known as “legal highs”, drugs such as meow meow actually became illegal in 2010 when they were classified as class B drugs. A powerful stimulant such as meow meow are part of the cathinone family, a group of drugs that are closely related to the amphetamines. They’re derived from the plant khat (pronounced chat), commonly used as a stimulant in East Africa and have similar effects to ecstasy and speed.

These drugs can over stimulate circulation, damaging the heart, speeds up the nervous system and can cause fits. They can also make you anxious and paranoid and aggravate any pre-existing mental health conditions. As with any drug that gives a “high”, combine them with alcohol and you’re at an increased risk of everything from nausea and vomiting to coma and death.

Medications For Alcohol Dependancy

A number of medications are recommended by the National Institute for Health and Care Excellence (NICE) to help treat alcohol misuse along with other therapies. These include:

  • Acamprosate
  • Disulfiram
  • Naltrexone
  • Nalmefene


Acamprosate (brand name Campral) is used to help prevent a relapse in people who have successfully achieved abstinence from alcohol. It’s usually used in combination with counselling and other types of therapies to help reduce alcohol craving.

Acamprosate works by affecting levels of a chemical in the brain called gamma-amino-butyric acid (GABA). GABA is thought to be partly responsible for inducing a craving for alcohol.

If you’re prescribed Acamprosate, the course usually starts as soon as you begin withdrawal from alcohol and can last for up to 6 months.


Disulfiram (brand name Antabuse) can be used if you’re trying to achieve abstinence but are concerned you may relapse or if you’ve had previous relapses.

Disulfiram works by deterring you from drinking by causing unpleasant physical reactions if you drink alcohol. These can include:

  • Nausea
  • Chest pain
  • Vomiting
  • Dizziness

In addition to alcoholic drinks, it’s important to avoid all sources of alcohol as they could also induce an unpleasant reaction. Products that may contain alcohol include:

  • Aftershave
  • Mouthwash
  • Some types of vinegar
  • Perfume

You should also try to avoid substances that give off alcoholic fumes, such as paint thinners and solvents.

You’ll continue to experience unpleasant reactions if you come into contact with alcohol for a week after you finish taking disulfiram, so it’s important to maintain your abstinence during this time.

When taking disulfiram, you’ll be seen by your healthcare team at rehab or at your drug and alcohol service about once every 2-3weeks for the first 2 months, and then every month for the following months.


Naltrexone can be used to prevent a relapse or limit the amount of alcohol someone drinks. 

It works by blocking opioid receptors in the body, stopping the effects of alcohol. It’s usually used in combination with other medicine, counselling or other supplementary therapies.

If naltrexone is recommended, you should be made aware it also stops painkillers that contain opioids working, including morphine and codeine.

If you feel unwell while taking naltrexone, stop taking it immediately and seek advice from your GP or care team.

A course of naltrexone can last up to 6 months, although it may sometimes be longer.

Before being prescribed any of these medications, you’ll have a full medical assessment, including blood tests.


Nalmefene (brand name Selincro) may be used to prevent a relapse or limit the amount of alcohol someone drinks.

It works by blocking opioid receptors in the brain, which reduces cravings for alcohol.

Nalmefene may be recommended as a possible treatment for alcohol dependence if you’ve had an initial assessment and:

  • you’re still drinking more than 7.5 units a day (for men) or more than 5 units a day (for women) 
  • you don’t have any physical withdrawal symptoms 
  • you don’t need to stop drinking immediately or achieve total abstinence 

Nalmefene should only be taken if you’re receiving support to help you reduce your alcohol intake and continue treatment.

Addiction Information For Addicts, Family & Friends

It can be difficult to know the best way to help the people we love when they are struggling with alcoholism. It tears families apart every day and wreaks havoc on the lives of everyone involved. But families can have an incredible impact on the recovery of their loved ones. In fact, families that are more involved with their loved one’s recovery tend to see higher success rates.

There are many ways you can help your loved one to quit drinking. From learning how to stop enabling your loved one to get yourself involved in support group meetings so you can take care of yourself. Addiction is a family disease, so let’s recover together.

We recommend that you speak to your nearest Drug and Alcohol Service as soon as possible before things worsen and more damage it done to the addict themselves as well as the others around them. Contact information for your nearest Drug and Alcohol Service can be found on our help & support page along with contact information for support groups for the family and friends of those with an addiction. Both the Drug and Alcohol Service and the organisations we list on our help & support page can provide information, advice, support and treatment options to all involved. The key thing is to contact people as soon as possible, this limits the damage done but also means that the addict in question may not have to undergo such invasive treatment options than they otherwise would.

Published by Drink ’n’ Drugs

Providing useful, relevant, up to date information and support for those suffering from active addiction or those who are in recovery.

5 thoughts on “All You Need To Know About… Alcohol

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