Mixing Norco and Alcohol

Mixing norco and alcohol can result in a number of side effects that can be dangerous to the user. Norco (also known as hydrocodone and acetaminophen), is a prescription opioid analgesic medication that is primarily used in the treatment of pain.

What Are the Effects of Mixing Norco and Alcohol?

Side effects as a result of mixing Norco with alcohol include some of or all of the following:^2,4

• Overdose from either drug as psychoactive effects are enhanced.
• Enhanced sedative effects of both drugs, which could lead to an individual engaging in potentially hazardous behaviors as a result of:
  • Impaired judgment.
  • Impaired perception.
  • Decreased motor coordination and decreased cognitive abilities (e.g., attention, planning, the ability to synthesize information).
• An increased risk of developing seizures.
• Severe weakness, vertigo, drowsiness, and potential loss of consciousness.
• Extremely dangerous decreases in heartbeat or breathing rate. These effects may lead to brain damage that could be fatal.
• Confusion, paranoia, psychosis, anxiety, or depression.
• Increased potential for liver damage, cardiovascular damage, damage to the respiratory system, and damage to other systems in the body.
• Enhanced potential to develop a substance use disorder to more than one substance. This complicates treatment and recovery.
• Higher rates of mortality occurring at earlier ages.

Norco Abuse

Norco is a combination medication that contains the opioid pain reliever hydrocodone, a Schedule II controlled substance, and the non-narcotic analgesic acetaminophen.¹ Both drugs work on specific mechanisms in a person’s brain to alter the experience of pain.

Acetaminophen can also reduce fever in individuals who take it. The formulation of acetaminophen with hydrocodone may enhance the effects of hydrocodone taken alone, but also increases the health risks of abusing drugs like Norco.

Hydrocodone is an opioid narcotic drug associated with a high potential for abuse and the development of physical dependence. Acetaminophen is not typically associated with abuse, but in large doses can result in liver damage. Anyone taking acetaminophen with alcohol dramatically increases this potential for liver damage.²

People who abuse drugs like Norco will commonly mix them with other drugs, particularly alcohol because it is so easily obtained. Though their primary mechanisms of action target two different neurotransmitter systems in the brain, both alcohol and hydrocodone ultimately depress central nervous system (CNS) activity.³

Coupled with the fact that alcohol lowers the threshold at which the acetaminophen in Norco becomes toxic to the liver, the combination of Norco and alcohol can be extremely dangerous.

Concerns of Mixing Alcohol with Other Opiates

• Codeine
• Dilaudid
• Fentanyl
• Heroin
• Hydrocodone
• Hydromorphone
• Lortab
• Methadone
• Morphine
• Oxycodone
• Oxycontin
• Percocet
• Tramadol
• Vicodin

What’s the Treatment for Addiction to Norco and Alcohol

When a person develops a moderate to severe substance use disorder (the clinical term for an addiction) to more than one drug, including Norco and alcohol, both addictions need to be treated simultaneously.⁵

Trying to address one without addressing the other often leads to issues with treatment compliance, continued substance abuse, and potential medical complications associated with drug abuse.

A successful treatment protocol should include:⁶

• Medical detoxification if appropriate.
  • The detoxification process may involve medical detox from Norco, from alcohol, or from both.
  • Some heavy alcohol users are at risk of experiencing life-threatening seizures during the acute alcohol withdrawal period. For this reason alone, this process should be supervised by a physician experienced in addiction medicine.
• Individual and group counseling for substance use disorders and other psychological issues.
• Medications for concurrent mental health issues or physical conditions.
  • Medical management of these conditions should only be undertaken by a physician or a team of physicians.
• Social support and case management.
• The development of relapse prevention skills, coping skills for stress, and other specialized skills to ensure a successful recovery.
• A long-term aftercare treatment plan to keep the person engaged in successful recovery over the long term.

If you’re concerned that the co-abuse of alcohol and Norco is impacting your health, or that of someone close to you, substance abuse treatment programs can help. Call us at to speak with a treatment support advisor about your recovery options.