Opiates are prescription narcotics and illicit drugs made from the opium poppy plant. Opiates include heroin and painkillers like morphine, hydrocodone, fentanyl, and oxycodone. Intravenous opiate use, such as heroin injection, produces a powerful euphoric rush, but prescription narcotics can give users a strong high even when used to treat pain.1

Alcohol, like opiates, increases the release of dopamine, a neurotransmitter that stimulates the brain’s reward system. However, these drugs differ in their physiological effects, presenting some unique behavioral signs.

Signs of Being Drunk or High

Shared Symptoms +

In examining the difference between being drunk and high, consider the following signs that the two drugs often share:

  • Increases in heart rate and blood pressure
  • Disoriented movements like swaying, stumbling and staggering
  • Mood swings, including depression with alcohol and anxiety with opiates
  • Slurred speech, drowsiness, vomiting, and irritability

Additional Side Effects from Alcohol Intoxication +

Along with these common problems, alcohol intoxication also causes these additional side effects:

  • Lack of coordination, including spilling drinks and missing the mouth with a glass or bottle
  • Flushed face, droopy eyelids, and bloodshot, watery, or glassy eyes
  • Loud speech that often includes rambling thoughts or irrational statements
  • Aggressive, obnoxious, argumentative, or overly friendly attitudes
  • Excessive perspiration, alcohol odors, and sudden sullenness2

Additional Side Effects from Opiate Highs +

In comparison, opiate highs can also cause additional problems. These include:

  • Constricted pinpoint pupils, even in lowlight environments
  • A tendency toward social withdrawal and isolation
  • Physical discomforts like constipation, insomnia and nausea3

There are also some distinct differences when it comes to being drunk or high. For example, an opiate high usually decreases appetite while drunkenness increases it. Likewise, opiates often lower response times while alcohol can make a user more animated.

Alcohol Intoxication and Opiate High Risks

Man holding liquor glass and pillsWhether drunk or high, the risks associated with dangerous behaviors while under the influence of alcohol or opiates are similar. Because each drug impairs judgment and slows reaction time, individuals in such states must avoid driving, operating machinery, childcare, and other important responsibilities.

Alcohol also causes scarring (cirrhosis) and inflammation (alcoholic hepatitis) of the liver as well as anemia. Alcohol abuse increases the risk of cardiovascular disease and certain forms of cancer.

Extensive opiate use can cause increased sensitivity to pain, and intravenous opiate use is associated with the spread of hepatitis and HIV. Opiate injections are also responsible for damaged veins and an increased risk of infection in the heart lining and valves.

Overdose is a risk for both alcohol and opiates. If someone shows the signs of being both high and drunk, then the risks are considerably greater. Many substances interact in ways that amplify the negative effects of the other. For example, opiates and alcohol both depress the central nervous system (CNS), which can lead to a potentially fatal respiratory collapse.

Alcohol and Opiate Abuse Help

People who regularly consume alcohol and opiates together may be addicted to one or both drugs. Whether the addiction involves one substance or many, rehab treatment centers offer the most effective recovery programs. The services offered include medically supervised detox, motivational and behavioral therapy, trauma and family counseling, release prevention strategies, and anger and stress management.

Treatment can also include integrated care for chronic pain and co-occurring mental health disorders. If you or a loved one struggles with drug abuse or has questions, call us at 706-914-2327, to speak with our admissions team. We can provide information about recovery, answer questions about your health insurance policy, and help you find the right treatment program. Call today.


1 What Are Opioids?” U.S. Department of Health and Human Services.
May 15, 2018.

2 Balentine, Jerry R. Alcohol Intoxication. EMedicineHealth.com. Accessed June 15, 2018.

3 Substance use – prescription drugs.” Medline Plus. November, 2014.

Articles posted here are primarily educational and may not directly reflect the offerings at Black Bear Lodge. For more specific information on programs at Black Bear Lodge, contact us today.