New research from West Virginia University shows that drinking alcohol while using drugs like fentanyl may help explain why more men than women die from accidental drug overdoses.
The study, led by Zheng Dai from WVU’s Health Affairs Institute, looked at overdose deaths in West Virginia. He pointed out that even though men and women use illegal drugs at about the same rate, men are dying much more often from overdoses. One reason may be that men tend to drink more alcohol than women—and more often mix alcohol with other drugs.
Dai explained that both alcohol and opioids (like fentanyl) slow down breathing. When taken together, their harmful effects on the body become stronger, making it more likely for someone to die. Many people don’t realize that even though alcohol and opioids are different, they can both cause the same dangerous outcome: stopping someone’s breathing.
The research was published in the Journal of Studies on Alcohol and Drugs. The data came from the West Virginia Office of the Chief Medical Examiner. Professors Marie Abate and Gordon Smith helped create a system to find out which overdose deaths involved alcohol and which other drugs were in the person’s body at the time.
West Virginia has the highest rate of overdose deaths in the country. From 2005 to early 2023, there were 2,057 deaths in the state where alcohol was mixed with at least one other drug. Of those, 1,578 were men and only 479 were women.
Dai said men may also take more risks when using drugs—for example, using drugs alone or without having the antidote naloxone nearby. These behaviors make overdoses more dangerous and more likely to be fatal.
The study found that opioids were involved in 85% of these cases. Fentanyl was the most common opioid. Other drugs included stimulants (like cocaine) and benzodiazepines (like Xanax).
Dai explained that while researchers can’t always know how much of each drug the person took before they died, they can measure the amount of each drug in the blood after death. This helps them understand which drugs were most likely to cause the overdose, and why men are two to three times more likely to die from drug-related causes.
He also said that body differences between men and women could affect how drugs work in the body. For example, men might have higher levels of some drugs in their blood.
Interestingly, the study also found that during the COVID-19 pandemic, alcohol-related overdose deaths increased among women. This could mean that overdose deaths among women may rise in the future.
Dai’s main message is clear: Alcohol makes drug overdoses more deadly for everyone. Many people assume alcohol is safe to mix with opioids and other drugs—but it’s not. Prevention strategies need to include warnings about alcohol use.
The study is published in the Journal of Studies on Alcohol and Drugs.
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