Alcohol, incidentally, also does not work for maintenance. Unlike opioid tolerance, alcohol tolerance doesn’t completely eliminate impairment, even if the drug is given in steady, regular doses. That means that even with high levels of tolerance, heavy alcohol users on a consistent dose are still significantly impaired. Contrary to the claims of those who criticize opioid maintenance as “just replacing vodka with gin,” the difference is that opioids produce complete tolerance in steady-state dosing, while alcohol does not.
