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Mixing Alcohol with Drugs

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Mixing alcohol with prescription drugs or illicit drugs (known as polysubstance use), can have dangerous health effects that many people may not realize. Since alcohol is such a commonly used substance, it’s even more important to understand how it reacts in the body and with other drugs to prevent potentially harmful health consequences.1, 2


Dangers of Mixing Drugs and Alcohol

Whether intentional or not, mixing drugs and alcohol presents several health risks. This situation may be of particular concern given just how common drinking behavior is in the United States.3 In 2019, nearly 70% of Americans age 18 or over reported having a drink in the previous year, and more than half reported drinking within the previous month.3 Just over a quarter reported binge drinking in the last month.3 Almost 15 million Americans aged 12 or over had an alcohol use disorder (AUD) in 2019.3

Since alcohol consumption is so common, there are more opportunities for polysubstance use or misuse. People who drink alcohol commonly use marijuana, opioids, cocaine, and other types of stimulants as well.4 Mixing alcohol with drugs like opioids and benzodiazepines, though it may seem to amplify the sought after effects, can lead to unnecessary health risks, even when the therapeutic medication is otherwise used as prescribed.2 When alcohol is combined with drugs, it may also increase the risk of potential side effects, overdose, and a range of other medical and mental health issues.1, 4, 5

Since alcohol is a central nervous system depressant, combining it with other drugs that depress certain physiological functions like breathing­, such as opioids and benzodiazepines, can intensify these potentially dangerous effects.1 Taking alcohol with stimulants, such as cocaine or methamphetamine, can mask some of the intoxicating effects. This puts a person at additional risk for overdose and other adverse health effects of this drug combo.6


Mixing Alcohol with Prescription Drugs

The use and misuse of prescription drugs in the United States is common, with over 16 million people aged 12 or over reporting misuse of prescription psychotherapeutic drugs in 2019.7 However, mixing certain prescription drugs with alcohol can lead to potentially fatal side effects, in addition to other adverse short-term or long-term health problems. 8 Prescription drugs commonly used in conjunction with alcohol include prescription opioids, benzodiazepines, and stimulants.1

When prescription painkillers, such as oxycodone, hydrocodone, or morphine, are combined with alcohol, some of the amplified and potentially dangerous health effects can include: 1, 8

  • Dizziness.
  • Decreased motor control.
  • Loss of memory.
  • Increased likelihood of overdose.
  • Slowed breathing and heart rate.
  • Profound sedation.
  • Loss of consciousness.
  • Coma.

Mixing alcohol with prescription drugs like benzodiazepines used to manage anxiety—such as Ativan, Valium, or Xanax—can result in over-sedation similar to the combination of opioids and alcohol, and dangerously slowed breathing and heart rate. 8

Combining prescription stimulants to treat attention deficit hyperactivity disorder (ADHD)—such as Adderall or Ritalin—with alcohol can cause: 8

  • Irregular heart rhythm.
  • Increased blood pressure and heart rate.
  • Greater risk of developing heart problems.

Mixing prescription stimulants with alcohol may also cause a person to feel less drunk. This may lead a person to drink too much alcohol and experience alcohol poisoning or overdose. 8

Nearly 1 in 5 adults have a mental illness in the U.S. Mental illness may be managed with medications like antidepressants, including Cymbalta, Lexapro, or Zoloft, and antipsychotics, like Risperdal, Seroquel, or Zyprexa.9 While these medications are important for many individuals, combining them with alcohol is not advisable because of the chance for potentially dangerous interactions.1


Mixing Alcohol with Illicit Drugs

Illicit drugs are commonly obtained with little information about their manufacture, potency, or purity. As such, their use can be especially risky, and may come with many unpleasant side effects, potential harm to various organ systems, and the risk of a potentially fatal overdose.8 Like their prescription drug counterparts, however, many of the intoxicating effects and associated health risks of illicit drugs may be amplified by mixing them with alcohol.2, 6

Illicit drug use is quite common. In 2019, 57.2 million Americans aged 12 or over had used illicit drugs in the previous year.7 Many people drink alcohol while using illicit drugs to enhance or otherwise modify their experience with these substances. But doing so can set the stage for several adverse health effects.6, 11

Drugs which are commonly combined with alcohol include cannabis, opioids, cocaine, and methamphetamine.2, 4 People may combine alcohol with illicit drugs for several reasons, unaware of the additional health risks they face by doing so. Examples include:

  • Opioids: Alcohol can be combined with opioids like heroin to increase the euphoric and pain-relieving effects of the drug, but it can also increase the risk of dangerously slowed heart and breathing rate, coma, or overdose deaths. 8, 11
  • Stimulants: Alcohol and stimulants such as methamphetamine or cocaine are commonly used together. This can increase the euphoric effects, but also reduce unpleasant effects, such as feeling too drunk or sedated from alcohol, or being unable to sleep as a result of stimulant intoxication.4, 6 However, such a combination can be both synergistically cardiotoxic (with alcohol and cocaine) and neurotoxic (with alcohol and meth), and can additionally make you feel less drunk than you are—which can lead to a greater risk of alcohol overdose.8, 11

Getting Drug and Alcohol Rehab Treatment

If you or a loved one are experiencing the adverse effects of compulsive polysubstance use, whether it involves mixing alcohol with illicit drugs, prescription medication, or any combination of substances, know that professional treatment has been a vital step in helping many people recover from similar situations.12 The abuse of one or more substances has the potential to create long-lasting changes to how a person thinks and behaves. This can make it difficult to stay sober without the support and care offered through treatment.12

One of the most important things to keep in mind is that effective treatment should be tailored to meet a person’s unique needs and the substances being used.12, 13 Depending on the type(s) of substance addiction, a range of treatment types are available in both outpatient and inpatient/residential settings including polysubstance detox, medications, behavioral therapies, support groups, and aftercare.12


Detox

Detox is generally the first step on the treatment journey, offering a safe, monitored environment to ease physical dependence from substances being used.12 Medical detox provides care and supervision by medical staff, which is especially important when experiencing withdrawal because there can be potentially dangerous side effects with cessation of certain substances.12, 14

Medications can be provided to help manage withdrawal symptoms from certain substances including alcohol, benzodiazepines, and opioids. Using medications can ensure that withdrawal is as safe and comfortable as possible.12, 15

Polysubstance withdrawal is most effectively dealt with by prioritizing treatment and addressing potentially
life-threatening withdrawal symptoms first, such as those associated with alcohol or benzodiazepines, followed by opioids.14 However, it is important to be aware that detox is only the first step toward recovery. Detox should be followed with more comprehensive treatment to create a foundation for long-term sobriety.12, 14, 15


Inpatient Treatment

Inpatient care involves staying at a treatment facility to receive monitoring, care, and support from medical and counseling staff around-the-clock.12, 15 This type of treatment generally lasts between 3 and 6 weeks, involves a combination of group and individual therapy sessions, may incorporate detox services at the start of the program, and may include a range of amenities suited to specific populations.12, 15 Inpatient or residential settings may be well suited to people who abuse multiple substances. These settings may offer a relatively intensive level of care and broader assortment of treatment options to address a range of issues.12, 15


Outpatient Treatment

Outpatient treatment offers care at scheduled appointments with the freedom to work, attend school, and live at home.12, 15 Treatment is available on an ongoing basis, with services tapering down as a person progresses in their recovery.12, 15 Therapy may involve group therapy and individual sessions.12, 15 This type of care is ideal for people who have a strong support system outside of treatment, and may cost less than inpatient care.12


Support Groups

Peer support groups are informal meetings that can take place in-person or online as a way to build on what is learned in treatment and continue to support the recovery process.12, 16 The most well-known support groups include 12-step groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).12, 16 These groups allow people to give and receive support from people recovering from similar substance use issues in a nonjudgmental, safe environment.12, 16 Participating in support groups is encouraged at any point in the recovery process, including before, during, and after treatment.12, 16


Aftercare

Once treatment is complete, aftercare can be a crucial part of ongoing recovery.12 A therapist will develop an aftercare plan before a person is discharged from treatment and incorporate support to help manage triggers, cope with cravings, and maintain sobriety. These can include:

  • Visiting a therapist on a regular basis.
  • Attending support groups.
  • Moving into sober housing.
  • Participating in alumni meetings at the treatment facility.
  • Identifying what to do in situations that can put a person at high-risk for relapse.

Treating polysubstance addiction may seem challenging because of the often more complicated withdrawal management that needs to take place as well as the need for any additional related health issues to be addressed. However, polysubstance treatment is possible, and has helped many in similar situations.

American Addiction Centers specializes in evidence-based treatment for all kinds of substance use disorders and mental healthcare, including medical detox, behavioral therapy, and outpatient services to support the whole person.17 If you or a loved one are struggling with substance misuse, contact us at (888) 608-0592 to start the journey to recovery.


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Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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