Alcohol & Health
Treatment
Helping Alcoholics
Medically Reviewed by Annamarie Coy, BA, ICPR, MATS
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If you’ve ever taken prescription medications, you’ve seen warning labels advising not to mix with alcohol.
But what about illicit drugs or over-the-counter medications?
Mixing any drug or medication with alcohol is dangerous. Certain mixtures can lead to:
While not all mixtures will have fatal results, there is an inherent risk in combining any drug with alcohol. Different results develop based on how the substances interact.
Each type of drug interacts differently with alcohol. It is important to understand the potential effects of each combination.
There are many types of illegal drugs. Cannabis is the most common. Although it is increasing in legality around the world.
Opioids and stimulants are Schedule II-IV Controlled substances. Most of these drugs are legal under doctor supervision and prescription but illegal on the street.
They can be injected, smoked, swallowed, or snorted. They create a sense of euphoria, drowsiness, and often severe impairment.
Lastly, “club drugs,” hallucinogens, and dissociative drugs are Schedule I-IV substances. They can be swallowed, snorted, or injected.
These substances can create extreme effects, from hallucinogenic and out-of-body experiences to lowered inhibition and severe sedation.
Below are some common interactions and risks associated with some of these drugs when mixed with alcohol.
When taken together, alcohol and cocaine mix to form a different substance called cocaethylene. This substance is more problematic to the body, particularly the liver.
It also causes dehydration more than either alcohol or cocaine ingestion alone. This causes further issues such as heat stroke or bad “comedowns.”
Both heroin and alcohol are depressants. This causes a stronger and often overwhelming intoxication when combined.
The likelihood of a fatal heroin overdose is more common when sedatives or other depressants, such as alcohol, are present in the bloodstream.
Taking methamphetamines and alcohol together can lead to:
Mixing these substances can also alter levels of certain neurotransmitters in the brain. This affects signals in the brain that help regulate critical functions.
Ecstasy, has recently shifted to become MDMA or “Molly,” which is one of the most used party drugs in the world. However, problems arise when taken with alcohol as the liver metabolizes both substances.
Alcohol, which is trying to be processed by the liver simultaneously, can slow the removal of MDMA. This leads to potential adverse effects such as:
As their name suggests, prescription drugs need to be prescribed by a doctor.
The FDA regulates them, and there has been a growing problem with abuse of these legal drugs. People use medication that was not prescribed for them or illegally obtain these drugs from street dealers.
Whether or not they are obtained legally, many of these drugs have severe and problematic interactions with alcohol, even in small amounts.
Below are some of the effects when common prescription medications are mixed with alcohol.
Both Xanax and alcohol are depressants with sedative effects. When taken together, they can cause fatigue, drowsiness, and a loss of muscle control, coordination, and balance.
Mixing these substances can also lead to:
Combining alcohol with opioids can be extremely dangerous. On top of more common symptoms, such as nausea, vomiting, and low blood pressure, mixing these substances can lead to:
According to drug labels on all benzodiazepines, none of them should be mixed with alcohol. Combining these can lead to cognitive reduction and mental health disorders. It can also lead to developing a physical dependence on one or both substances.
Mixing sleeping pills with alcohol can cause issues, such as:
This is true of prescription sleeping pills and over-the-counter sleep aids and herbal supplements. All have these effects when mixed with alcohol.
Consuming alcohol while taking antidepressants is problematic. Alcohol has the potential to deepen depression further and can also cause unwanted side effects. Some side effects include drowsiness, dizziness, and decreased coordination.
Other substances like Phentermine, Keppra, fluconazole, metoprolol, and even ibuprofen can interact with alcohol.
Many people use over-the-counter (OTC) medications. A doctor's prescription is not required for these medications.
Most of them can also be found in pharmacy aisles in addition to behind the pharmacist counter. They are generally considered safer than illicit drugs and are regulated by the FDA.
Some common examples of OTCs include:
Mixing OTCs with alcohol is often seen as less problematic than mixing other drugs with alcohol. However, that does not mean risks are absent.
Depending on the amount of medication ingested and the amount of alcohol consumed, there could be serious consequences. This includes heart complications and death.
There is enough medicine in a bottle of ibuprofen or acetaminophen, often seen as harmless, to harm adults seriously. The risks increase when alcohol is added to the mix.
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Generally, you should not consume alcohol with substances that alter the way you feel. Drinking alcohol with caffeinated products can hide the effects of alcohol. As a result, users may feel more impaired than they realize.
Other over-the-counter items or supplements may also contain untested ingredients that negatively interact with alcohol.
As well as high levels of caffeine, many energy drinks have chemicals that can increase energy levels and hide the effects of alcohol. These chemicals include guarana, taurine, ginseng, and sugar.
This can increase the risk of dangerous behavior when a person combines energy drinks and alcohol.
Over-the-counter herbal supplements have become popular for various health issues. Many claim to treat a selection of health problems, including weight gain, cosmetic problems, and mood issues.
Many diet pills, in particular, are addictive and can lead to many health issues when combined with alcohol. Herbal supplements marketed as mood enhanced may also combine dangerously with alcohol.
Some users have reported blacking out or experiencing seizures after drinking alcohol with 5-HTP. This is a supplement that may improve depression.
It is essential to be careful when you drink alcohol with herbal supplements. Always follow the directions on medication labels. If you take any form of supplement, speak with your doctor before drinking alcohol.
When someone regularly abuses more than one drug, they are prone to developing polysubstance abuse.
People who chronically combine different drugs may worsen physical dependence on one or both of the drugs. They may develop a substance use disorder.
As well as developing a physical dependence on several drugs, polysubstance abuse may lead to:
Polysubstance abuse can be challenging to treat for various reasons. Clinicians may accidentally miss or overlook an individual’s alcohol use and instead focus on their drug use.
Patients in treatment for alcohol use disorder who have problems with polysubstance abuse need to have all of their issues assessed simultaneously. Treatment focused on one substance abuse is unlikely to be successful.
All substance abuse issues must be identified and treated. Chronic polysubstance abuse problems typically lead to significant issues with emotional, cognitive, and physical functioning.
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