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Updated on October 12, 2023
8 min read

Is It Safe To Combine Steroids and Alcohol?

Steroids, a class of compounds with diverse biological functions, have been a subject of medical and athletic interest for decades. Medically, they reduce inflammation and other symptoms. However, its variants are also used to improve one’s physique.

When combined with alcohol, steroids can create a complex interplay of effects on the body and mind. Understanding the potential risks of these substances is essential for making informed decisions regarding these two substances.

What Are Steroids?

Steroids are synthetic hormones that reduce inflammation in the body.1 They help manage symptoms of rheumatoid arthritis, gout, and autoimmune conditions.

Besides taking it orally, you can use steroids via injection, eye drops, and topical creams applied to the skin for conditions like eczema, psoriasis, and rosacea.

The side effects associated with steroids include:

  • Increased appetite and weight gain
  • Acne
  • Stomach ulcers
  • Muscle weakness
  • Rapid mood swings
  • Mental health problems like depression and anxiety
  • Diabetes
  • High blood pressure
  • Increased risk of infection
  • Suppression of adrenal glands
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What Are the Different Types of Steroids?

There are two primary types of steroids. Corticosteroids are a short-term treatment different from anabolic steroids used by athletes and bodybuilders.

Corticosteroids

Corticosteroids are hormonal medications containing cortisol, which prevent the body from producing substances that cause inflammation2.

Examples of corticosteroids include prednisone, hydrocortisone, and dexamethasone, which help treat:

  • Asthma
  • Chronic obstructive pulmonary disorder (COPD)
  • Rashes and skin conditions
  • Multiple sclerosis
  • Lupus

Taking high doses of corticosteroids for prolonged periods can cause osteoporosis (the brittleness of bones), delayed growth in children, and adrenal insufficiency (the body’s inability to respond to stress).

Anabolic Steroids

Anabolic steroids mimic testosterone, which helps individuals develop muscles3. Healthcare providers may prescribe anabolic steroids to young males undergoing delayed puberty or individuals who lose muscle mass due to cancer, AIDS, or osteoarthritis.

Unfortunately, using performance-enhancing drugs often leads to steroid abuse in athletes. This can damage the liver, kidneys, and heart.

Steroids and Alcohol Interactions

While studies don’t indicate direct interactions between steroids and alcohol, drinking alcohol can exacerbate the side effects of steroids4.

How severe the side effects of prednisone are when drinking alcohol depends on:

  • The steroid dosage
  • The length of treatment (short-term or long-term)
  • How many alcoholic drinks an individual consumes
  • The presence of alcohol use disorder (AUD)
  • Interaction with other medications

The Implications on Athletes Using Steroids and Alcohol

For athletes, taking steroids and alcohol can have significant implications, potentially jeopardizing sports performance and interpersonal relationships. Unless under medical supervision, athletes should avoid alcohol while on steroids.

Besides the risk of dependence, alcohol’s impact on the liver can worsen potential liver damage caused by certain steroids. The cardiovascular risks associated with this combination can be particularly concerning for athletes, potentially affecting their long-term health and athletic careers.

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How Does Alcohol Potentially Affect Steroid Efficacy?

Mixing alcohol and prednisone can increase the liver’s workload, interfering with its ability to metabolize steroids effectively. If the liver focuses on eliminating alcohol from the body, it can lead to altered drug clearance, lessening the therapeutic levels of steroids in the bloodstream.

Below are a few other ways alcohol use can diminish steroids’ efficacy:

  • Irritating the gastrointestinal tract: Drinking alcohol while taking prednisone can put an individual at higher risk of GI bleeding and ulcers5.
  • Immune system suppression: Because prednisone is immunosuppressive, drinking alcohol can weaken the immune system, leading to an increased risk of infection6.
  • Cardiovascular effects: Excessive alcohol consumption while on steroids can lead to hypertension (high blood pressure) and other cardiovascular complications7.
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What Are the Health Implications of Mixing Steroids and Alcohol?

Drinking alcohol while taking steroids like prednisone can increase several health risks associated with either substance. Below are the health implications of mixing alcohol and steroids.

Organ Damage

Chronic alcohol misuse while taking prednisone can overexert the liver, leading to cirrhosis8. Liver cirrhosis is a late stage of scarring (fibrosis) of the liver caused by long-term liver damage and inflammation. It’s characterized by impaired liver function and scar tissue formation that can lead to liver failure.

Mental Health Issues

Alcohol and prednisone use can exacerbate psychological issues by causing mood swings9. Because alcohol is a depressant, it can lead to irritability, aggression, and mood instability.

In addition, steroids increase feelings of anxiety and paranoia. Alcohol and steroids disrupt sleep patterns, leading to fragmented and less restorative sleep.

Changes in Blood Sugar Levels

Taking prednisone with alcohol can increase blood sugar levels, leading to hyperglycemia10. Individuals who develop hyperglycemia may experience dehydration, blurred vision, and fatigue.

Weakened Bones

Mixing prednisone with alcohol puts individuals at risk of developing osteoporosis or weakened bones11. Risk factors like pregnancy and premenopausal symptoms can exacerbate these effects.

Potential Risks and Side Effects of Combining Steroids With Drug and Alcohol Dependence

When you drink alcohol while taking steroids, it can exacerbate the side effects associated with both substances. Alcohol intake can significantly impact the side effects of steroids, particularly concerning blood pressure and stomach problems.

Blood Pressure

Some steroids, particularly corticosteroids like prednisone, can cause an increase in blood pressure as a side effect. Alcohol, when consumed in excess, can also elevate blood pressure.

When alcohol and steroids are used together, especially in people prone to high blood pressure, there is an increased risk of hypertension. People with steroid-induced diabetes should take extra precautions when taking steroids and alcohol.

Gastrointestinal Problems

Alcohol increases the risk of gastritis (inflammation of the stomach lining) and ulcers, and steroids can further compound these effects. Combining alcohol and steroids can lead to more severe stomach problems, including pain, nausea, and an increased risk of gastrointestinal bleeding or ulceration.

Which Steroids Pose the Greatest Risk When Combined with Alcohol?

Individual responses to alcohol and medication can vary, depending on your body’s reaction to them. However, several types of steroids can pose a greater risk when combined with alcohol due to their potential for specific side effects and interactions.

These steroids typically pose the most significant risk when combined with alcohol:

  • Corticosteroids: These increase the risk of high blood pressure, mental health issues, and gastrointestinal issues.
  • Anabolic androgenic steroids: These steroids, when combined with alcohol, can lead to liver damage, aggressive behavior, and cardiovascular complications.
  • Glucocorticoids: Medications like dexamethasone and hydrocortisone used for allergies and asthma can cause mood swings, changes in blood pressure, and gastrointestinal problems when mixed with alcohol.12
  • Immunosuppressive steroids: Cyclosporine and tacrolimus suppress the immune system in individuals with autoimmune conditions. When paired with heavy alcohol use, these medications can compromise the immune system’s ability to fight off infections.

If you’re taking steroids for treatment, consult your healthcare provider to confirm how to proceed with alcohol consumption.

Tips for Drinking While on Steroids

While the occasional drink while taking prednisone won’t cause long-term consequences, it’s best to avoid drinking alcohol while undergoing treatment.

If you choose to drink while taking steroids, here are a few things you can do to dull alcohol’s effects on your body:

  • Take your steroids after a balanced meal to protect against damaging effects on your digestive system.
  • Eat small meals throughout the day to keep blood sugar levels manageable.
  • Avoid salty foods to prevent water retention.
  • Avoid consuming stimulants like caffeine and nicotine, which can exacerbate sleep issues.

Is There a Safe Amount of Alcohol to Consume While on Steroids?

There’s no universally safe amount of alcohol to consume while undergoing prednisone treatment. However, binge drinking (more than five drinks for men or more than four drinks for women within 2 hours) can drastically increase the side effects of prednisone.

Are There Any Safe Alcohol Alternatives for Those on Steroids?

When taking steroids, you should drink safe beverages that won’t interact negatively with your medication. Here are a few alternatives you can enjoy with steroid use:

  • Water
  • Herbal tea
  • Fruit juice and smoothies
  • Mocktails
  • Milk and dairy alternatives

Besides alcohol, avoid the following drinks to prevent adverse interactions:

  • Grapefruit juice
  • Sugary drinks
  • Excessive sports or energy drinks
  • Caffeinated beverages
  • Acidic beverages

Common Questions on Steroids and Alcohol

Is it safe to have a glass of wine while on prednisone?

It may be safe to drink alcohol like wine while on prednisone if your dose is low and you aren’t using it for long-term treatment. However, it’s best to consult your doctor before drinking.

How long after stopping steroids can one consume alcohol safely?

When you can drink alcohol after stopping prednisone depends on the dosage and individual health factors. However, it’s recommended to wait at least 24 hours.

Can occasional alcohol consumption have long-term effects when on steroids?

Yes. Occasional alcohol consumption while on steroids can still have long-term effects. The two substances may exacerbate side effects and contribute to health issues over time.

How do steroids and alcohol impact mental health?

Steroid use with concurrent substance use disorder (SUD) with alcohol can lead to unpredictable moods, irritability, aggression, and depression.

Are there specific medical conditions that heighten the risk of combining steroids and alcohol?

Medical conditions, such as liver disease, cardiovascular issues, and a history of alcohol abuse, can heighten the risk of combining steroids and alcohol.

Summary

While the FDA claims no direct interactions if you drink alcohol while taking steroids, combining them can cause significant consequences like brittle bone tissue, weight gain, a weakened immune system, stomach ulcers, and depression.

Fortunately, the substance abuse treatment options for alcohol addiction and steroid abuse are plentiful. The road to a successful recovery takes a single phone call to your primary physician or mental health counselor. If you need help managing withdrawal symptoms from alcohol use or drug abuse, contact an addiction specialist to find the proper treatment you need.

Updated on October 12, 2023
12 sources cited
Updated on October 12, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. “Steroids.” DEA. 2023.
  2. Williams, D.M. “Clinical Pharmacology of Corticosteroids.” Respiratory Care, 2018.
  3. Angell et al. “Anabolic Steroids and Cardiovascular Risk.” Sports Medicine, Springer Link, 2012.
  4. Fukushima et al. “The effect of alcohol intake and the use of oral corticosteroids on the risk of idiopathic osteonecrosis of the femoral head.” The Bone & Joint Journal, Bone & Joint, 2013.
  5. Narum et al. “Corticosteroids and risk of gastrointestinal bleeding: a systematic review and meta-analysis.” BMJ Open, BMJ Journals, 2014.
  6. Adams et al. “From immunosuppression to tolerance.” Journal of Hepatology, ScienceDirect, 2015.
  7. Vanberg, P., and Atar, D. “Androgenic Anabolic Steroid Abuse and the Cardiovascular System.” Doping in Sports: Biochemical Principles, Effects and Analysis, Springer Link, 2009.
  8. Ziaolhagh et al. “The effect of boldenone anabolic steroid, and endurance and resistance training on liver damage markers in rats” Feyz Journal of Kashan University of Medical Sciences, Kashan University of Medical Sciences, 2018.
  9. Carta M et al. “Coping with the New Era: Noise and Light Pollution, Hperactivity and Steroid Hormones. Towards an Evolutionary View of Bipolar Disorders.” Clinical Practice & Epidemiology in Mental Health, U.S. National Library of Medicine, 2018.
  10. Aravind Sosale et al. “Steroid use during COVID-19 infection and hyperglycemia – What a physician should know.” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, ScienceDirect, 2021.
  11. Manolagas, S.C. “Steroids and osteoporosis: the quest for mechanisms.” The Journal of Clinical Investigation, 2013.
  12. Merih Oray et al. “Long-term side effects of glucocorticoids.” Expert Opinion on Drug Safety, Taylor & Francis Online, 2016.
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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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