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

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.