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Stimulants are drugs that work to speed up the way the body functions. Prescription stimulants are used to treat a variety of different conditions. However, because they increase the effects of excitatory neurotransmitters, they make addiction and misuse a common concern. 

Illegal stimulants work in the same manner, providing a euphoric high, that leads many to addiction. Co-occurring substance abuse, such as stimulants and alcohol, are also common in the U.S. 

The National Institute on Drug Abuse reports that five million Americans misuse prescription stimulants and almost half a million people in the United States have a stimulant use disorder.

What are Stimulants?

There are prescription stimulants, such as amphetamines or diet aids, and there are illicit stimulants, such as methamphetamine. When prescribed, they treat conditions such as attention deficit hyperactivity disorder (ADHD), narcolepsy, and aid in weight loss. 

Often referred to as “uppers,” stimulants increase the heart rate and brain function, with the common goal of increasing focus and energy. Unfortunately, they are also highly addictive and have the potential for physical and psychological dependence.

Common stimulants include:

  • Amphetamines – Adderall and Dexedrine
  • Methylphenidates – Concerta and Ritalin
  • Diet Aids – Didrex, Bontril, Preludin, and Meridia
  • Illegal Stimulants – methamphetamine, cocaine, and methcathinone

While prescription stimulants come in tablet, capsule, or liquid form taken by mouth, illicit stimulants come in a variety of forms. This includes smoking, snorting, and dissolving and injecting.

The Side Effects of Stimulants

Stimulants work to speed up how your body functions. Prescription stimulants increase the activity of the brain chemicals dopamine and norepinephrine. 

Dopamine is involved in the reinforcement of rewarding behaviors. Norepinephrine affects blood vessels, blood pressure and heart rate, blood sugar, and breathing. This change in function can be very beneficial when used as prescribed. 

However, stimulants can also cause some unpleasant side effects. These can include:

  • Depression
  • Anxiety
  • Increased blood pressure
  • Increased breathing rate
  • Rapid heart rate
  • Heart Palpitations

When someone regularly uses stimulants, their body and brain become accustomed to the higher levels of stimulation. This means more amounts of stimulants become necessary to achieve results. This tolerance leads to misuse and abuse. 

Symptoms of misuse and abuse can include the above as well as:

  • Increased levels of euphoria
  • High levels of self-confidence
  • Increased sociability
  • Difficulty sleeping
  • Reduced appetite
  • Extremely rapid heart rate
  • Dangerously high body temperature
  • Cardiovascular complications
  • Seizures
  • Structural brain changes
  • Hallucinations, delusions, and paranoia
  • Suicidal thoughts and other mental health issues

Alcohol Abuse and Alcoholism

Alcohol is a central nervous system depressant. It slows down how the brain processes certain functions. When you drink, you may experience a relaxed and euphoric mood, followed by a variety of adverse effects of alcohol including:

  • Drowsiness
  • Nausea and vomiting
  • Headaches
  • Slurred speech
  • Impaired judgment
  • Disturbances in vision and hearing
  • Loss of coordination and reduced perception
  • Loss of consciousness

Moderate drinking, which is one drink per day for women and two drinks per day for men, is considered relatively safe. However, when alcohol consumption exceeds this amount or includes regular binge drinking, alcohol abuse can occur. When abuse progresses and dependency occurs, a person may receive a diagnosis of alcohol use disorder. Signs of alcohol use disorder can include:

  • The inability to control or reduce your alcohol consumption
  • Spending most of your day drinking alcohol, thinking about drinking, or recovering from drinking
  • Alcohol tolerance and the need to drink more to achieve the desired results
  • Loss of interest in regular and favorite activities
  • Missing time from work, school, or social events
  • Drinking despite is causing physical, emotional, or social harm
  • Experiencing withdrawal symptoms when alcohol is not in your system

Combining Stimulants and Alcohol

It is not uncommon for someone abusing drugs to abuse another drug at the same time. This is true with stimulants and alcohol. The co-occurrence of stimulant use and alcohol abuse is very common, even among those taking stimulants as a prescription. For instance, several studies show that there is a strong connection between ADHD, drug abuse, and alcohol use disorder. 

ADHD is five to 10 times more common among adult alcoholics. Children with ADHD are more likely to start abusing alcohol during the teenage years.

The use of alcohol in conjunction with stimulant medication is undertaken to reduce the effects of the stimulant medication. For example, to take off the edge or the shakiness associated with stimulants while at the same time maintaining high levels of energy and euphoria.

Dangers of Combining Stimulants and Alcohol

Alcohol and stimulants can cancel out or enhance the effects of the other. So, taking stimulants with alcohol can be extremely dangerous and even life-threatening. How alcohol and stimulant use affects a person often depends on the stimulants in use. 

For example, alcohol interacting with amphetamines can increase the risk of alcohol poisoning. The amphetamines mask the effects of intoxication, enabling a person to consume more alcohol. In contrast, those using cocaine, methamphetamine, or Ritalin with alcohol experience the reduction stimulant effects. This increases their risk of taking more and overdosing.

Other possible complications that can occur when combining stimulants and alcohol include:

  • Severely reduced cognitive ability
  • Severe changes in mood and behavior
  • Problems with motor function, such as walking
  • Increased risk of developing seizures, high blood pressure, or suffering a heart attack
  • Increased risk of liver or kidney disease
  • Tolerance rapidly develops to both alcohol and stimulants
  • Reduced immune system function
  • Long-term neurological conditions resulting in problems with movement or memory
  • Increased risk of suicidal thoughts or suicide

Treating Stimulant and Alcohol Abuse

Treating stimulant and alcohol abuse requires a medically assisted treatment plan. This helps medical professionals monitor and treat potentially life-threatening withdrawal symptoms. Treatment is usually completed at an inpatient or residential rehab facility. A person’s treatment begins with detox and may also include specific medications, therapy, and aftercare.


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Egan, Kathleen L, et al. “Simultaneous Use of Non-Medical ADHD Prescription Stimulants and Alcohol among Undergraduate Students.” Drug and Alcohol Dependence, U.S. National Library of Medicine, 1 July 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644523/.

Kaloyanides, Kristy B, et al. “Prevalence of Illicit Use and Abuse of Prescription Stimulants, Alcohol, and Other Drugs among College Students: Relationship with Age at Initiation of Prescription Stimulants.” Pharmacotherapy, U.S. National Library of Medicine, May 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377411/.

National Institute on Drug Abuse. “Most Commonly Used Addictive Drugs.” NIDA, https://www.drugabuse.gov/publications/media-guide/most-commonly-used-addictive-drugs.

National Institute on Drug Abuse. “Five Million American Adults Misusing Prescription Stimulants.” NIDA, 16 Apr. 2018, https://www.drugabuse.gov/news-events/news-releases/2018/04/five-million-american-adults-misusing-prescription-stimulants.

“Stimulants.” DEA, https://www.dea.gov/taxonomy/term/346.

“Your Brain on Stimulants, Part 1: How Stimulants Work.” NIDA for Teens, https://teens.drugabuse.gov/blog/post/your-brain-stimulants-part-1-how-stimulants-work.

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