Alcohol is a commonly used substance among the American population, with the statistics only increasing. The 2021 National Survey  of Drug Use and Health reports that in 2021, there were 133.1 million alcohol users aged 12 or older, 60.0 million people (or 45.1 percent) of whom engaged in binge drinking in the previous month. Although we don’t typically think of alcohol as a drug, it is in fact a depressant that affects the central nervous system. Research shows  that the most fatal overdoses involve the use of more than one type of drug (known as poly-drug or poly-substance use), alcohol often being one of them. Mixing drugs and alcohol can carry severe consequences. Abuse of illicit drugs occurs more often among heavy users of alcohol. People who drink alcohol commonly use marijuana, opioids, cocaine, and other types of stimulants as well. With alcohol consumption being so widespread, it is important to be aware of the potential dangers of mixing alcohol with over-the-counter, prescribed, and illicit drugs.
When it comes to prescribed medications and over-the-counter drugs, they are typically safe and effective when used correctly. However, if you’ve ever read the medication guide that comes with prescribed drugs, you will have seen that there is always a warning against taking them with alcohol. It is a known risk that mixing alcohol and drugs causes an effect called alcohol-related adverse drug reactions (ADRs).
Join Avenues Recovery, leaders in addiction rehabilitation, as we discover how certain drugs, both legal and illicit, work in the body and the effect that alcohol has when combined with them.
What are the Risks of Mixing Drugs and Alcohol?
One of the dangers of combining drugs (whether legal or illicit) with alcohol is the unpredictability involved. In the book The Truth about Drugs , the authors explain, “Sometimes combining illicit drugs and alcohol will intensify the reaction caused by the drugs; at other times the mixture will produce a completely different reaction from what you expect.” So too, with legal drugs, alcohol can alter the pharmacological effects of the medication, which can increase or decrease the effect of the medication on the body. This unpredictability is dangerous because a person won't recognize the risks of their behavior. Furthermore, the effect of mixing drugs and alcohol might be radically different from what a person thought it would be.
The precise way in which a person can be harmed by mixing alcohol and drugs depends on several factors. In the book Neurobiology of Alcohol and the Brain , Singh explains that these are “ the physicochemical properties of the medicines, the doses of drugs and alcohol, the mode of administration, and the health status of the patients.” The frequency and quantity of alcohol consumption also play a role. Again, what this means is that the outcomes of mixing won't be known in advance.
What are Depressants and Stimulants?
Depressants and stimulants are two categories of drugs that users might mix with alcohol. Let’s take a look at exactly what they are.
Depressants are drugs that slow down the body parts controlled by the central nervous system. Legal depressants such as Prozac, Paxil, Luvox, Celexa, Cipralex, and Zoloft are prescribed to those with depression and anxiety disorders. They are designed to decrease anxiety and panic, increase relaxation, aid sleep, and reduce the risk of seizures.
Stimulants, on the other hand, speed up the body parts controlled by the central nervous system, including the brain. Their effect is that they make a person feel more:
They are widely prescribed to treat ADHD and sometimes narcolepsy. The increased dopamine in the brain improves concentration and decreases fatigue among those who find it difficult to focus and become tired very easily. The two most well-known legal stimulant drugs are Adderall and Ritalin.
Mixing Alcohol with Depressants
Alcohol itself is a central nervous system depressant that slows down parts of the brain. The key appeal of alcohol is the fact that it makes it easier for us to loosen up and feel more relaxed and less inhibited. Depressant drugs and alcohol work synergistically together. This means they act on many of the same areas of the brain, with alcohol compounding the effect of the drugs. The combined effect of two chemicals is much greater than the sum of the effects of each agent given alone. Mixing alcohol with depressants therefore means that a person will become more intoxicated faster.
One effect of this is that thinking and alertness become impaired. Combining antidepressants and alcohol affects judgment, coordination, motor skills, and reaction time more than just alcohol alone. A person can encounter physical harm from falling after losing balance. Some combinations may make a person feel sleepy and drowsy as the sedative effects are enhanced by alcohol. One dangerous effect of this is that it can impair one’s ability to drive or do other tasks that require focus and attention. This, together with impaired eye-to-hand reaction times, is amplified when alcohol and depressants are combined. Mixing the two substances and driving under the influence creates a higher risk of being involved in an automobile accident. The lack of awareness also increases the risk of becoming the victim of a crime like assault or rape.
Increased Depression When Mixing Drugs and Alcohol
Another effect is increased feelings of depression or anxiety. If a person is taking antidepressant medication, drinking can counteract its benefits. Alcohol may seem to improve your mood in the short term, but its overall effect increases symptoms of depression and anxiety. The National Institute on Alcohol Abuse and Alcoholism  reports that “people commonly drink alcohol to cope with depression, but alcohol worsens depression over time, and those who report binge drinking are twice as likely to have suicidal ideation in the past year compared to non-drinkers.” Among people taking medication for depression, even low levels of drinking may be problematic because alcohol may reduce antidepressant response and decrease patient adherence while promoting impulsivity, all of which may potentiate suicide risk.
Mixing Alcohol with Stimulants
A common stimulant drug is cocaine. Alcohol and cocaine are often ingested simultaneously as recreational drugs, with some people believing that alcohol will help to magnify the effects of the cocaine high. Once the cocaine wears off, it can cause a “crash” with feelings of depression and agitation. Some users combine cocaine with alcohol and sedatives in an attempt to self-medicate and reduce the negative symptoms they are experiencing.
Because alcohol is a depressant, people sometimes mistakenly think that mixing stimulants with alcohol will cancel out the side effects of each substance. In reality, however, this combination only masks the effects of each substance leading to a false sense of sobriety that makes a person feel less drunk than they really are. A person mixing these two drugs maintains the illusion of being alert and stimulated, although physical reactions are impaired. This deceptive perception of being sober and alert means that when using amphetamine or cocaine with alcohol, the number of alcoholic drinks required to feel intoxicated is greatly increased. This leads to an increased risk of alcohol poisoning. The false sense of sobriety can also lead to an increased risk of severe legal and safety problems, such as driving under the influence, driving while intoxicated, and physical altercations.
Additional Risks of Mixing Alcohol and Stimulants
Alcohol and stimulants can also have an antagonistic effect, meaning that they work against one another. They work to compete with each other and interfere with the transmission of neurotransmitter messages. The depressant drug tries to slow the brain/central nervous system down, while the stimulant tries to speed it up. This puts your brain/central nervous system under great pressure.
Combining prescription stimulants used to treat ADHD - such as Adderall or Ritalin - with alcohol can cause irregular heart rhythm (cardiac arrhythmias), increased blood pressure and heart rate. Thsi can lead to a greater risk of having a heart attack and/or developing heart problems.
The false sense of sobriety that occurs when a person mixes alcohol with stimulants also increases the risk of stimulant overdose, which can have potentially fatal consequences.
Treating Drug and Alcohol Addictions
Alcohol can drastically compound the effects of other drugs. Many of the intoxicating effects and associated health risks of illicit drugs may be amplified by mixing drugs and alcohol.
If you or a loved one are struggling with any type of alcohol or drug addiction, Avenues Recovery is here to support you.
With detox and treatment programs throughout the USA, we tailor-make treatment plans that work for you. Contact us today to hear more about how we can help you. You deserve better than a life of addiction! Let your future start today.