Dangers of Mixing Alcohol With Other Drugs

Mixing alcohol with other drugs might be a common occurrence for those who do both regularly, but most people don’t realize how dangerous this practice is. Whether combined with prescription medications, over-the-counter remedies, or recreational drugs, alcohol can amplify or interfere with the effects of these substances, setting the stage for dangerous reactions. And over time, using any combination of substances can damage your physical, mental, and emotional health. Understanding the risks involved is the first step toward staying safe.

Here’s what you should know about mixing alcohol with other substances:

What Happens When You Combine Alcohol With Drugs?

Mixing drugs with alcohol can be risky because it creates interactions that are hard to predict. Sometimes, alcohol makes a drug more powerful; other times, it weakens the effects. Either way, these combinations can cause serious health issues like heart problems, liver damage, or even overdose. The CDC warns:

If you drink alcohol while using other drugs, the effects may be stronger and more deadly than using either one alone…It can be dangerous to use two or more drugs at the same time, or within a short time of each other.

Here’s what you need to know about how different types of substances interact with alcohol.

Alcohol and Prescription Medications

Prescription drugs are carefully calibrated to provide specific therapeutic effects, but drinking alcohol while taking these drugs can throw off that balance.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “Alcohol and medications have the potential to interact¹ in three main ways:”

Alcohol can change how your body processes a medication, either speeding it up or slowing it down. That can make the level of medication in your bloodstream higher or lower than intended.
Some medications can affect how your body absorbs and processes alcohol, which might result in higher blood alcohol levels and other unwanted effects.
Alcohol can also influence how a medication works in your body, making it either more or less effective than it should be.

Opioids

Combining alcohol with opioids (like oxycodone or hydrocodone) slows your breathing and lowers your blood pressure to dangerous levels. Both substances relax your central nervous system, and together, they can lead to overdose. The CDC warns,

Drinking alcohol at the same time or within a few hours of using other drugs like opioids or benzodiazepines² can cause serious harm. It can make it hard to breathe, which can damage your brain and other organs. This can also lead to early death.

Antidepressants

Drinking alcohol while on antidepressants, like SSRIs or tricyclics, can reduce how well the medication works. It may also increase side effects like dizziness, drowsiness, or worsening depression. It can also increase suicide risk. One 2018 study found that “in patients being treated for depression, even low levels of drinking may be problematic because alcohol may reduce antidepressant response³ and decrease patient adherence while promoting impulsivity, all of which may potentiate suicide risk.”

Alcohol has other adverse effects for people taking antidepressants:

Dangerous blood pressure spikes: Some antidepressants, like tranylcypromine (Parnate) and phenelzine (Nardil), can cause dangerously high blood pressure when combined with drinks that are rich in tyramine, like beer and red wine.
Increased seizure risk: Bupropion (Wellbutrin) lowers the seizure threshold, and alcohol can raise this risk even further.
Higher risk of liver damage: Duloxetine (Cymbalta) may contribute to liver damage. Mixing it with alcohol can increase the chances of liver toxicity.
Fatal overdose risk: Combining alcohol with venlafaxine (Effexor) can significantly increase the risk of fatal alcohol overdose.

Sedatives and Benzodiazepines

Alcohol intensifies the sedating effects of drugs like Valium or Xanax. This can impair your memory and coordination, increasing the risk of accidents and even respiratory failure. Like opioids, mixing benzos with alcohol also increases the risk of fatal overdose:

Any combination of alcohol, opioids, and benzodiazepines is particularly dangerous because they may have synergistic rather than additive effects on brain circuits involved in vital physiological functions.

Alcohol is involved in about 20% of benzodiazepine-related overdose deaths.⁴

Alcohol also amplifies the side effects of certain insomnia medications,⁵ increasing the risk of accidents related to impaired motor function, memory loss, and sleepwalking.

Even medications prescribed for non-mental health conditions, such as blood pressure drugs, can interact with alcohol. Alcohol can counteract the medication’s effects, raising your blood pressure and increasing the risk of heart problems.

If you have questions about drinking while taking your medication, you can check for warnings on the label or look up the drug in DailyMed, a resource from the National Library of Medicine.

Alcohol and Over-the-Counter Medications

Over-the-counter (OTC) medications can also cause problems when combined with alcohol.

Cold and Allergy Remedies

Many OTC cold and allergy medications contain antihistamines, which make you drowsy. Alcohol can make that drowsiness worse, affecting your ability to focus or drive.

Pain Relievers

Alcohol and acetaminophen (like Tylenol) can put a lot of strain on your liver. And combining alcohol with NSAIDs, like ibuprofen, can irritate your stomach and increase the risk of ulcers or bleeding.

Cough Syrups

Some cough syrups already contain small amounts of alcohol. Adding more alcohol on top of that can amplify drowsiness and impair your motor skills.

Alcohol can also interact with OTC medications that are commonly used to treat a wide range of symptoms:

Allergies
Cough
Cold and flu
Arthritis
ADHD
Diabetes
Heartburn
Muscle pain

…and more.

Always read the labels of your medications carefully, and avoid drinking alcohol while taking them unless explicitly approved by your doctor.

Alcohol and Recreational Drugs

Mixing alcohol with illicit drugs is especially unpredictable. Each combination affects the body differently, and the risks can be severe.

Marijuana

Alcohol and marijuana are often used simultaneously. But using alcohol and marijuana together can intensify the relaxing effects of both, which might impair your coordination and judgment. It can also make you feel nauseous or dizzy. Interestingly, research shows that some people tend to drink more when they use marijuana.⁶

Cannabis can also heighten the risk of car accidents⁷ due to its effects that impair your ability to drive:

Slowed reaction time
Loss of coordination and problem-solving skills
Distorted perception of time, distance, and speed

Cocaine

When alcohol and cocaine mix, your liver creates a toxic substance called cocaethylene. The “only known instance where a new psychoactive substance is formed entirely within the body,” cocaethylene lasts longer and has more intense effects than cocaine.⁸ As the substance increases your heart rate and blood pressure, it raises the risk of heart attack or stroke.

Ecstasy (MDMA)

In most spaces where people use ecstasy, alcohol is also involved. Mixing alcohol and MDMA dehydrates your body and puts strain on your organs, which increases the chances of heatstroke or even organ failure. It can also cause confusion or anxiety.

Heroin

As with other opioids, drinking alcohol amplifies heroin’s depressive effects on the nervous system. This can cause a number of adverse reactions:

Slowed breathing
Loss of consciousness
A high risk of fatal overdose

Substance use can lead to high-risk behaviors that have serious consequences. According to the CDC,

Using alcohol together with other drugs can increase your risk of overdose; injury; violence; sex without protection, which can lead to sexually transmitted infections, HIV, or unplanned pregnancy; chronic disease; and alcohol or other substance use disorders.

Adapting to one substance can also affect your tolerance for another. Learn more about cross-tolerance here.

Signs of Dangerous Interactions When Mixing Alcohol With Other Drugs

It’s not always easy to tell when a drug and alcohol combination has taken a turn for the worse—but certain symptoms can be red flags.

Physical Symptoms

Keep an eye out for physical warning signs like:

Extreme drowsiness or dizziness
Nausea or vomiting
Slurred speech or trouble walking
Slow or irregular breathing
Chest pain or a racing heart
Seizures or unconsciousness

If you or someone else experiences these symptoms, it’s important to get medical help immediately.

Behavioral Symptoms

Behavioral changes can also indicate a harmful interaction between alcohol and other substances. Watch for these warning signs:

Confusion or memory lapses
Unusual aggression or irritability
Paranoia or hallucinations
Risky or reckless behavior
Difficulty concentrating or staying awake

Behavioral changes may not always be immediately noticeable, but they often signal a serious issue that requires intervention.

What to Do if You or Someone You Know Is Experiencing a Negative Reaction

If someone is experiencing a negative reaction after mixing alcohol with other drugs, taking quick action can save lives.

Call 911 immediately. If someone loses consciousness, has trouble breathing, or shows other severe symptoms, contact emergency services. Be honest with the responders about what substances they took.
Stay with the person. Keep them awake and monitor their breathing. Turn them onto their side to stop them from choking if they vomit.
Avoid self-treatment. Don’t try to manage severe symptoms on your own or rely on home remedies. Medical professionals are trained to handle dangerous drug interactions.
Plan for long-term support. If the situation isn’t immediately life-threatening but indicates a pattern of misuse, consider contacting a treatment center or addiction specialist for help.

Find a Supportive Drug Rehab Program

Mixing alcohol with other drugs can have life-altering consequences. From intensifying side effects to increasing the risk of overdose, these combinations are far more dangerous than many people realize. Understanding the risks and recognizing the signs of harmful interactions can prevent serious complications and even save lives.

Mixing drugs with alcohol isn’t just dangerous—it can be a sign of substance use disorder. If you’re struggling with these behaviors, intervening early can put you on the path to recovery before the problem gets worse. Comprehensive addiction treatment programs provide medical care, therapy, and ongoing support to help you overcome addiction safely and effectively.

If you’re concerned about your alcohol and drug use, the best time to reach out for help is now. Search for rehab programs by location, price range, facilities, and more, and talk to a support specialist directly today.

Sources

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The Dangers of Mixing Alcohol With Other Drugs