Alcohol and Mood-Altering Drugs

Effects of Alcohol & Mood-Altering Drugs

Alcohol use is prevalent in the United States due mainly to its legality and accessibility. For many adults, there are plenty of opportunities to drink while taking prescription medications or illicit drugs. People who misuse alcohol commonly report using additional substances, including marijuana, opioids, cocaine, and sedatives. Some try to negate the effects of one drug by using the other, and others seek a more intense high. Unfortunately, many attempt to self-medicate with whatever substance they determine might help them escape from negative feelings and stress.

Combining alcohol with various psychoactive and mood-altering drugs can result in some effects perceived as desirable by the person experiencing them. Still, there are risks associated with the achievement of this objective, including dangerous interactions and an overall combined impact so extreme it is potentially lethal. The following describes the different types of drugs and risks associated with concurrent alcohol use.

Stimulants

Stimulants increase activity in the central nervous system (CNS). Because alcohol is a CNS depressant, stimulants can mask some intoxicating effects of drinking, such as sedation. Individuals in this situation may therefore be at a higher risk for alcohol poisoning or overdose. Common stimulants include methamphetamine, cocaine, and medications prescribed for treating ADHD and other conditions.

Adderall, Concerta, & Other ADHD Medications

Adderall and its generic equivalents (amphetamines) are the most common prescription drugs used for ADHD. Concerta (methylphenidate) is also used to treat this condition, and although the active ingredients are different, they work similarly.

Reasons for Combining Alcohol With ADHD Medications or Other Stimulants:

• To reduce the depressant effects of alcohol. In theory, this would allow a person to stay awake and active for longer than they otherwise would during an episode of heavy drinking.
• To reduce the stimulating effects of the medication. Some people without ADHD who take these medications experience ADHD-like symptoms, including hyperactivity, restlessness, and anxiety. As such, they might believe alcohol could offset some of these symptoms due to its depressant effects.
• To enhance a euphoric “high” or buzz. Both substances have psychoactive, albeit opposing, effects. Despite this, combining stimulants and depressants is a common approach to intensifying feelings of energy and elation. However, the combined actions of alcohol and ADHD medications can increase the adverse effects of each, leading to significant side effects like elevated blood pressure, heart rate, and increased risk of arrhythmia. (1)

Methamphetamine

Methamphetamine (meth) is an illicit drug with more intense effects than prescription amphetamines and can cause profound hyperactivity, mania, restlessness, and anxiety. Using meth with alcohol puts immense strain on the heart and increases blood pressure. Moreover, it can increase the risk of neurotoxicity, resulting in damage to the brain and nervous system. (2)

Cocaine

Cocaine is another illicit drug commonly misused to increase energy and induce euphoria. Cocaine’s effects can be very intense but are much shorter in duration than meth. For this reason, cocaine is often used repeatedly and rapidly in a brief period, thereby increasing the risk of overdose.

When alcohol and cocaine combine in the body, a third psychoactive substance called cocaethylene is formed. Cocaethylene has similar properties as cocaine, but its effects are longer in duration. It’s been associated with seizures, liver damage, and compromised immunity, and comes with up to a 25-fold increase in immediate death than cocaine alone. (3)

Drinking while using cocaine can have detrimental effects on the cardiovascular system, including accelerated and irregular heart rate and high blood pressure. Consequently, it increases the risk of heart attack and stroke. (4)

Depressants

Drinking alcohol while using other depressants, including opioids, can impair vital physiological functions such as breathing and heart rate. Severe CNS depression can lead to respiratory arrest, brain damage, and death.

Opioids

Opioids have depressant properties but are more commonly referred to as narcotics or painkillers. They include a wide variety of prescription medications, such as oxycodone, and illicit drugs, such as heroin. Regardless of legality, all opioids can cause life-threatening CNS depression and overdose when misused. The combined effects of alcohol and opioids significantly increase the risk of severe or lethal damage to the brain, the heart, and other organs. (5)

Side Effects of Alcohol & Opioids Include:

• Nausea and vomiting.
• Dehydration.
• Blood pressure fluctuations.
• Irregular heart rate.
• Cardiovascular instability.
• Loss of coordination.
• Disinhibition and erratic behavior.
• Liver damage.
• Loss of consciousness.
• Respiratory arrest.
• Coma.
• Death.

Benzodiazepines

Benzodiazepines (benzos) are CNS depressants commonly used to treat acute anxiety and seizures and to promote sleep. Combined use of alcohol can lead to profound sedation and slow, erratic, or stopped breathing. Lack of oxygen to the brain can result in irreversible brain damage in minutes. Without emergency medical intervention, a person overdosing on benzos and alcohol is at high risk for respiratory arrest and death. Less severe side effects include dizziness, drowsiness, and impaired concentration and judgment.

Hallucinogens

Typical sought-after effects of classic hallucinogens, such as LSD, peyote, and psilocybin, are pronounced hallucinations and altered sensory perceptions. However, side effects can also include depersonalization, confusion, anxiety, panic attacks, vomiting, and increased heart rate. Combining alcohol with hallucinogens can amplify these symptoms and result in a wide range of unwanted, unforeseen effects because how hallucinogens will impact a person at any time is unpredictable. (7)