Alcohol and Mood-Altering Drugs

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Significant health risks have been associated with drinking alcohol while using mood-altering illicit drugs or prescription medications. Also known as polysubstance use, combining substances that alter mood and behavior can result in a wide range of side effects, varying in severity from mild to life-threatening. Therefore, it’s essential to understand how alcohol reacts with other intoxicants to prevent dangerous interactions and adverse health consequences.

Treatment for polysubstance use disorder is more complex than that which focuses on the misuse of a single drug. As a result, health experts and addiction specialists recommend that those struggling with dependencies on multiple drugs and alcohol seek professional help. At Guardian Recovery, we offer integrated programs and an all-encompassing approach to treatment designed to address dependence on all addictive substances. If you are motivated to overcome addiction and reclaim your life, reach out to us and learn more about how we can help.

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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 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 (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 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)


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 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 (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.


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)

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Other Mood-Altering Drugs

Some drugs don’t fit nicely into categories because they have different effects depending on individual factors, the dosage, and in the case of marijuana, the strain.


MDMA, also known as Ecstasy or Molly, is a unique drug with both stimulating and hallucinogenic effects. (8) Using MDMA with alcohol can lead to profound dehydration. In fact, many MDMA-related overdoses and deaths from hyperthermia result from mixing it with alcohol. Due to its stimulating effects masking alcohol-related sedation, MDMA can also increase the risk of alcohol poisoning and overdose. Other consequences can include seizures, loss of consciousness, high blood pressure, and heart failure.


Marijuana, or cannabis, is a popular recreational drug with stimulant, depressant, and mild hallucinogenic effects. Its use has become even more prevalent in recent years due to widespread decriminalization. Although marijuana is often seen as benign, when combined with alcohol, it can cause numerous severe effects, including profound impairment of cognitive abilities and motor coordination.

Also, according to research, consuming alcohol increases the absorption of THC in cannabis by priming liver enzymes. (9) This can result in intense and unexpected effects due to the ingestion of more THC than intended.

Common Side Effects of Alcohol & Marijuana Include:

  • Dizziness and fainting.
  • Numbness.
  • Nausea and vomiting.
  • Extreme anxiety and panic attacks.
  • Emotional dysregulation.
  • Paranoia.
  • Terrifying hallucinations.
  • Delusions.
  • Impaired judgment, thinking, and problem-solving.
  • Decreased attention.
  • Altered perception of time.
  • Impaired motor coordination.
  • Memory loss.

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Getting Professional Treatment for Polysubstance Misuse

Polysubstance use disorder can pose unique challenges for health and addiction professionals, but it can be effectively addressed using an individualized treatment approach. Medical detox and clinical supervision are essential for alcohol and benzodiazepine withdrawal to prevent life-threatening complications. Furthermore, the detox process involving alcohol combined with other drugs can be equally dangerous, so medical monitoring is vital to ensure a patient’s mental and physical health remains stable.

Following detox, continuing inpatient or outpatient care is recommended to help individuals address their emotional issues and other factors underlying their need for alcohol or drug misuse. We offer various therapeutic methodologies and services customized to meet each person’s unique needs and goals.

Contact Guardian Recovery today to speak to a Treatment Advisor and receive a free assessment and no-obligation health insurance benefits check. Learn more about our evidence-based treatment programs and various levels of care. We provide our clients with the tools, resources, and support needed to maintain sobriety and foster a healthy, fulfilling life in recovery.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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