Combining alcohol with medications is not a good idea. In fact, medication guides that come with many prescriptions and over-the-counter (OTC) medicines emphasize the importance of not mixing alcohol and drugs.
Unfortunately, these rules are often disregarded, and it’s not uncommon for people to combine the two. This is especially the case in persons with alcohol use disorder. The more you know about the subject, the easier it will be to make the right choices.
In this post, we are going to talk about the effects of mixing drugs and alcohol. Read on to learn more.
Mixing Alcohol and Drugs – Quick Facts
Mixing alcoholic drinks and medications (both prescription and OTC) is not uncommon, but it’s impossible not to wonder just how common it is. A survey of 1052 people found that 56% of people mixed alcohol with OTC pain medications.
About 52% combined medication with alcohol a couple of times a year, while 17% did so a few times a week. Find more info in the tables below.
| Medication | Men | Women | Overall |
|---|---|---|---|
| Antibiotics (Flagyl, Avelox, Vabomere) | 9.0% | 15.0% | 12.5% |
| Antidepressants (Prozac, Wellbutrin) | 13.0% | 23.0% | 18.8% |
| Antipsychotics (Abilify, Latuda) | 3.0% | 3.0% | 3.1% |
| Blood pressure medication (Cardene etc.) | 7.0% | 7.0% | 7.1% |
| CNS depressants (Valium, Xanax, Ativan) | 6.0% | 8.0% | 7.4% |
| CNS stimulants (Ritalin, Adderall) | 8.0% | 3.0% | 5.3% |
| Corticosteroids (Hexadrol, Cortef) | 2.0% | 3.0% | 3.1% |
| Diabetes medication (DiaBeta, Diamicron) | 3.0% | 2.0% | 2.8% |
| Muscle relaxants (Robaxin, Zanaflex) | 11.0% | 7.0% | 8.7% |
| Opioid pain medication (Methadose, Oxycontin) | 15.0% | 13.0% | 14.2% |
| OTC allergy medication (Benadryl) | 13.0% | 26.0% | 20.1% |
| OTC cough/cold medication (Mucinex, Robitussin) | 11.0% | 14.0% | 14.8% |
| OTC pain medication (Advil, Tylenol) | 54.0% | 57.0% | 56.0% |
| OTC stomach/digestion medication (Pepto-Bismol, ant-diarrheal) | 10.0% | 7.0% | 8.7% |
| Reason | Prevalence |
|---|---|
| Accidentally, e.g., forgot about the medication before having a drink | 33.9% |
| Coping with sadness | 10.3% |
| Desire to drink despite taking a medication | 37.3% |
| Enhancement of alcohol’s effects | 14.2% |
| Enjoyment of the mixed effect of alcohol and medication | 17.3% |
| To attend an event, despite feeling unwell | 22.2% |
| To attend an event, despite taking medications | 19.9% |
| To deal with stress and/or anxiety | 19.5% |
| To fit in with peers and friends | 8.6% |
| To prevent hangover | 16.0% |
Important facts to know:
- 3% of people combine antidepressants with alcohol to cope with stress and/or anxiety
- 40% of people mix alcohol and OTC pain medications to prevent a hangover
| Frequency | Men | Women | Overall |
|---|---|---|---|
| More than once a week | 18.8% | 15.3% | 17.2% |
| Once a week | 18.8% | 10.9% | 15.0% |
| Once a month | 14.8% | 16.5% | 15.6% |
| A few times a year | 47.7% | 57.3% | 52.2% |
The effects of mixing alcohol with drugs depend on the class of medications. To protect health and wellbeing, persons with alcohol dependence need well-structured treatment at the inpatient alcohol rehab center near Fort Worth.
Below, we are going to discuss the impact of combining alcohol with different kinds of drugs.
Effects of Mixing Alcohol With Antidepressants
Antidepressants are a class of medications used primarily to treat and alleviate symptoms of depression. These medications may also help with generalized anxiety disorder, obsessive-compulsive disorder (OCD), diabetic peripheral neuropathic pain, neuropathic pain, social anxiety disorder, and other types of anxiety.
Some off-label uses of antidepressants include, but aren’t limited to, fibromyalgia, chronic urticaria (hives), hot flashes, premenstrual symptoms, Tourette syndrome, bulimia nervosa, binge eating disorder.
How Common Is The Use of Antidepressants?
According to the CDC, during the 2015 to 2018 period, about 13.2% of adults reported using antidepressants in the past 30 days. Women were more likely to take antidepressants than men. The use of antidepressants in women and men was 17.7% and 8.4%, respectively.
Moreover, the use of antidepressants tends to increase with age. For instance, about 7.9% of adults 18 to 39 use antidepressants, while 14.4% of those aged 40 to 59 do so. About 19.0% of adults over 60 years of age use antidepressants.
Types of Antidepressants and How They Work
Not all antidepressants are the same. We can divide them into several categories. The table below demonstrates different types of antidepressants and their mechanisms of action.
| Type | Selective serotonin reuptake inhibitors (SSRIs) | Serotonin and noradrenaline reuptake inhibitors (SNRIs | Tricyclic antidepressants (TCAs) | Monoamine oxidase inhibitors (MAOIs) | Noradrenaline and specific serotoninergic antidepressants (NASSAs) |
|---|---|---|---|---|---|
| First introduced | 1988 | 1993 | 1959 | 1950s | 1957 |
| Mechanism of action | SSRIs increase the levels of the neurotransmitter serotonin in the brain. They block the reabsorption (reuptake) of serotonin into neurons. In turn, more serotonin is available to improve the transmission of messages between neurons. | SNRIs inhibit the reuptake of serotonin and noradrenaline, neurotransmitters that play a role in mood regulation. | TCAs act on about five neurotransmitter pathways to achieve their effects. They block the reuptake of serotonin and norepinephrine (noradrenaline) in presynaptic terminals. This increases levels of these neurotransmitters in the synaptic cleft and may contribute to antidepressant effects. | MAOIs influence the changes in brain chemistry that are operational in depression. Monoamine oxidase enzyme is involved in removing norepinephrine, serotonin, and dopamine from the brain. MAOIs prevent that from happening. | NASSAs have a dual mechanism of action that increases 5-HT and noradrenaline in synaptic cleft to within the normal range. They enhance adrenergic and serotonergic neurotransmission in the brain involved in mood regulation. |
| Examples | Fluoxetine (Prozac) Citalopram (Celexa) Sertraline (Zoloft) Paroxetine (Paxil) Escitalopram (Lexapro) |
Duloxetine (Cymbalta) Venlafaxine (Effexor) Desvenlafaxine (Pristiq) |
Amitriptyline (Elavil) Amoxapine-clomipramine (Anafranil) Desipramine (Norpramin) Doxepin (Sinequan) |
Isocarboxazid (Marplan) Tranylcypromine (Parnate) Selegiline (Emsam) Phenelzine (Nardil) |
Mianserin (Tolvon) Mirtazapine (Remeron, Zispin, Avanza) |
What Happens When You Combine Alcohol and Antidepressants?
As seen above, some people purposely combine alcohol and antidepressants to cope with anxiety and stress. However, some men and women may use alcohol in conjunction with antidepressants to enhance psychoactive effects from the medication itself.
That being said, antidepressants don’t produce euphoria in most people. Combining alcohol with these medications will not make you euphoric; in fact, it can produce the opposite effect.
A study from the ISRN Psychiatry found that the prevalence of depression among alcohol-dependent persons is high, and about 63.8%. Depressed subjects had a significant craving for alcohol. Scientists concluded alcohol dependence was strongly associated with depression.
That being said, after alcohol detox and rehabilitation, recovery from depression was observed. Most people didn’t need treatment for depression.
The above-mentioned study demonstrated perfectly that alcohol dependence might go hand in hand. Taking antidepressants with alcohol could seem necessary to a person who believes they can cope with symptoms of depression that way.
However, as a study from the International Journal of Risk and Safety in Medicine points out, the interaction between alcohol and antidepressants can lead to serious consequences. This research focused on SSRIs, but since literature research didn’t yield enough results, the scientists collected cases from their colleagues’ practices, regulatory agencies, and web-based discussions.
In 100 out of 201 cases, pathological intoxication indicated by unexpected and often gross disinhibition was observed. The most prominent complication was memory impairment ad it was present in 53 out of 100 above-mentioned cases. Some outcomes were incredibly serious and included serious violence and even homicide.
A paper from the Iranian Journal of Public Health found that mixing antidepressants, especially SNRIs, with alcohol is a potential risk factor for rhabdomyolysis. Rhabdomyolysis is a serious and potentially life-threatening syndrome indicated by the breakdown of skeletal muscle fibers with leakage of muscle contents into circulation.
Although some people drink alcohol with antidepressants to amplify the effects of the latter, the reality is different. You see, alcohol can worsen symptoms of depression and make it difficult to treat this mental health problem. Additionally, alcohol can increase the risk of side effects (or worsen them) of antidepressants.
The most common effects linked with the combination of alcohol and antidepressants include:
- Drowsiness
- Dizziness
- Increased risk of overdose
- Amplified feelings of depression or hopelessness
- Impaired motor control
- Liver damage
The MAOIs can increase the risk of heart-related side effects such as high blood pressure, stroke, and heart attack. Drinking certain alcoholic beverages can increase the risk of tyramine. Tyramine is an amino acid that can significantly increase blood pressure when present in high amounts.
Although rare, high tyramine levels can trigger cerebral hemorrhage and may even result in death. These effects happen because MAOIs prevent the breakdown of this amino acid. Keep in mind that MAOIs are rarely prescribed for depression lately.
Certain classes of antidepressants may produce different effects when used in combination with alcohol. For that reason, to preserve your health and wellbeing, the best thing to do is to avoid mixing the two together.
The best alcohol rehab center for women in Texas can help overcome alcohol addiction and save you from mixing the medications with drinking.
Effects of Mixing Alcohol and Antihypertensive Medications
According to the American Heart Association, about 77.9 million people had hypertension (high blood pressure) in 2012. In other words, this problem was present in one out of every three people.
Just five years later, in 2018, nearly half of adults in America (108 million, 46% of the adult population) had hypertension, according to the CDC. That being said, only one in four people with hypertension (24%) had their condition under control.
About 30 million adults who are recommended to take medication for hypertension need a prescription to start taking it. Most adults with hypertension in the US are recommended both prescription antihypertensive medications and lifestyle modification. About 87 million of them, to be more precise.
As you can conclude, antihypertensive medications are a class of drugs specifically formulated to lower blood pressure.
Types of Antihypertensive Drugs
Doctors may prescribe different types of hypertensive drugs to a patient. For example, they may start with diuretics first, but if the blood pressure doesn’t lower, they may opt for different medications. The table below demonstrates the most commonly prescribed medications for hypertension and their mechanisms of action.
| Type | Diuretics | Angiotensin-converting enzyme (ACE) inhibitors | Angiotensin II receptor blockers (ARBs) | Calcium channel blockers | Beta-blockers | Renin-inhibitors |
|---|---|---|---|---|---|---|
| First introduced | 1958 | 1981 | 1995 | Mid-1960s | Mid-1960s | 2007 |
| Mechanism of action | Diuretics remove excess sodium and water from the body. As a result, there’s less fluid flowing through veins/arteries, thus reducing pressure on the walls of blood vessels. | ACEs help relax blood vessels by preventing the formation of angiotensin (a chemical that narrows blood vessels). | ARBs block the activity of angiotensin. | Calcium channel blockers prevent calcium from entering the cells of the heart and arteries. This allows arteries to relax and open. | Beta-blockers block the effects of the hormone epinephrine (adrenaline). The heart beats slower and with less force as a result. | Renin-inhibitors slow the production of renin (a substance produced by the kidneys that trigger a chain of reactions that increase blood pressure). |
| Examples | Three types of diuretics are available: thiazide, loop, and potassium-sparing. Chlorothiazide (Diuril) Bumetanide (Bumex) Amiloride (Midamor) |
Enalapril (Epaned, Vasotec) Lisinopril (Zestril, Prinivil, Qbrelis) Ramipril (Altace) |
Valsartan (Diovan) Losartan (Cozaar) |
Amlodipine (Norvasc) Diltiazem (Cardizem, Tiazac) Nifedipine (Adalat CC, Procardia) Verapamil (Verelan, Calan) |
Metoprolol (Lopressor, Toprol-XL) Nadolol (Corgard) Atenolol (Tenormin) |
Aliskiren (Tekturna) |
When a patient is unable to manage blood pressure with one medication, a doctor may prescribe other drugs, too — for example, alpha-blockers, alpha-beta blockers, central-acting drugs, vasodilators, and aldosterone antagonists.
What Happens When You Mix Alcohol and Antihypertensive Drugs?
Most people mix alcohol and antihypertensive drugs due to a strong desire to drink, despite feeling unwell or knowing they shouldn’t.
First, it is important to mention that alcohol consumption increases the risk of high blood pressure. A study from PLoS One confirmed the link between alcohol intake and elevated blood pressure but also showed the effect is dose-dependent. That means the more you drink, the more you’re at risk of high blood pressure.
If you have hypertension or you’re in a high-risk group, drinking alcohol can worsen your condition. Taking medications for hypertension doesn’t mean it’s safe to drink alcohol too. Combining antihypertensive drugs with alcohol can cause a number of complications.
A study from China found that drinking alcohol with ACE inhibitors can lower the effects of these antihypertensive medications. Drinking more than 50ml of alcohol a day lowered the efficacy of the medication by 45% in terms of systolic blood pressure and 76% in terms of diastolic blood pressure.
Mixing alcohol and antihypertensive medications can lead to the following effects:
- Dizziness
- Fainting
- Drowsiness
- Arrhythmia (irregular heartbeat)
Combining alcohol and medications is common in persons with alcohol dependence. For that reason, the safest medical detox center for alcoholism in Texas can help you achieve recovery.
Effects of Mixing Alcohol With Anticonvulsant Drugs
Anticonvulsant or antiepileptic drugs are a class of medications prescribed to treat epileptic seizures. These medications do not cure epilepsy but rather prevent seizures, i.e., decrease their frequency. Epilepsy is not uncommon. The CDC reports about 1.2% of people in the US had active epilepsy in 2015.
That is about 3.4 million people (3 million adults and 470,000 children). The term active epilepsy refers to a history of doctor-diagnosed epilepsy or seizure disorder where a person is currently taking medications and has had one or more seizures in the past year.
Types of Anticonvulsants
There are different types of anticonvulsants or antiepileptic drugs. The doctor prescribes a specific medication based on a patient’s age, lifestyle, type of seizures, and frequency of seizures. For women, the choice of an anticonvulsant medication depends on the chance of pregnancy, too. We can classify anticonvulsants into two main categories: narrow-spectrum AEDs and broad-spectrum AEDs.
| Category | Narrow-spectrum AEDs | Broad-spectrum AEDs |
|---|---|---|
| Definition | Designed for specific types of seizures. They are used for seizures occurring in a specific part of the brain on a regular basis. | Designed to prevent seizures in more than one part of the brain. |
| Examples | Carbamazepine (Carbatrol, Tegretol, Epitol, Equetro) Clobazam (Onfi) Diazepam (Valium, Diastat) Divalproex (Depakote) Eslicarbamazepine acetate (Aptiom) Ethosuximide (Zarontin) Gabapentin (Neurontin, Gralise) Lacosamide (Vimpat) Methsuximide (Celontin) Oxcarbazepine (Trileptal, Oxtellar XR) Perampanel (Fycompa) Phenobarbital Phenytoin (Dilantin) Pregabalin (Lyrica) Rufinamide (Banzel) Tiagabine hydrochloride (Gabitril) Vigabatrin (Sabril) |
Clonazepam (Klonopin) Clorazepate (Tranxene-T) Ezogabine (Potiga) Felbamate (Felbatol) Lamotrigine (Lamictal) Levetiracetam (Keppra, Spritam) Lorazepam (Ativan) Primidone (Mysoline) Topiramate (Topamax) Valproic acid (Depacon) Zonisamide (Zonegran) |
What Happens When You Mix Alcohol With Anticonvulsants?
The Frontiers in Neurology published a study that showed heavy alcohol consumption is bad news for people with epilepsy, especially generalized genetic epilepsy. Heavy alcohol intake can increase the risk of seizures in these cases.
Not only does alcohol increase the likelihood of seizures, but it can also cause complications for persons who mix it with antiepileptic drugs. In fact, people who take anticonvulsants tend to be sensitive to the effects of alcohol.
Some of the most common effects of mixing the two together include:
- Alcohol may interfere with the absorption of antiepileptic drugs and make them less effective.
- Worsened adverse reaction of anticonvulsants
- Some anticonvulsants may enhance the effects of alcohol, thus leading to alcohol intoxication after drinking a small amount.
- Drowsiness
- Dizziness
- Unusual behavior and changes in mental health
Effects of Mixing Alcohol With Antibiotics
Antibiotics are a class of drugs that kill bacteria and slow their growth. These medications treat bacterial infections, not viruses. The use of these drugs is not uncommon.
Numbers show that in 2015 alone, providers in doctors’ offices, emergency departments, and other outpatient settings across the US wrote about 270 million antibiotic prescriptions. This amounts to 838 antibiotic prescriptions per 1000 people.
What Happens When You Mix Alcohol and Antibiotics?
People drink alcohol with antibiotics for several reasons. Some of them include the desire to drink despite feeling ill, forgetting about the medication before having a drink, or attending an event despite illness or medication.
However, a growing body of evidence confirms alcohol can interact with a wide range of drugs, including antibiotics.
While alcohol may not make all antibiotics less effective, it can increase the risk of side effects.
The consequences depend on the specific antibiotics a person takes alongside alcohol. The table below provides more info about this subject.
| Antibiotics that interact with alcohol | Effects of mixing with alcohol | General side effects of antibiotics | Symptoms of a negative alcohol-antibiotic reaction |
|---|---|---|---|
| Metronidazole, cefoperazone, tinidazole, cefotetan, and ketoconazole | Nausea Vomiting Stomach cramps Flushing Headache Fast heartbeat |
Nausea | Flushing (reddening and warming of your skin) |
| Griseofulvin | Excessive sweating Fast heartbeat Flushing |
Sleepiness | Racing heart rate |
| Isoniazid and linezolid | High blood pressure Liver damage |
Dizziness/lightheadedness | Severe headache |
| Doxycycline and erythromycin | Alcohol can make these antibiotics less effective. | Diarrhea | Alcohol can also make it more difficult to heal from an infection |
Effects of Mixing Alcohol With Diabetes Medications
Diabetes is a chronic or long-lasting health condition wherein blood glucose (blood sugar) levels are too high because the pancreas fails to produce insulin, or the body can’t use it properly. According to the American Diabetes Association, about 34.2 million Americans, or 10.5% of this population, had diabetes in 2018. Of these, 26.8 million cases were diagnosed, whereas 7.3 million were undiagnosed. In 2017, diabetes was the seventh leading cause of death in the United States.
Alcohol and Diabetes
Alcohol and diabetes have a complicated relationship, which we need to address before discussing the effects of mixing alcohol and diabetes medications. A study from the Diabetes and Metabolism Journal elaborated on the complex relationship between diabetes and alcohol.
The paper confirms chronic; heavy alcohol consumption is an independent risk factor for type 2 diabetes. Heavy alcohol drinking disrupts glucose homeostasis and is associated with insulin resistance.
Additionally, heavy amounts of alcohol exhibit diabetogenic effects with its contribution to excess caloric intake and obesity, induction of pancreatitis, disturbance of glucose and carbohydrate metabolism, and impairment of liver function, which affects blood glucose levels and may cause hypoglycemia (low blood sugar levels).
In other words, too much alcohol can cause blood sugar levels to drop to dangerous levels, especially in persons with type 1 diabetes. But more pronounced is the effect of alcohol on glucose intolerance and insulin resistance. Alcohol also stimulates appetite and contributes to overeating, which disrupts blood sugar control.
Heavy alcohol intake may also increase blood pressure and triglycerides, all of which can be dangerous for a person with diabetes.
What Happens When You Mix Alcohol and Diabetes Medications?
Considering the strong impact of alcohol on diabetes, it is safe to presume consequences of mixing drinking and medications for this condition can be serious as well. And they are.
The most common type of medication for type 1 diabetes is insulin. In persons with type 1 diabetes, the body is unable to produce insulin on its own. The primary objective of the treatment is to replace the insulin the body can’t make. Doctors may prescribe insulin to persons with type 2 diabetes, as well.
When alcohol is combined with insulin, the glucose-lowering effect of insulin may decrease or increase. A person may experience either hypoglycemia or hyperglycemia (high blood sugar), depending on the amount of alcohol and frequency of drinking. In other words, mixing alcohol and insulin can jeopardize blood sugar control and thereby make it difficult for a person to manage their condition.
The table below demonstrates the effects of mixing some type 2 diabetes medications with alcohol.
| Medication | Alpha-glucose inhibitors | Biguanides | Dopamine agonist | Dipeptidyl peptidase-4 (DPP-4) inhibitors | Glucagon-like peptide-1 receptor agonists (GL-1 receptor agonists) | Meglitinides | Sodium-glucose transporter (SGLT) 2 inhibitors | Sulfonylureas | Thiazolidinediones |
|---|---|---|---|---|---|---|---|---|---|
| First introduced | 1990s | 1977 | 2009 | 2006 | 2005 | 1983 | 2017 | 1956 | 1996 |
| Mechanism of action | Help the body break down starchy foods and table sugar to lower blood glucose levels. | Decrease how much sugar the liver makes. Biguanides lower the absorption of sugar in the intestines and improve insulin sensitivity. | May affect rhythms in the body and prevent insulin resistance. | Help the body continue to make insulin. They reduce blood sugar levels without causing hypoglycemia | GL-1 receptor agonists are similar to the natural hormone called incretin. They increase B-cell growth and the amount of insulin the body uses. Also, they decrease appetite, slow body emptying, and reduce the usage of glucagon. | Help body release insulin. | Prevent the kidneys from holding on to glucose. Instead, the body gets rid of glucose through urine. | Stimulate the pancreas with the help of beta cells to support the production of insulin. | Decrease glucose in the liver, help fat cells use insulin better. |
| Examples | Acarbose (Precose) Miglitol (Glyset) |
Metformin-alogliptin (Kazano) Metformin-canagliflozin (Invokamet) Metformin-dapagliflozin (Xigduo XR) etc. |
Bromocriptine (Cycloset) | Alogliptin (Nesina) Linagliptin (Tradjenta) Saxagliptin (Onglyza) Sitagliptin (Januvia) |
Albiglutide (Tanzeum) Dulaglutide (Trulicity) Exenatide (Byetta) Liraglutide (Victoza) Semaglutide (Ozempic) |
Nateglinide (Starlix) Repaglinide (Prandin) Repaglinide-metformin (Prandimet) |
Dapagliflozin (Farxiga) Canagliflozin (Invokana) Empagliflozin (Jardiance) Ertugliflozin (Steglatro) |
Glimepiride (Amaryl) Gliclazide Glipizide (Glucotrol) Glyburide (DiaBeta) Chlorpropamide (Diabinese) Tolazamide (Tolinase) Tolbutamide (Orinase) |
Rosiglitazone (Avandia) Pioglitazone (Actos) |
| Effects in combination with alcohol | Severe low blood sugar | Increased risk of low blood sugar Risky glucose imbalances Higher risk of lactic acidosis, a dangerous condition indicated by weakness, increased sleepiness, slow heart rate, muscle pain, feeling cold, stomach pain, and shortness of breath. |
Alcohol can enhance the nervous system side effects of bromocriptine, e.g., drowsiness, dizziness, and difficulty concentrating. Some people may experience impairment of thinking and judgment. | Increased risk of low blood sugar. | Severe low blood sugar or severe high blood sugar. | Severe and prolonged low blood sugar. | Increased risk of dehydration Low blood sugar |
Higher risk of hypoglycemic reactions. Chlorpropamide and others may produce a disulfiram-like reaction and cause flushing, hypotension, nausea, tachycardia, vertigo, blurred vision, and dyspnea (shortness of breath). |
Increased risk of lactic acidosis in a combination of alcohol and rosiglitazone/metformin Lower blood sugar May interfere with diabetes treatment |
To sum up, the table above, mixing alcohol and diabetes medications can lead to hyper- or hypoglycemia, both of which are serious problems for someone with conditions.
Persons who mix the two may also experience sudden changes in blood pressure, fatigue, weakness, headache, nausea, and/or vomiting.
Effects of Mixing Alcohol With CNS Depressants
Central nervous system (CNS) depressant medications such as sedatives, tranquilizers, and hypnotics slow down brain activity. They are usually prescribed to treat anxiety, panic attacks, acute stress reactions, and sleep disorders.
It’s not entirely known how many people use CNS depressants in the US. One study that focused on elderly persons found that 10.4% of this population use CNS depressant medications.
What Happens When You Mix Alcohol and CNS Depressants?
Most CNS depressants act on the brain by increasing the activity of gamma-aminobutyric acid (GABA). GABA is a neurotransmitter that inhibits brain activity.
This produces calming and drowsy effects that make CNS depressants effective for persons with sleep disorders and anxiety.
The table below demonstrates different kinds of CNS depressants that you need to know about first.
| CNS depressant | Benzodiazepines | Non-benzodiazepine sedative-hypnotics | Barbiturates |
|---|---|---|---|
| First introduced | 1960 | Early 1990s | 1903 |
| Examples | Diazepam (Valium) Clonazepam (Klonopin) Alprazolam (Xanax) Triazolam (Halcion) Estazolam (Prosom) |
Zolpidem (Ambien) Eszopiclone (Lunesta) Zaleplon (Sonata) |
Mephobarbital (Mebaral) Phenobarbital (Luminal) Phenobarbital sodium (Nembutal) |
Benzodiazepines and Alcohol
Benzodiazepines are misused and abused across the United States. Numbers show that 12.5% of adults in the US use benzodiazepines, which amounts to about 30 million people. That being said, 2.1% misused them at least once, and only 0.2% meet the criteria for benzodiazepine use disorders. This happens because benzodiazepines are rarely taken on their own. People use them in conjunction with other substances.
Mixing benzodiazepines with alcohol can be very dangerous. The most serious risks include:
- Enhanced effects of both alcohol and benzodiazepines
- Increased risk of overdose
- Significant reduction in cognitive abilities, including loss of inhibitions that can lead to accidents, impaired judgment that leads to risky decisions, significantly decreased reasoning abilities, and inability to control emotions
- Reduced physical reactions
- Higher risk of side effects
- Increased risk of developing acute conditions such as heart attack, suicidal tendencies, psychosis, seizures
- Increased risk of long-term physical conditions such as gastrointestinal issues, cardiovascular problems, liver damage, kidney damage, neurological issues
- Increased risk of mental health disorders
- Greater potential of developing an addiction to either benzodiazepine or alcohol
Non-Benzodiazepine Sedative Hypnotics
Mixing non-benzodiazepine sedative-hypnotics such as Ambien with alcohol can cause a wide range of adverse reactions. Some of them include:
- Confusion
- Dizziness
- Impaired judgment
- Loss of physical coordination
- Difficulty concentrating
- Impaired cognition
- Sleepwalking
- Sleep apnea
- Depressed breathing
Barbiturates
Combining barbiturates and alcohol can be fatal. Both alcohol and barbiturates slow down the nervous system and taking them together can also slow heart and lung functions. This effect can slow down so much the organs stop functioning. Effects of mixing these drugs are similar to those of other kinds of CNS depressants and include impaired thinking and judgment, lack of coordination, and others.
Effects of Mixing Alcohol with CNS Stimulants
The central nervous system (CNS) stimulants are drugs that stimulate brain activity. They are primarily prescribed to treat depression, attention deficit hyperactivity disorder, and narcolepsy (a sleep disorder). These medications act on dopamine levels by blocking reuptake (i.e., reabsorption of dopamine by neurons). The CNS stimulants may also block some metabolic enzymes that absorb loose dopamine. The neurotransmitter dopamine plays a vital role in reward and movement regulation.
What Happens When You Mix Alcohol with CNS Stimulants?
According to a study from the Journal of Attention Disorders, the off-label use of CNS stimulants is at least 40% of total use, and it is more common in adults. The CNS stimulants are numerous, but we can classify them into short-acting, intermediate-acting, and long-acting stimulants.
Short-acting stimulants include:
- Amphetamine/dextroamphetamine (Adderall)
- Dexmethylphenidate (Focalin)
- Methylphenidate (Ritalin)
Intermediate-acting stimulants include:
- Amphetamine sulfate (Evekeo)
- Methylphenidate (Ritalin SR)
Long-acting stimulants include:
- Amphetamine (Adzenys XR-ODT)
- Dexmethylphenidate (Focalin SR)
- Dextroamphetamine (Adderall XR)
- Lisdexamfetamine (Vyvanse)
- Methylphenidate (Concerta, Daytrana, etc.)
The table below demonstrates the effects of mixing some of these medications with alcohol.
| CNS stimulant | Adderall | Focalin | Ritalin | Vyvanse | Concerta |
|---|---|---|---|---|---|
| First introduced | 1996 | 2001 | 1954 | 2007 | 2000 |
| Effects of mixing with alcohol | Alcohol poisoning Heart problems (faster heart rate, high blood pressure, irregular heartbeat) Raised body temperature Behavioral issues (e.g., aggressiveness) |
Amplified effects of alcohol and Focalin Raised body temperature Increased heart rate Mood changes Stroke Sudden death |
Higher blood pressure Increased heart rate Faster breathing Fever Dilated pupils Sleep problems Mood problems Anxiety |
Increased blood pressure and heart activity Risk of alcohol poisoning |
Alcohol poisoning Increased risk of side effects of Concerta (nausea, headache, dry mouth, irritability, impaired concentration, dizziness, drowsiness) |
Conclusion
Alcohol wreaks havoc on a person’s health and even more so when taken in combination with different medications. This post provided a deeper insight into the effects of mixing drugs and alcohol. Make sure to follow the doctor’s instructions when taking medications and avoid drinking alcohol when using them.
References
https://www.cdc.gov/nchs/products/databriefs/db377.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3658562/
https://pubmed.ncbi.nlm.nih.gov/25214162/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174052/
https://www.ncbi.nlm.nih.gov/books/NBK539848/
https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319587.pdf
https://www.cdc.gov/bloodpressure/facts.htm
https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html
