The Dangers of Mixing Alcohol and Medications

Mixing Drugs and Alcohol

The Dangers of Mixing Alcohol and Medications

Many people know that mixing alcohol with illicit drugs or prescription drugs is risky, but drinking after taking over-the-counter medicines or supplements can also cause health problems. The side effects of mixing alcohol with other substances aren’t limited to coordination loss or drowsiness.

Combining alcohol with some illicit drugs can cause long-term organ damage, and mixing alcohol with certain prescription pills can make a person stop breathing. Even some over-the-counter supplements can cause major health problems when mixed with alcohol.

Illicit Drugs

One of the riskiest ways to drink alcohol is with illicit drugs. Drugs can worsen side effects of alcohol. They can also conceal the effects of alcohol, making people believe they’re sober. When people combine alcohol with other drugs, they’re more ly to partake in risky behaviors, such as driving under the influence.

Unfortunately, alcohol addiction commonly co-occurs with drug addiction. People addicted to multiple substances — referred to as polysubstance use disorder — may be more ly than people addicted to a single substance to experience negative consequences.


Cocaine worsens certain side effects of alcohol, such as impaired coordination, motor function and memory. Mixing alcohol and cocaine increases heart rate, causing stress on the heart.

When the substances are combined, a toxic byproduct called cocaethylene is formed, according to a medical review published in the journal Addiction.

Cocaethylene can cause significant damage to the heart and liver.


Marijuana can also increase impairment when consumed with alcohol. Some small studies have found that combining the drugs can hamper the ability to drive even more than taking either drug alone.

Other studies have found that the detriments are similar regardless of whether the drugs are combined or taken alone.

A 2015 review of these studies was published in the journal Alcoholism: Clinical & Experimental Research.


Ecstasy, also known as MDMA, can conceal the effects of alcohol when individuals consume both drugs.

A small study published in the Journal of Pharmacology and Experimental Therapeutics found that people who combined MDMA with alcohol felt they were sobering up, but they did as poorly on motor skills and other performance tests as individuals who consumed only alcohol. Another small study published in Psychopharmacology analyzed driving performance and found similar results in individuals who combined the drugs.

Medications & Pills

Many pill bottles warn that individuals taking the medication should limit or avoid alcohol intake. Most medications cause minor side effects on their own, but alcohol can amplify the effects. For example, a medication Tylenol is safe for most people in low doses. But when it’s combined with alcohol or taken in high doses, Tylenol can cause serious liver damage.


Alcohol and benzodiazepines, such as Xanax and Valium, combine to cause a synergistic effect that can make you pass out and stop breathing. A synergistic effect is when two substances are more powerful when combined than the sum of their individual effects. Side effects of mixing alcohol with Xanax include drowsiness, dizziness, memory loss, loss of consciousness and death.


Alcohol and opioids, such as oxycodone or hydrocodone, can combine to reduce respiration to the point that a person stops breathing. The illicit opioid heroin causes similar effects when combined with alcohol.

Alcohol can also make extended-release opioids release their entire dose at once, a phenomenon called dose dumping, according to a 2014 article published in Postgraduate Medicine. This increases the risk of overdose.


Drinking while on antibiotics can weaken your immune system, decreasing your ability to fight illness. Alcohol also interacts dangerously with certain antibiotics, such as Flagyl (metronidazole) and Tindamax (tinidazole), causing dizziness, anxiety, chest pain and heart problems. In some situations, mixing alcohol with antibiotics can cause organ damage.

Sleeping Pills

Combining alcohol and sleeping pills is also dangerous. Sleep aids such as Ambien, Lunesta and Sonata slow activity in the brain to help a person fall asleep. When the sleep aids are combined with alcohol, they can severely impair coordination, disrupt memory and make a person pass out.

ADHD Medications

Medications used to treat attention-deficit/hyperactivity disorder help people with ADHD concentrate. When alcohol is mixed with Adderall and similar drugs, people taking the medications therapeutically may struggle to focus. The substances can also cause heart problems and liver problems when they’re combined.

Cold & Allergy Medicines

Several ingredients in cold and allergy medications can interact dangerously with alcohol. Cough medicines that contain dextromethorphan or codeine can cause drowsiness, dizziness and overdose if taken with alcohol. Antihistamines, such as brompheniramine, chlorpheniramine or Claritin (loratadine), can cause similar symptoms when mixed with alcohol.


DayQuil contains both dextromethorphan and acetaminophen. That means mixing DayQuil and alcohol can cause liver damage, drowsiness and dizziness.


Most NyQuil products contain dextromethorphan, acetaminophen and doxylamine. The latter ingredient is used to treat cold or allergy symptoms and short-term sleep problems. Combining it with alcohol can cause extreme drowsiness, slowed breathing, impaired motor function and memory problems. Overall, taking NyQuil and alcohol is risky and should be avoided.


Mucinex products that contain guaifenesin and no other medications are unly to cause dangerous interactions with alcohol. However, some Mucinex combination products also contain dextromethorphan and acetaminophen. Mixing alcohol and Mucinex products that are designed to treat cold, flu or allergy symptoms can cause liver damage and other serious side effects.

In general, you shouldn’t drink alcohol with substances that change the way you feel.

The Centers for Disease Control and Prevention warns Americans to avoid combining alcohol and caffeinated products because caffeine can mask the effects of alcohol. As a result, people may become more impaired than they realize.

Additionally, other types of over-the-counter products or supplements may contain untested ingredients that interact dangerously with alcohol.

Energy Drinks

In addition to high amounts of caffeine, many energy drinks contain chemicals that can boost energy levels and mask the effects of alcohol, including guarana, taurine, ginseng and sugar.

This can increase the risk of reckless and dangerous behavior when a person mixes energy drinks and alcohol.

One study on mice suggested that repeated exposure to alcoholic energy drinks at a young age could increase the risk for substance abuse later in life.

Herbal Supplements

Over-the-counter supplements have become popular products for a variety of ailments. Herbal supplements claim to treat a variety of health issues, including weight gain, cosmetic issues and mood problems. Many diet pills have addictive properties and can cause a variety of health problems when combined with alcohol.

Supplements that are marketed as mood enhancers may also interact dangerously with alcohol. Some people have reported blacking out or having seizures after combining alcohol with 5-HTP, a supplement that may improve symptoms of depression.

It’s important to be cautious when you drink alcohol. Always follow instructions on medication labels. If you take any type of supplement, talk to your doctor before drinking alcohol. You should always avoid illicit drugs and other hazards. If you decide to misuse illicit drugs, it’s best not to mix multiple substances, including alcohol.

If you or someone you know is dealing with drinking problems, call an alcohol hotline. These toll-free services can help you understand the dangers of alcohol, recognize signs of alcohol addiction and locate a nearby treatment center.

Medical Disclaimer: aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes.

We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment.

It should not be used in place of the advice of your physician or other qualified healthcare provider.


Alcohol and illegal drugs

The Dangers of Mixing Alcohol and Medications

The effects of illegal drugs will always be unpredictable. Generally, when you mix them with alcohol they’re exaggerated in some way, which can result in anything from nausea to heart failure. Best advice is to completely steer clear of illegal drugs, especially with alcohol.

What happens in the body?

Alcohol is a depressant. Combine it with a stimulant, such as cocaine, and the two drugs compete with each other. The depressant drug tries to slow the brain/central nervous system down, while the stimulant tries to speed it up – putting your brain/central nervous system under great pressure.

Combine alcohol with another depressant drug, heroin for example, and the effect they each have of slowing your central nervous system will be multiplied, and you risk your body shutting down altogether.1

With no quality control in the world of illegal drugs, you can never be 100% sure of exactly what’s in the substance you’re taking. It could be cut with other cheaper drugs such as tranquilisers or even toxic substances such as drain cleaner. Add alcohol into the mix and you’ve got a potentially lethal cocktail.

If you’re under the influence of drugs, you’re less ly to make considered decisions about how much alcohol you drink. So you also put yourself at risk of alcohol poisoning and longer-term health effects of alcohol such as heart disease and cancer.

Here are some facts about individual drugs and what can happen when you mix them with alcohol.

If you use cannabis and alcohol together, the results – both physical and psychological – can be unpredictable. Having alcohol in your blood can potentially cause your body to absorb the active ingredient tetrahydrocannabinol (THC) faster. This can lead to the cannabis having a much stronger effect than it would normally have.2

Physically, you can experience dizziness, nausea and vomiting. Psychological effects include panic, anxiety or paranoia. Skunk, a term for stronger types of cannabis, can pose even greater risks, because it may contain three times as much THC.3

There’s a serious long-term risk to your health too. Cannabis is usually smoked with tobacco, which can cause cancer. Tobacco and alcohol work together to damage the cells of the body, multiplying the damage.

Alcohol makes it easier for the mouth and throat to absorb the cancer-causing chemicals in tobacco4.

Taking alcohol and cocaine together increase the risk of heart attacks and fits and even sudden death. The two drugs interact to produce a highly toxic substance in your liver called cocaethylene. It can increase the depressive effects of alcohol, making your reaction to the cocaine stronger. You’re also more ly to be aggressive with cocaethylene in your system.

Cocaethylene takes longer to get your system than either the alcohol or the cocaine, subjecting your heart and liver to a longer period of stress. Mixing alcohol and cocaine can be fatal up to 12 hours after you’ve taken it.5,6

How to stop drinking completely

It’s possible that alcohol will deaden the ‘high’ you feel from ecstasy while the drugs are in your system7. But the next day, when you ‘come down’, you’ll feel much worse if you’ve been drinking alcohol. A severe hangover is one of the milder side-effects of combining these drugs though, together they can be deadly.

Ecstasy dehydrates you. So does alcohol. You risk overheating and becoming dangerously dehydrated when you combine the two. Alcohol is involved in most ecstasy related deaths, many of which are from heatstroke after people have danced for long periods of time in hot clubs without replacing the fluids they’ve lost by drinking water.

As alcohol is a diuretic, which means it makes you go to the loo a lot and sweat more, it’s even harder to keep enough fluid in your body when you drink it while on ecstasy8. There’s also a greater strain on your liver and kidneys when you combine the two drugs. And, as with many other combinations, you’re ly to experience nausea and vomiting.

The effects of amphetamines, often called ‘speed’, are very much an adrenalin rush. When you take it, your breathing, blood pressure and heart rate speed up. ecstasy, speed can also increase your body temperature and cause dehydration – which is heightened when you add alcohol. As speed already puts pressure on your heart, if you add alcohol, that pressure can be fatal.

Alcohol can intensify your emotions and make you lose your inhibitions. So can speed. Combine the two and you may end up behaving in a way you seriously regret.

Under the influence of speed you may feel more confident or energised, but you can easily become anxious, paranoid or aggressive, particularly when you put alcohol in the mix.9 You don’t feel the full effects of alcohol until the speed has worn off. Mixing the two means you can drink dangerous amounts without realising.

How to spot your triggers

Alcohol with heroin is one of the most dangerous combinations of drugs. ‘Downers’ heroin slow down your heart rate and breathing. When combined with another ‘downer’ such as alcohol you’re basically doubling up and putting yourself at risk of overdosing.

Even small amounts of alcohol seem to lower the amount of heroin needed to fatally overdose.

Around three quarters of people who die from heroin overdoses have drunk alcohol10.

Previously known as ‘legal highs’, drugs such as meow meow actually became illegal in 2010 when they were classified as class B drugs.

A powerful stimulant, these drugs can over stimulate circulation, damaging the heart, speed up the nervous system and cause fits. They can also make you anxious and paranoid.

As with any drug that gives a ‘high’, combine them with alcohol and you’re at risk of everything from nausea and vomiting to coma and death.11,12

More information

For more information on drugs, contact the National Drugs Helpline – Talk to Frank — 0300 1236600.

If you are concerned that you or someone you care about has a problem with alcohol there is a lot of help available. Here you can find useful links and phone numbers to get the support you need.

Support services


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