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Home / Alcohol & Other Drugs / Overdose Prevention / Common Alcohol & Drug Combinations

Common Alcohol & Drug Combinations

Alcohol and Energy Drinks/Caffeine:

When using Red Bull or Monster as a mixer or drinking pre-mixed drinks like Four Loko or
Sparks, you are tricking your body into thinking it’s not tired. Your body is more intoxicated than
you may feel, which can lead to alcohol poisoning. Energy drinks also increase dehydration
which leads to hangovers the next day. Those who consumed both alcohol and caffeine were at
least two times as likely -- compared to those drinking alcohol without caffeine -- to be hurt,
need medical attention, take sexual advantage of another, or accept a ride with someone who
was inebriated.

Alcohol and Adderall:

Adderall causes one to feel like they are not as drunk as they really are. This can lead to making
very dangerous decisions since you are unaware of your level of intoxication. Because alcohol
is a depressant and Adderall is a stimulant, drinking alcohol while taking Adderall can cause
cardiac arrhythmias, and paranoid or psychotic reactions, on top of the risks of vomiting,
dizziness, muscle twitching and headaches that are more likely to increase when mixed with
When prescribed Adderall, patients are advised not to drink alcohol. The side-effects could be
much more dangerous for students using Adderall without a prescription.

Alcohol and Painkillers:

Includes: Vicodin, Xanax, Oxycontin, Percocet, Demerol, Norco, etc.

Mixing painkillers with alcohol is dangerous. The mixture of these two substances can lead to
intensified sedative effects and respiratory depression. Painkillers can lead to liver problems
and disease when used recreationally, the mixture of this drug with alcohol can intensify these

Alcohol and Marijuana:

Mixing these two substances can cause heavy vomiting, spins, very strong paranoia, decreased
motor control and decreased mental concentration. Also, because marijuana suppresses the
gag reflex, you may not be able to throw up alcohol when your body

needs to.

Alcohol and Cocaine:

These two substances are commonly mixed with the thought that they cancel each other out;
this is NOT TRUE. Combining cocaine and alcohol produces a high amount of a third unique
substance, called cocaethylene. A high amount of cocaethylene in the body increases the
already harmful risk of cardiovascular toxic
ity to a much higher extent than any other drug. Cardiovascular toxicity causes pressure and
stress on the heart.

Alcohol and Heroin:

Each of these substances alone causes depression of the central nervous system, so the
mixture of the two is extremely dangerous and has been proven to be fatal.

Alcohol and Ecstasy:

It is very well known that one should never mix ecstasy with any other drug substance,
especially alcohol. It is known that most ecstasy related deaths have been due to the mixture of
alcohol with the drug. When the two are mixed the alcohol reduces the feeling of the ecstasy’s
high and puts a much greater strain on the kidneys. Also, dehydration caused by drinking
alcohol occurs more rapidly when on ecstasy.

Alcohol and LSD/Acid:

Alcohol is mixed with LSD to take down or slow down the effects and relax. However, more
commonly combining alcohol can make the comedown of the drug much worse with extreme
nausea and vomiting.

Alcohol and Mushrooms:

Mushrooms or "Shrooms" are a psychedelic and are not meant to ever be taken with any other
drugs. The mixture of alcohol and shrooms is usually to help take away the

effect and high of the shrooms because alcohol is a depressant. However, the intended
outcome is not a guarantee and side-effects include nausea and vomiting.

Alcohol and Amphetamines:

Amphetamines alone are very risky because of the strain on the heart and the increase in blood
pressure. When mixing alcohol with amphetamines side-effects can become much more
serious. Consuming alcohol while taking amphetamines can make someone act very aggressive
and irresponsible; it is extremely harmful to the kidneys and intensifies hangover effects.
Alcohol and Antibiotics:

It is important to always read the labels on prescription medications and adhere to the warnings
about alcohol intake. Drinking alcohol while on antibiotics can cause nausea, dizziness,
vomiting, fatigue and in some cases convulsions, immense headache, flushing, rapid heart rate
and shortness of breath. Since antibiotics and alcohol are both broken down through the liver
the combination of these substances can result in liver damage. This combination also
diminishes the effects of the antibiotics you are taking. Try to focus on getting healthy again.
You’ll probably enjoy drinking more once you’re healthy anyway.

Alcohol and Antidepressants:

Combining alcohol with antidepressants (Zoloft, Prozac, etc.) can cause an increased response
to alcohol -- For example, having one drink might feel like two. Also, the combination might
create unexpected emotions and inhibit the antidepressant from doing what it's supposed to do.
If it is a new prescription, try it out without drinking alcohol so you are familiar with your body's
reaction first and then consult your doctor if any problems occur.
Alcohol and Antihistamines:

Drinking alcohol while taking antihistamines can cause a less effective outcome of the
medication. Your body will choose to metabolize the alcohol before the antihistamines. Labels
typically suggest you stay away from alcohol all together when on antihistamines so it is very
important to always check any label on the drug.

Alcohol and Birth Control Pills:

Birth control pills take three full hours to get into your blood stream and be effective. If you vomit
due to drinking or any other causes before that three hour window, the effectiveness of birth
control pills is diminished. Mixing alcohol and birth control can make some people feel
nauseous, which can cause vomiting.

Also, some women feel drunk quicker when on the pill since their bodies are metabolizing the
hormones of the pill making it more difficult to metabolize the ethanol in alcohol. Plus, drinking
can interfere with remembering to take your pill at the same time, which also increases the
chances of pregnancy.

Home Facts Health Effects of Alcohol Alcohol and illegal drugs
Alcohol and illegaldrugs
Mixing alcohol with illegal drugs can be very dangerous. Get the facts about alcohol and drugs.

What happens in the body?

Alcohol and marijuana
Alcohol and cocaine
Alcohol and ecstasy
Alcohol and amphetamines
Alcohol and heroin
Alcohol and ‘legal highs’
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

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 likely 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.

Alcohol and marijuana (cannabis)

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.

Alcohol and cocaine

A common but particularly dangerous partnership, 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 likely to be aggressive
with cocaethylene in your system.

Cocaethylene takes longer to get out of 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

Alcohol and ecstasy (MDMA)

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 likely to experience nausea and vomiting.

Alcohol and amphetamines

The effects of amphetamines, often called ‘speed’, are very much like an adrenalin rush. When
you take it, your breathing, blood pressure and heart rate speed up. Like 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.

Alcohol and heroin

Alcohol with heroin is one of the most dangerous combinations of drugs. ‘Downers’ like 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.

The National Treatment Agency for Substance Misuse says that 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.

Alcohol and ‘legal highs’

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, drugs such as meow meow
are part of the cathinone family, a group of drugs that are closely related to the amphetamines.
They’re derived from the plant khat, commonly used as a stimulant in East Africa and have
similar effects to ecstasy and speed.

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