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The Dangers of Mixing Prescription Drugs and Alcohol

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Prescription drugs are helpful to people with a variety of medical conditions. However, some of these drugs are frequently misused by people who take higher or more frequent doses than prescribed or take them without a prescription to get high. They may also mix the prescription drug with other substances, such as alcohol. For people who misuse or abuse prescription drugs, about 12% meet the criteria for a substance use disorder, or drug addiction.1

The misuse of prescription drugs is common, with about 20% of people in the United States over the age of 12 admitting to nonmedical prescription drug abuse. In 2014, around 2.1 million people misused a prescription drug for the first time.2

People who misuse these drugs often experience adverse consequences, with 1.2 million people receiving treatment in emergency rooms in 2011 for prescription drug related issues.3 Combining prescription drugs with alcohol can have harmful consequences, potentially resulting in overdose and other medical health issues, as well as increasing the likelihood of addiction development. Should a person become addicted to drugs and alcohol, there are several types of treatment available.

Prescription Drug Overview

There are several classes of prescription drugs, but only a few are actively abused. These categories are:1,6

  • Opioids: These medications are painkillers. Common name brands include Vicodin, Percocet, and OxyContin.
  • Sedative-hypnotic-anxiolytics: This is a broad category that includes several types of medications that function as central nervous system (CNS) depressants. Benzodiazepines, such as Xanax and Klonopin, are a type of drug in this category; they are prescribed to manage anxiety and panic disorders. Another kind includes sleep aids, such as Ambien, Lunesta, and Sonata. A third type is barbiturates, which are mainly prescribed to control seizures, but have but have other medical uses as well. Prescription barbiturate drugs include phenobarbital (Luminal) and butalbital (Fiorinal).
  • Prescription stimulants: These are commonly prescribed to help people manage symptoms of attention-deficit hyperactivity disorder (ADHD). In some cases, doctors will prescribe stimulants to help people who suffer from narcolepsy, a sleep disorder. Common brand names include Adderall, Ritalin, and Concerta.

All of these medications are federally controlled substances due to their potential for diversion and abuse. Using any of the above mentioned prescription drugs in a way other than prescribed, such as combining them with alcohol, can have detrimental and even fatal effects.

Combining Alcohol & Drugs

It is incredibly dangerous to mix any prescription drug with alcohol or any type of drug. Like opioids and sedatives, alcohol depresses certain brain functions. If a person is taking opioids or sedatives and then adds alcohol, the combination can suppress their central nervous system so much that they can stop breathing, lapse into a coma, or die.4 When combined with alcohol, stimulants can mask the effects of the alcohol so that the user doesn’t feel the sedation or intoxication and wind up drinking to excess.7

Before combining drugs of any kind, including over-the-counter medications or alcohol, you should consult your physician, as drugs and alcohol can interact in unanticipated ways.4

Opioids & Alcohol

When abusing opioids, a person’s heart rate and breathing slow down and, in the event of an overdose, can stop completely. If a person uses alcohol and opioids together, there is a high risk of overdose and possibly death.4

Even when these substances are abused separately, they can produce serious side effects. For example, opioids may cause the following:5,8

  • Severe constipation.
  • Constriction of the pupils, which causes visual problems.
  • Possible erectile dysfunction in men.
  • Menstrual irregularities in women.
  • Intranasal effects, such as nasal bleeding or perforated nasal septum.
  • Intravenous effects, such as collapsed veins, abscesses, and contraction of HIV or hepatitis.
  • Damage to vital organs due to blood vessels clogged by additives.
  • Kidney disease. 

Further, there are many dangers associated with abusing alcohol, including:5,9

  • Cirrhosis and other liver disorders.
  • Cardiac problems, including hypertension and myopathy.
  • Stroke.
  • Pancreatitits.
  • Increased risk of cancer, especially of the throat, mouth, esophagus, and stomach.
  • Immune system dysfunction.

The most severe risk of combining opioids and alcohol is the lowered overdose threshold and likely consequences of overdose, such as loss of consciousness and possible damage to the brain and other organs caused by lack of oxygen.5

Sedative-Hypnotic-Anxiolytics & Alcohol

Sedative-hypnotic-anxiolytics also depress the central nervous system, causing sedation. This category of prescription drugs can be deadly when taken with alcohol, as their combined effects can more quickly lead to reduced cardiac and respiratory functioning. The combination of one or many of these drugs with alcohol can lead to overdose and death.4 

In addition to this risk of lethal overdose, there are several other serious health consequences related to mixing alcohol and sedatives, which include:5

  • Problems with cognitive functioning, especially in older adults.
  • Increased risk of falls and subsequent injury, particularly among older people.
  • Lowered inhibitions and increased aggression, which can result in social or legal problems.

Prescription Stimulants & Alcohol

Unlike opioids and sedative-hypnotic-anxiolytics, prescription stimulants, such as Adderall or Ritalin, increase the activity of the central nervous system. These stimulants also hide the intoxicating effects of alcohol, which may lead people to drink more than they’d intended.4 This increases the risk of experiencing alcohol poisoning or overdose. 

Prescription stimulant and alcohol abuse can have serious ramifications, including:5,7,10

  • Myocardial infarction, or heart attack.
  • Hypertension.
  • Increased heart rate.
  • Greater amount of stress on the heart and brain.
  • Increased risk of cancer.
  • Disruptions of memory and learning.
  • Impaired blood flow to the brain.
  • Depleted neurotransmitters, or chemical messengers in the brain.

If you or someone you know abuses alcohol and prescription drugs, comprehensive treatment is available. It’s never too late to get clean.

Drug Abuse Treatment Options

Treatment helps many people recover from a drug and/or alcohol addiction. Treatment can help a person understand and address the issues that led to drug abuse in the first place and rectify maladaptive patterns in order to promote long-term sobriety. If you’re seeking drug abuse treatment but are unsure how to proceed, you may want to first receive a comprehensive evaluation from your doctor. They can then refer you to the appropriate level of care for your specific needs.

Treatment can occur in two types of settings: inpatient and outpatient. Inpatient programs provide around-the-clock support and medical monitoring for addiction treatment. For people addicted to multiple drugs or for those who have other medical or psychological conditions that require integrated treatment, inpatient treatment is often necessary. For example, withdrawal from alcohol or benzodiazepines often requires inpatient treatment in order to monitor a person for serious medical complications, like seizures.

Outpatient treatment is a less intensive type of recovery program in which people receive counseling and medical oversight during the day but return home at night. This option is helpful for those who wish to continue working or attending school while recovering from an addiction. It is also useful as step-down treatment after completing an inpatient program.

After a person completes an inpatient or outpatient treatment program, it is imperative to follow up with aftercare treatment to help maintain sobriety. It is easy to slip back into active addiction without ongoing support for recovery. Many people attend aftercare services for weeks or months after treatment ends, while some people attend for life. Some examples of aftercare include regular attendance of 12-Step meetings, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), or follow-up appointments with your counselor or therapist.


  1. National Institute on Drug Abuse. (2016). Misuse of Prescription Drugs.
  2. National Institute on Drug Abuse. (2016). What is the Scope of Prescription Drug Misuse?
  3. National Institute on Drug Abuse. (2016). How Many People Suffer Adverse Health Consequences from Misuse of Prescription Drugs?
  4. National Institute on Drug Abuse. (2016). Is it Safe to Use Prescription Drugs in Combination with Other Medications?
  5. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of of Mental Disorders (DSM-5). Arlington, VA: American Psychiatric Publishing.
  6. National Institute on Drug Abuse. (2018). Which classes of prescription drugs are commonly misused?
  7. Althobaiti, Y.S. & Sari, Y. (2016). Alcohol Interactions with Psychostimulants: An Overview of Animal and Human Studies. Journal of addiction research and therapy, 7(3), 281.
  8. National Institute on Drug Abuse. (2018). Heroin.
  9. National Institute on Alcohol Abuse and Alcoholism. (n.d.) Alcohol’s Effects on the Body.
  10. Jiao, X., Velez, S., Ringstad, J., Eyma, V., Miller, D., & Bleiberg, M. (2009). Myocardial Infarction Associated with Adderall XR and Alcohol Use in a Young Man. Journal of the American Board of Family Medicine, 22 (2), 197-201.

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