What Happens If You Mix Alcohol And Drugs?

October 21, 2022

ambien withdrawal headache

Combining prescription medications or recreational drugs with alcohol can trigger unwanted and unpredictable consequences. 

Additionally, mixing alcohol with recreational drugs can increase the chance of physical dependence developing.

Alcohol is the most abused intoxicant in the United States. As such, alcohol is often likely to be mixed with prescription medications or illicit narcotics. A highly reactive substance, alcohol impacts various bodily systems, reacting with other substances it encounters. 

In some cases (like with many opioid-based drugs) alcohol intensifies the effects of the other substance, often to dangerous levels. In other cases – like with many prescription medications – alcohol either completely or partially negates the effects of the other substance. There are also substances like cocaine which creates new outcomes when mixed with alcohol. 

Many potential interactions between alcohol and recreational drugs are dangerous. You should avoid mixing alcohol with any other substances without first consulting your physician. 

Today’s guide highlights what to expect when you mix alcohol with:

  • Marijuana
  • Cocaine
  • Ecstasy

What Happens When You Mix Alcohol and Marijuana?

Many people use alcohol and marijuana together. 

Both of these substances trigger similar physical and psychological effects, including:

  • Impaired judgment
  • Altered perception of time
  • Drowsiness
  • Dulled reflexes
  • Loss of coordination

Combining alcohol and marijuana can magnify the effects of both substances, causing potential adverse reactions. This combination of substances can also prompt people to engage in risky behaviors with potentially damaging outcomes. 

Not everyone will react in the same way to alcohol, marijuana, or a combination of these substances. Many variables can impact your personal response.

At present, research on the long-term consequences of combining alcohol and marijuana is limited. As more states begin legalizing the use of marijuana, also known as weed or cannabis, the body of research is liable to grow. 

The following established outcomes could result from mixing alcohol and weed:

  • More intense effects of THC
  • Amplified side effects
  • Impaired judgment
  • Accelerated physical dependence
  • Increased overdose potential
  • Long-term effects

More intense effects of THC

Mixing alcohol with any other drug causes that drug to remain in your system for longer than it otherwise would. This occurs because alcohol is first metabolized by the liver.

The liver operates on a system of priority when metabolizing alcohol and other substances taken at the same time. The liver is able to process 1oz of pure alcohol per hour. This translates to one standard drink

If you combine alcohol and weed, THC levels will remain unchanged until the alcohol is metabolized. THC (tetrahydrocannabinol) is the primary psychoactive component in marijuana.

Amplified side effects

When you use alcohol in combination with any other prescription medication or recreational drug, the side effects associated with the other substance will be intensified. 

The side effects triggered by using marijuana can include: 

  • Anxiety
  • Depression
  • Drowsiness
  • Lightheadedness
  • Fatigue
  • Paranoia

If you mix alcohol with marijuana, this can increase the likelihood of negative outcomes and also raise the risk of allergic reactions.

Impaired judgment

Both alcohol and marijuana can impair your ability to think rationally. The synergistic effects of combining the substances can increase the potential for:

  • Acting impulsively
  • Poor judgment
  • Risky or dangerous behaviors
  • Accidents
  • Memory loss
  • Blackouts
  • Cognitive problems

Accelerated physical dependence

Abusing alcohol can lead to the development of physical dependence. When this occurs, you require alcohol to function normally and experience adverse withdrawal symptoms in its absence.

The chronic use of marijuana can result in the manifestation of withdrawal symptoms if you discontinue use.

Combining these substances can inflame issues of dependence on either substance and can bring about complications during detox and withdrawal.

Increased overdose potential

If you use alcohol in combination with any other addictive substance, this increases the risk of overdose on either substance.

While overdosing on THC can be intensely unpleasant and psychologically disturbing, alcohol overdose, otherwise known as alcohol poisoning, is much more damaging and possibly deadly. 

Long-term effects

The chronic abuse of alcohol can increase the risk of developing: 

  • Cardiovascular issues
  • Kidney disease
  • Liver disease
  • Gastrointestinal issues
  • Certain cancers
  • Compromised immune system

By simultaneously abusing marijuana, you may inflame the above outcomes.

Additionally, the chronic use of alcohol or marijuana is associated with an increased risk of mental health disorders like anxiety or depression. Combining the substances magnifies this risk.

What Happens When You Mix Alcohol and Cocaine?

Mixing alcohol and cocaine is one among the most common forms of polysubstance abuse.

Using cocaine, whether in powdered form or freebase form (crack), triggers stimulant effects and the following side effects:

  • Intense euphoria
  • Increased alertness and energy levels
  • High blood pressure
  • Heart palpitations
  • Constricted blood vessels
  • Appetite loss
  • Increased body temperature
  • Increased risk-taking behaviors
  • Anxiety
  • Irritability
  • Aggression
  • Restlessness
  • Paranoia
  • Insomnia
  • Cravings for cocaine

Alcohol is a CNS depressant and brings about opposing effects to those triggered by stimulant drugs. These include:

  • Slow speech
  • Blurred vision
  • Slowed reaction times
  • Dulled reflexes
  • Loss of motor control
  • Impaired judgment
  • Reduced inhibitions
  • Memory loss
  • Blackouts
  • Confusion
  • Anxiety
  • Depression
  • Fatigue
  • Sleepiness
  • Slow heart rate
  • Lower blood pressure levels
  • Slow breathing rate
  • Excessive sweating
  • Nausea
  • Vomiting
  • Dehydration

As with most cases of polysubstance abuse, the combination of alcohol and cocaine is likely to ratchet up the intensity of side effects from either substance.

In the case of mixing alcohol and cocaine, though, there is a much more serious problem that can occur when the substances are metabolized in the liver. This mixture results in the production of cocaethylene, a toxic by-product that can accumulate in the body, straining the liver and other major organ systems, in particular the cardiovascular system.

The production of cocaethylene also temporarily intensifies the high associated with both alcohol and cocaine. This enhanced euphoria also triggers:

  • Increased blood pressure
  • Aggressive thoughts
  • Violent thoughts
  • Poor judgment

If cocaethylene builds up to toxic levels in your liver, this can be fatal. Potential consequences include:

  •  Heart attack with heart pain
  • Cerebral infarction (death of blood vessels)
  • Brain damage
  • Stroke
  • Aneurysm
  • Intracranial hemorrhage
  • Cardiomyopathy (heart disease)
  • Cardiac arrhythmia

Heavy drinking and alcohol use disorder can both cause liver failure, a process that is accelerated when cocaine is introduced to the mix.

This study shows that combining alcohol and cocaine can increase the risk of suicidal outcomes.

Some other side effects associated with combining these substances are:

  • Breathing problems
  • Increased blood pressure levels
  • Cognitive impairment
  • Heart palpitations
  • Loss of coordination
  • Impaired motor function
  • Increased heart rate
  • Loss of inhibitions
  • Risky behaviors

What Happens When You Mix Alcohol and Ecstasy?

Mixing alcohol with ecstasy (MDMA) can prompt an array of physical and psychological consequences. Combining club drugs with alcohol can magnify the side effects of both substances and increase the risk of dangerous and life-threatening outcomes.

MDMA is a synthetic drug known chemically as 3, 4-methylenedioxymethamphetamine and informally as ecstasy. Ecstasy can be found in liquid or powdered form, but is most commonly encountered pressed into pill form. 

MDMA has hallucinogenic and stimulant effects. These effects set in within 30 to 45 minutes. Although the primary positive effect of ecstasy is euphoria and an increased sense of wellness, not all this drug’s effects are as positive. Adverse outcomes associated with using ecstasy include:

  • Faintness
  • Chills
  • Nausea
  • Clenching teeth or jaw
  • Blurred vision
  • Increased body temperature
  • Muscle tension
  • Sweating
  • Rapid breathing
  • Increased heart rate
  • Hypertension
  • Heat exhaustion
  • Anxiety
  • Hallucinations
  • Paranoia

Most people use ecstasy in environments like nightclubs or festivals where it is commonplace to dance for hours in extreme heat. As such, use of MDMA is associated with both heat stroke and hyperthermia.

As well as the short-term adverse effects outlined above, using ecstasy can trigger these long-term effects:

  • Confusion
  • Memory loss
  • Depression
  • Anxiety
  • Insomnia

Alcohol is the most common substance abused with ecstasy, according to this study.

Taking ecstasy and drinking alcohol can raise the risk of hyperthermia. This risk is further inflamed if you drink insufficient fluids and engage in vigorous exercise like dancing.

Both alcohol and ecstasy are linked to an increased risk of rhabdomyolysis (breakdown of muscle tissue). The risk is enhanced when you combine these substances and can result in severe kidney damage or death if not immediately treated.

The sustained use of ecstasy can cause abnormally large serotonin release in the brain, as well as a depletion of serotonin when the ecstasy high subsides. This often brings about episodes of depression or sadness that can persist for weeks or even months.

Chronic alcohol abuse heightens the risk of depression, in addition to triggering complications with employment, interpersonal relationships, and finances. Research shows that those diagnosed with alcohol use disorder (the clinical descriptor for alcoholism) are at increased risk of experiencing major depressive disorder, even after quitting alcohol.

Get Help for Drug and Alcohol Addiction at Gratitude Lodge

If you are ready to commit to recovery from drug addiction or alcoholism, begin your journey at Gratitude Lodge. We have affordable luxury rehab centers located in San Diego, Newport Beach, and Long Beach, all offering a pet-friendly and distraction-free environment for recovery from addiction.

All Gratitude Lodges offer access to the following services:

  • Medically-assisted detox
  • Intensive outpatient treatment
  • 30-day residential rehab

Both alcohol use disorder and opioid use disorder respond positively to MAT (medication-assisted treatment). Medications can streamline withdrawal and encourage ongoing abstinence. Additionally, you can access these interventions during addiction treatment at Gratitude Lodge:

  • 12-step immersion program
  • Daily meetings
  • Group therapy
  • Family therapy
  • Individual counseling
  • Psychotherapy (talk therapies like CBT or DBT)
  • Holistic therapies

Reach out to the friendly team today for immediate assistance with drug or alcohol addiction. Call admissions at 888-861-1658.


Help for you or a loved one is only one call away.


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Jenni Bussi

Jenni Busse

Jenni Busse MS, LPSS is the Clinical Director at Gratitude Lodge. Jenni oversees the clinical program and the clinical team at Gratitude Lodge as a whole. Jenni has worked in treatment for almost 14 years. Her background as a licensed therapist and her passion for helping others intersected with addiction recovery when she started working primarily in detox residential treatment.
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Joseph Gilmore

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