What Happens When You Mix Alcohol With Other Drugs?

Alcohol is one of the most pervasive compounds throughout the world. Save a select few countries, most of the world has accepted this as the mind-altering substance of choice, and global usage of this substance reflects this societal acceptance.

What happens when users mix this legal drug with other, more fringe substances? There are currently 882 million adults in the world that display episodic alcohol abuse; couple that with the 37.7 million habitual amphetamine users, 18.1 million opioid users and 17.1 million cocaine users, and the potential to mix drugs and alcohol becomes a real threat to society. So let's dive into what makes a drug, what these drugs do and how they interact with alcohol in our bodies.

What Is A Drug?

In looking at the effects of mixing alcohol with other drugs, we have to first clarify just exactly what drugs. According to Merriam Webster's dictionary, a drug is, "a substance used as a medication or in the preparation of medication", "a substance other than food intended to affect the structure or function of the body" and "something and often an illegal substance that causes addiction, habituation or a marked change in consciousness". Often times instead of referring to the literal definition, we use "drugs" in a cultural context to describe illicit compounds and forget that most mind-altering substances are by definition considered drugs. This means caffeine, tobacco and yes, even the world's favorite: alcohol, are all considered "drugs" in some form or another.

Why do we bring this up? It's because one must remember that when one mixes alcohol with other drugs, one is mixing two drugs together. Many are quick to write off the dangers of alcohol, and thus they overlook the dangers of mixing it with other substances. So make no mistake, alcohol is a drug, and mixing it with other substances significantly amplifies the dangers inherent in both substances.

What Are The Chemical Effects Of Alcohol?

To understand the effects of mixing alcohol with drugs, we have to first understand how alcohol affects our bodies. Alcohol increases the amount of norepinephrine and dopamine in the brain; the dopamine produces those "happy" feelings that accompany alcohol while the norepinephrine gives rise to the rowdiness and energy spike that so many people experience from the substance. Alcohol also increases the concentration of GABA in the brain, which is an inhibitory neurotransmitter that ensures the brain's various systems don't fire too rapidly or frequently. Alcohol also has a notorious impact on the formation of memories, in large part because alcohol interferes with N-Methyl-D- aspartic acid (NMDA), which is heavily involved in the memory creation process.

What Are The Physiological Effects Of Alcohol?

Glucose is the brain's preferred source of energy. A recent study showed that alcohol led to a decrease in brain glucose consumption in both the prefrontal and temporal cortexes. These areas are responsible for regulating aggressive behavior, generating rational thoughts and facilitating decision-making. The increased concentration of GABA in the brain causes nearly everything, from electrical signals throughout the brain to respiration rate to physical movements, to slow down. Hence one of the biggest reasons alcohol is considered a depressant.

What Happens When We Combine Drugs?

When users combine drugs, their brains are fighting an uphill battle to deal with the sharp increase in chemicals. Sometimes the effects of both compounds are accentuated and can lead to far greater intoxication than anticipated. Different substances can also cause what's called a "negative interaction" which is a hazardous interaction between alcohol and other drugs.

To better understand what a negative interaction is, let's take a look at kava, a substance used to enhance calm and relaxation which derives its main ingredient from a plant in the Pacific Islands. Kava and alcohol produce a "negative interaction" because they compete for similar pathways in the liver. The liver uses the enzyme CYP 2E1 to break down both kava and alcohol. When alcohol and kava compete in the body, the liver cannot produce enough CYP 2E1 to break both down simultaneously, and thus some of the substances pass through the liver unprocessed, which can have very toxic and serious consequences.

Mixing Alcohol With Benzodiazepines

How Do Benzodiazepines Work?

Benzodiazepines (a.k.a. "benzos") are a class of drugs prescribed to treat things like Generalized Anxiety Disorder. They're thought to help calm patients down, and with the rise in anxiety diagnoses, benzodiazepine prescriptions and usage are skyrocketing.

Benzos are prescribed to treat anxiety because they act to increase the overall GABA concentration in the brain, a neurotransmitter that inhibits the brain's circuitry from over-firing, which is one of the causes believed to underlie the condition.

Benzos' effects are mainly seen in the Central Nervous System (CNS) which consists of the brain and spinal cord. The CNS handles our thoughts, emotions, heart rate, breathing, body temperature, and other vital functions.

Mixing Benzodiazepines With Alcohol

Many individuals who suffer from anxiety combine benzos with alcohol to get the strongest anxiolytic (anti-anxiety) effects they can, as both are known to reduce anxiety and lower inhibitions. Mixing benzos with alcohol decreases the effects of glutamate, a vital neurotransmitter that contributes to respiratory function. The effect of benzos on GABA combine with alcohol's effects on GABA lead to significantly elevated brain concentrations of GABA, leading to potentially life-threatening sedation of the brain's electrical circuitry. Benzodiazepines are still relatively new on the pharmacological stage. Due to the nature of the drug, combining it with alcohol significantly increases the potential for respiratory distress or failure. To highlight how dangerous this mixture is, nearly 30% of alcohol-related deaths involve benzodiazepines. Users would be wise to stay away from mixing these two.

Mixing Alcohol With Marijuana

What Are The Effects Of Marijuana On The Brain?

Marijuana acts on the brain's endocannabinoid system, which plays a critical role in the body's Central Nervous System. Marijuana also stimulates the release of dopamine in the brain, hence the "high" feeling. One of the things that makes marijuana so useful in cancer treatment is its antiemetic effect, which means it makes it harder for patients to vomit and enables patients undergoing chemotherapy to better keep their food down. If used properly, marijuana's antiemetic effect is truly therapeutic for patients undergoing treatments. But when mixed with alcohol, marijuana's antiemetic effect is also is what makes the combination of alcohol and cannabis so dangerous.

What Happens When You Mix Alcohol And Marijuana?

The presence of alcohol in the blood can lead to more rapid absorption of THC in the body, meaning it hits users "all at once", and combining the two substances can cause panic, anxiety, and paranoia. Marijuana has a negative effect on the brain's ability to make memories, which is largely due to marijuana's disruptive effects on the brain's memory center, the hippocampus. Combine marijuana's effects on memory with alcohol's propensity to erode decision-making and you have a concoction that will cloud users' judgment and make them far more susceptible to dangerous situations and risky behavior.

However, marijuana's antiemetic effect poses the greatest risk to users who combine the two substances. When users ingest marijuana before or during alcohol consumption, they are more likely to drink excessively than they would be without it. The body's normal reaction to excessive alcohol consumption is to vomit, but marijuana's antiemetic properties make users less able to vomit and expel the dangerously high concentration of alcohol in their system. This can lead to alcohol poisoning and potentially if the patient doesn't receive rapid and proper treatment, fatal consequences.

Mixing Alcohol With Opioids

How Do Opioids Work?

The United States is battling an opioid epidemic across the nation, and it is not the first nation to do so. Opioids have plagued societies time and again, and they are some of the most addictive medicines on the market today.

Opioids work by binding to opioid receptors in the brain and blocking any pain signals that come across them. However, this can also stop electrical signals throughout the brain, including signals that carry information about vital organs like the heart and lungs. And this is what makes opioids so dangerous. Their ability to block vital functions in the human body have led them to be some of the most dangerous and deadly pharmaceutical compounds ever synthesized by chemists to date.

The Opioid and Alcohol Combination

Combining alcohol and opioids can lead to significant respiratory distress. Both compounds are depressants, and both decrease the rate of respiration in patients. In fact, one study showed that a moderate dose of opioids combined with a moderate level of alcohol consumption lowered respiration rates by almost 50 %. Furthermore, opioids decrease signals sent to the diaphragm, which is responsible for the contraction of the lungs. Add to the equation that opioids decrease the body's ability to monitor for carbon dioxide buildup and you have an extraordinarily dangerous combination that can lead to fatal side-effects rather quickly.

This combination is lethal even amongst patients using prescription opioids as directed by their physician. If you take prescription opioids, avoid mixing them with alcohol regardless of the dosage. If you do mix them and begin to feel things like decreased respiration rates and have a harder time breathing, its time to call a hospital and seek immediate medical treatment.

Mixing Alcohol With Amphetamines

Speed's Affect On The Brain

Amphetamines are some of the most popular drugs in the world today, and the rise of amphetamine ADHD treatments such as Adderall and Ritalin significantly increase the prevalence and accessibility of the substance. Whether obtaining it through illegal channels or getting a prescription from your doctor, it is crucial that users understand the dangers of mixing alcohol with amphetamines.

Amphetamine is a stimulant, which means it increases heart rate and blood pressure. Amphetamines stimulate the release of dopamine and norepinephrine in the brain and then further act to decrease their reuptake. The result is a brain flooded with dopamine and norepinephrine, which is how alcohol affects the brain, too.

What Happens When You Mix Alcohol With Amphetamines?

Because alcohol and amphetamines both increase the release of dopamine and norepinephrine, and because amphetamines decrease the recycling of these chemicals, mixing alcohol and amphetamines leads to extremely higher-than-normal levels of dopamine and norepinephrine in the brain. This can lead users to make poor decisions or get involved in violent confrontations.

Amphetamines also delay the sedative effects of alcohol. Because it takes longer for people to feel the effects of alcohol consumption, they potentially drink far more than they would otherwise, only to get hit with the full consequences of their consumption hours later. Alcohol and amphetamines also compete for the same liver enzyme in the body. This puts a huge strain on your liver and if both substances are consumed at high quantities, the liver must at times "pick" which of the two substances it chooses to process, leading to toxic consequences for users. Users who combine alcohol and amphetamines face potentially lethal consequences including increased blood pressure, arrhythmia, accelerated heart rate and increased chance of heart attack or stroke.

Mixing Alcohol With Cocaine

What Does Cocaine Do To The Brain?

Cocaine is one of the most highly addictive and abused drugs on Earth, and because cocaine is known as the "party drug", users tend to mix it with alcohol frequently. Cocaine acts to block the reuptake of dopamine, serotonin, and norepinephrine in the brain. This results in intense feelings of euphoria and leads to risky decision-making and sometimes violent behavior. Cocaine also, amongst other things, leads to high blood pressure, higher core body temperature and elevated heart rate.

What Happens When You Mix Cocaine And Alcohol?

Adding alcohol to cocaine consumption increases cocaine metabolite levels in the blood 30% more than cocaine alone. Cocaine use also prevents users from feeling the depressant effects of alcohol as much, which causes them to drink far more and for far longer than they would otherwise, increasing the risk for things like alcohol poisoning.

The biggest danger in this combination actually lies in what the human body does with the two substances. When ingested together, the body combines them into a compound called cocaethylene, which is extremely toxic to both the heart and the liver. Cocaethylene has been blamed for many under-40s heart attacks and many of the UK's authorities believe the cocaine-alcohol combination has led to a recent increase in extremely violent outbursts and risky sexual behavior amongst the nation's youth. This is further corroborated by a new study showing co-occurring alcohol and cocaine use reduced white matter in the brain's anterior cingulate cortex, which is an area responsible for regulating emotion.

Treatment Options For Those Addicted To Alcohol And Another Substance

Just like a drug, the reaction in the brain from mixing alcohol with other drugs can become an addictive feeling in of itself, and users may, therefore, become addicted to the high they achieve from co-occurring use of the drug. If you or someone you know struggles with this addiction, it is vital to seek out resources that will help address this, as the dangers of substance use rise dramatically and carry unforeseen consequences when substances are combined.

Substance use is a problem our society has been battling for years, and in the short term, it appears to be an uphill battle. But if we do our part and help those struggling with substance abuse, especially those who use multiple substances simultaneously, we can help to fight this societal epidemic and perhaps even begin to turn the tide.