Abusing drugs and alcohol simultaneously is common in America, but it doesn’t come without serious risks. In 2011, there were 606,653 Emergency Department visits involving alcohol, and many of these also involved other drugs.1 Research findings also show people who are addicted to alcohol are much more likely than the general population to also abuse drugs, and vice versa, which increases their risk for fatal overdose.2
Table of contents
Although there are more than 150 drugs that are harmful to a person’s health when they are combined with alcohol,1 here are ten particularly dangerous alcohol and drug combinations to avoid.
Cocaine and Alcohol
Mixing cocaine and alcohol is dangerous, but still a common practice. About 75 percent of cocaine abusers drink alcohol at the same time.3 Since cocaine is a stimulant, many people combine cocaine and alcohol to stave off the sedating effects of alcohol. However, the combination of the two causes the liver to create a toxic substance called cocaethylene, which then travels through the bloodstream, increasing the risk of damage to the heart, liver, and immune system. The combination of cocaine and alcohol in the body also severely increases heart rate and blood pressure which can cause a heart attack or cardiac arrest.4
DXM and Alcohol
While some users report that combining DXM and alcohol can prevent nausea while enhancing a high, it’s an extremely dangerous combination that should be avoided. Dextromethorphan (DXM) is an over-the-counter cough suppressant that is found in several cough and cold medicines. When taken in high doses, it can cause euphoria and auditory and visual hallucinations.5 Recreational abuse of DXM is common and results in about 6,000 emergency room visits each year.6
Since both of these drugs are central nervous system depressants, abusing DXM and alcohol simultaneously can enhance the side effects and dangers, causing extreme sedation, lethargy, loss of coordination, slurred speech, delusional behaviors, and loss of consciousness. Combining DXM and alcohol also exacerbates hallucinations, and can cause psychosis, coma, or death.7 Most DXM-related deaths are caused by ingesting DXM in combination with other drugs or alcohol.5
Clonidine and Alcohol
Clonidine is a prescription medication that is used to treat high blood pressure, anxiety disorders, panic attacks, pain, and ADHD. Sometimes it is also used to treat symptoms of alcohol and opiate withdrawal.8 Although it is not an addictive or habit-forming drug, people often abuse clonidine to enhance the effects of alcohol and other drugs. Some people also abuse it to reduce the amount of heroin they need to get high.
Mixing clonidine and alcohol can have life-threatening effects. Alcohol intensifies the side effects of clonidine, causing severe sedation, dizziness, hallucinations, loss of consciousness, and seizures. The combination of clonidine and alcohol can also cause a dangerous drop in blood pressure, stroke, heart attack, or death.9
Suboxone and Alcohol
Suboxone is a prescription medication that is used to treat opioid addiction. It is a combination of the drugs buprenorphine and naloxone, which work together to help relieve uncomfortable symptoms of opioid withdrawal and reverse the effects of narcotics.10 Although it has been shown to be effective in the treatment of opioid addiction, it also has a potential for abuse and is classified as a Schedule II drug.
Suboxone and alcohol are both central nervous system depressants, so using them both at the same time increases the risk of respiratory depression and it can even stop your breathing completely.10 Additionally, mixing Suboxone and alcohol can cause extreme drowsiness, dizziness, nausea and vomiting, impaired judgment, cognitive problems, blurred vision, slowed heart rate, and heart palpitations. Long-term abuse of Suboxone and alcohol can also increase a person’s risk of certain types of cancers, cardiovascular disease, and brain damage.11,12
Adderall and Alcohol
Adderall is a prescription stimulant drug and a Schedule II drug. It is a frequently prescribed drug that is used to treat ADHD in adults and children. Although Adderall is a stimulant and alcohol is a depressant, abusing Adderall and alcohol together can have serious effects. Instead of the effects just canceling each other out, the combination of Adderall and alcohol can make it more difficult for users to realize they are drunk, which greatly increases the risk of alcohol poisoning. Drinking on Adderall can also cause heart problems by raising body temperature, increasing heart rate and blood pressure. It often also leads to unpredictable, risky, and aggressive behavior.13
Zolpidem (Ambien) and Alcohol
Zolpidem, sold under the brand name Ambien, is a prescription sedative-hypnotic that is used to treat sleep problems like insomnia in adults. It works by producing a calming effect in the brain, which can be particularly dangerous when it is combined with alcohol. Using zolpidem and alcohol together is dangerous, but many people do it because it enhances the effects of both substances. When used together, the effects of Ambien work faster and the alcohol intoxication becomes more intense. Therefore, less alcohol is needed to experience the effects of intoxication.
When Zolpidem (Ambien) is combined with other sedatives like alcohol, it severely decreases heart rate and can cause serious breathing problems. Using zolpidem and alcohol together can also cause psychiatric problems like hallucinations, violent and/or peculiar behavior, loss of motor control, or performing dangerous activities like sleep driving.14,15
Diazepam (Valium) and Alcohol
Diazepam, sold under the brand name Valium, is a prescription medication and a benzodiazepine. It is used to treat seizures, muscle spasms, restless leg syndrome, and alcohol withdrawal. It is classified as a habit-forming drug and abusing diazepam and alcohol together may increase the likelihood of the user becoming addicted.16
Mixing diazepam and alcohol can increase nervous system depression and cause shallow breathing. It can also make the user feel extremely sleepy, confused, disoriented, and dizzy. Abusing Valium and alcohol may also cause blackouts, memory loss, liver damage, overdose, brain damage, and may make a person more vulnerable to accidents.17 According to the CDC, about a quarter of people who died as a result of benzodiazepine abuse were also abusing alcohol.18
Robitussin and Alcohol
Robitussin is a cough and cold medication that contains dextromethorphan (DXM). As mentioned earlier in this blog, combining Robitussin and alcohol can cause serious interactions like extreme sleepiness, drowsiness, difficulty breathing, coma, or death.19
Other common medications that contain dextromethorphan (DXM) include:
- Alka Seltzer Plus
- Mucinex DM
- Tylenol Cough & Cold
- Vicks DayQuil/NyQuil
- Vicks Formula 44
Benzodiazepines and Alcohol
Abusing benzodiazepines like Valium, Xanax, Ativan, and Klonopin (among many others) can cause sedating effects like intense drowsiness or confusion, dizziness, slurred speech, and respiratory depression. Alcohol can cause the same effects. As a result, abusing benzodiazepines and alcohol at the same time can exacerbate the side effects of each and cause excessive sedation and breathing problems. The side effects of using benzodiazepines and alcohol together can also result in serious accidents, injuries, coma, or even death.20
Opioids and Alcohol
Opioids and alcohol are two of the most commonly abused drugs in America, so it should be no surprise that the two are often abused together. Alcohol is a central nervous system depressant and so are and illegal opioids like heroin and prescription opioids like morphine, oxycodone and hydrocodone. These substances all produce feelings of relaxation and sedation, and in large doses, can cause severe lethargy and respiratory problems.
Using opioids and alcohol together is extremely dangerous and can exacerbate the sedating side effects of both substances. This can lead to breathing problems, decreased heart rate, and blood pressure, brain damage, increased risk of overdose and alcohol poisoning, cognitive problems, heart attack or stroke. People who chronically abuse opioids and alcohol are also much more likely to develop physical dependence and addiction.21
As you can see, there are plenty of reasons to avoid these dangerous alcohol and drug cocktails. Unfortunately, the disease of addiction will compel a person to continue using these substances, despite the many dangers and side effects.