Mixing Drugs and Alcohol

Alcohol can be a dangerous substance. When it’s consumed responsibly, the risks are low. When it’s taken with other substances, it can cause serious side effects or death.

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Many people know that mixing alcohol with illicit drugs or prescription drugs is risky, but drinking after taking over-the-counter medicines or supplements can also cause health problems. The side effects of mixing alcohol with other substances aren’t limited to coordination loss or drowsiness.

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Combining alcohol with some illicit drugs can cause long-term organ damage, and mixing alcohol with certain prescription pills can make a person stop breathing. Even some over-the-counter supplements can cause major health problems when mixed with alcohol.

Illicit Drugs

One of the riskiest ways to drink alcohol is with illicit drugs. Drugs can worsen side effects of alcohol. They can also conceal the effects of alcohol, making people believe they’re sober. When people combine alcohol with other drugs, they’re more likely to partake in risky behaviors, such as driving under the influence.

Unfortunately, alcohol addiction commonly co-occurs with drug addiction. People addicted to multiple substances — referred to as polysubstance use disorder — may be more likely than people addicted to a single substance to experience negative consequences.


Cocaine worsens certain side effects of alcohol, such as impaired coordination, motor function and memory. Mixing alcohol and cocaine increases heart rate, causing stress on the heart. When the substances are combined, a toxic byproduct called cocaethylene is formed, according to a medical review published in the journal Addiction. Cocaethylene can cause significant damage to the heart and liver.


Marijuana can also increase impairment when consumed with alcohol. Some small studies have found that combining the drugs can hamper the ability to drive even more than taking either drug alone. Other studies have found that the detriments are similar regardless of whether the drugs are combined or taken alone. A 2015 review of these studies was published in the journal Alcoholism: Clinical & Experimental Research.


Ecstasy, also known as MDMA, can conceal the effects of alcohol when individuals consume both drugs. A small study published in the Journal of Pharmacology and Experimental Therapeutics found that people who combined MDMA with alcohol felt like they were sobering up, but they did as poorly on motor skills and other performance tests as individuals who consumed only alcohol. Another small study published in Psychopharmacology analyzed driving performance and found similar results in individuals who combined the drugs.

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Medications & Pills

Many pill bottles warn that individuals taking the medication should limit or avoid alcohol intake. Most medications cause minor side effects on their own, but alcohol can amplify the effects. For example, a medication like Tylenol is safe for most people in low doses. But when it’s combined with alcohol or taken in high doses, Tylenol can cause serious liver damage.


Alcohol and benzodiazepines, such as Xanax and Valium, combine to cause a synergistic effect that can make you pass out and stop breathing. A synergistic effect is when two substances are more powerful when combined than the sum of their individual effects. Side effects of mixing alcohol with Xanax include drowsiness, dizziness, memory loss, loss of consciousness and death.


Alcohol and opioids, such as oxycodone or hydrocodone, can combine to reduce respiration to the point that a person stops breathing. The illicit opioid heroin causes similar effects when combined with alcohol. Alcohol can also make extended-release opioids release their entire dose at once, a phenomenon called dose dumping, according to a 2014 article published in Postgraduate Medicine. This increases the risk of overdose.


Drinking while on antibiotics can weaken your immune system, decreasing your ability to fight illness. Alcohol also interacts dangerously with certain antibiotics, such as Flagyl (metronidazole) and Tindamax (tinidazole), causing dizziness, anxiety, chest pain and heart problems. In some situations, mixing alcohol with antibiotics can cause organ damage.

Sleeping Pills

Combining alcohol and sleeping pills is also dangerous. Sleep aids such as Ambien, Lunesta and Sonata slow activity in the brain to help a person fall asleep. When the sleep aids are combined with alcohol, they can severely impair coordination, disrupt memory and make a person pass out.

ADHD Medications

Medications used to treat attention-deficit/hyperactivity disorder help people with ADHD concentrate. When alcohol is mixed with Adderall and similar drugs, people taking the medications therapeutically may struggle to focus. The substances can also cause heart problems and liver problems when they’re combined.

Cold & Allergy Medicines

Several ingredients in cold and allergy medications can interact dangerously with alcohol. Cough medicines that contain dextromethorphan or codeine can cause drowsiness, dizziness and overdose if taken with alcohol. Antihistamines, such as brompheniramine, chlorpheniramine or Claritin (loratadine), can cause similar symptoms when mixed with alcohol.


DayQuil contains both dextromethorphan and acetaminophen. That means mixing DayQuil and alcohol can cause liver damage, drowsiness and dizziness.


Most NyQuil products contain dextromethorphan, acetaminophen and doxylamine. The latter ingredient is used to treat cold or allergy symptoms and short-term sleep problems. Combining it with alcohol can cause extreme drowsiness, slowed breathing, impaired motor function and memory problems. Overall, taking NyQuil and alcohol is risky and should be avoided.


Mucinex products that contain guaifenesin and no other medications are unlikely to cause dangerous interactions with alcohol. However, some Mucinex combination products also contain dextromethorphan and acetaminophen. Mixing alcohol and Mucinex products that are designed to treat cold, flu or allergy symptoms can cause liver damage and other serious side effects.

Other Substances

In general, you shouldn’t drink alcohol with substances that change the way you feel. The Centers for Disease Control and Prevention warns Americans to avoid combining alcohol and caffeinated products because caffeine can mask the effects of alcohol. As a result, people may become more impaired than they realize. Additionally, other types of over-the-counter products or supplements may contain untested ingredients that interact dangerously with alcohol.

Energy Drinks

In addition to high amounts of caffeine, many energy drinks contain chemicals that can boost energy levels and mask the effects of alcohol, including guarana, taurine, ginseng and sugar. This can increase the risk of reckless and dangerous behavior when a person mixes energy drinks and alcohol. One study on mice suggested that repeated exposure to alcoholic energy drinks at a young age could increase the risk for substance abuse later in life.

Herbal Supplements

Over-the-counter supplements have become popular products for a variety of ailments. Herbal supplements claim to treat a variety of health issues, including weight gain, cosmetic issues and mood problems. Many diet pills have addictive properties and can cause a variety of health problems when combined with alcohol.

Supplements that are marketed as mood enhancers may also interact dangerously with alcohol. Some people have reported blacking out or having seizures after combining alcohol with 5-HTP, a supplement that may improve symptoms of depression.

It’s important to be cautious when you drink alcohol. Always follow instructions on medication labels. If you take any type of supplement, talk to your doctor before drinking alcohol. You should always avoid illicit drugs and other hazards. If you decide to misuse illicit drugs, it’s best not to mix multiple substances, including alcohol.

If you or someone you know is dealing with drinking problems, call an alcohol hotline. These toll-free services can help you understand the dangers of alcohol, recognize signs of alcohol addiction and locate a nearby treatment center.

Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

Chris Elkins, MA
Senior Content Writer, DrugRehab.com
Chris Elkins worked as a journalist for three years and was published by multiple newspapers and online publications. Since 2015, he’s written about health-related topics, interviewed addiction experts and authored stories of recovery. Chris has a master’s degree in strategic communication and a graduate certificate in health communication.
Medical Reviewer
Ashraf Ali
Psychiatrist, Los Angeles County Department of Mental Health

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