What Happens If We Mix Alcohol and Stimulants?

Caffeinated alcohol drinks are on the rise. From hard energy drinks to coffee cocktails, the combination of alcohol and stimulants is highly normalized. Is this safe? We’ll learn in a bit that it’s not. The opposing mechanisms can send mixed signals to our brain — leading to adverse effects. 

Prescription or illicit stimulants are more potent than caffeine, and mixing them with alcohol is even more dangerous. To help us practice safe alcohol consumption, let’s first learn about how stimulants and depressants affect us and interact with each other.

A Look Into the Pharmacology of Alcohol and Stimulants 

Alcohol is categorized as a central nervous system (CNS) depressant. This means that it slows down messaging within our brain and to different parts of our body. Alcohol does this by acting on the neurotransmitters or chemical messengers in our brain. Specifically, alcohol enhances the effect of gamma-aminobutyric acid (GABA), dopamine, and serotonin — producing a calming feeling. It also inhibits glutamate, which is an excitatory neurotransmitter that aids in different cognitive functions. Stimulants, on the other hand, have the opposite effect.

Stimulants speed up the body’s systems and act on both the central nervous system and the peripheral nervous system. Different types of stimulants include prescription drugs such as amphetamines and methylphenidate (Ritalin), illicit drugs such as cocaine and methamphetamine, and other drugs such as caffeine and nicotine. In general, stimulants work by increasing levels of catecholamine (chemicals that send signals to other cells) and stimulating adrenergic receptors. When these receptors are stimulated, they mimic the function of the sympathetic nervous system, increasing our heart rate, blood pressure, and breathing. 

By looking at the way stimulants and depressants (specifically alcohol) work, we can see that they have opposite effects on the body. However, they can both impact our CNS. What exactly do they do? 

How Stimulants and Alcohol Affect the Central Nervous System

Our CNS is our brain’s processing system. It reads and sends signals that regulate how we feel, think, and move. Both alcohol and stimulants can affect our CNS, impacting our thoughts, movement, and actions.

CNS depressants like alcohol suppress our excitatory nerve pathway activity. This interferes with communication between our nerve cells and slows down signaling. Depressing our CNS leads to a variety of symptoms.

• Slowed reflexes 
• Slurred speech 
• Higher pain tolerance
• Drowsiness 
• Low heart rate
• Slowed breathing 
• Headaches 
• Impaired judgment 

CNS stimulants increase neural activity in our brain, which speeds up mental and physical processes. They can lead to a range of side effects.

• Rapid heart rate 
• Increased blood pressure 
• Reduced appetite 
• Increased alertness 
• Higher focus 
• Higher energy 
• Jitteriness and anxiety 

Since depressants and stimulants have opposite mechanisms of action, they also produce opposite effects. Since they’re opposites, do they interact?

Interaction Between Alcohol and Different Types of Stimulants 

Alcohol and stimulants have opposing effects and both affect our CNS. This causes many direct and indirect interactions between alcohol and different types of stimulants. Let’s further examine how alcohol clashes with certain stimulants. 

Alcohol and Prescription Stimulants

Prescription stimulants are controlled medications that enhance brain activity. They are commonly used to treat conditions such as ADHD, narcolepsy.  Sometimes they serve as a short-term treatment for obesity. Prescription stimulants are associated with risks such as misuse and overdose. 

Two main categories of prescription stimulants include amphetamines such as Adderall and Dexedrine and methylphenidates such as Ritalin and Focalin. Alcohol and all prescription stimulants have direct interactions. This means that alcohol can impact the way the drug works in our body. 

Alcohol can cause abnormal levels of the medication in our body and affect the way some extended-release forms of the medication work. For example, mixing the delayed-release form of Focalin and alcohol together can promote faster release of the medication, leading to dangerously high levels of the drug in our body. Stimulants can also counteract some of the depressant effects of alcohol, making us feel less intoxicated. This can indirectly cause us to drink more and increase the risk of alcohol poisoning. 

Alcohol and Illicit Stimulants

Common illicit stimulants include cocaine, ecstasy, and methamphetamine. These illegal drugs are strong and frequently misused for their “upper” effects. Illicit stimulants can create a temporary feeling of euphoria, increased energy, and alertness. 

Mixing alcohol and illicit stimulants is extremely dangerous. They can decrease each other’s effects and increase the risk of alcohol poisoning and drug overdose. The duo can also heighten the risk of dependence on either substance. While alcohol is a depressant, it has some stimulant effects. Specifically, alcohol and stimulants both promote the release of dopamine and serotonin, the body’s “feel-good” hormones. This extra boost in mood and pleasure increases the chances of dependence.

Alcohol and Other Stimulants

Other stimulants, such as nicotine, caffeine, and herbal supplements, may be less potent than prescription and illicit stimulants. However, these legal stimulants still have many of the same effects as other stimulants and can negatively interact with alcohol. 

Since they are less potent than prescription and illicit stimulants, these other stimulant drugs may cause less severe effects when combined with alcohol. However, they can still block some of the depressant effects of alcohol. But don’t be fooled: This isn’t the perfect solution it may sound like. While we may be able to get through a night of drinking without feeling extremely drowsy or disoriented, this can lead us to drink more and more without noticing and increase our likelihood of drinking excessively. 

We know that excessive drinking can be detrimental to our health, but what exactly are the risks of combining alcohol with stimulants?

Risks of Alcohol, Stimulants, and Mixing the Two

Alcohol and stimulants can each result in dangerous consequences for our body. Individually, they artificially prompt our brain to speed up or slow down. Imagine this: Let’s say we’re not flexible enough to do the splits. However, by taking a magic pill, we won’t feel the pain and can force ourselves into them. We may be able to do it at that moment, but our muscles, joints, and bones may suffer as a result. 

The consequences of consuming alcohol and stimulants together are similar in that they can open the door to many potential consequences. Mixing the two, known as polysubstance use, can cause even greater harm. Let’s take a closer look.

• Risk of cardiovascular toxicity. Alcohol and stimulants both cause stress on our heart. They can cause increased blood pressure and a rapid heart rate. Over time, our heart can become damaged, increasing the risk of heart attack, cardiovascular disease, and stroke.
• Impaired brain and cognitive function. By themselves, alcohol and stimulants can affect cognitive function. Since they have opposing mechanisms, combining the two can send mixed signals to our brain and further impair our cognitive functions. 
• Inadequate blood flow to the brain. At high levels, alcohol can cause our blood vessels to constrict. Similarly, stimulants also have the same effects. When mixed, the vasoconstriction effects are amplified. This can cause inadequate blood flow to the brain. 
• Increased strain on kidneys. Stimulants and alcohol both cause strain on our kidneys due to elevated blood pressure and heart rate. Together, the risk of kidney damage is heightened.
• Increased hangover symptoms. Stimulants may temporarily block the depressant effects of alcohol when we drink. This can lead us to unintentionally drink more and more, resulting in an even more unpleasant aftermath.

• Risk of overdose. Just the way stimulants can block the effects of alcohol, drinking can do the same to stimulants. The result is an excessive level of stimulants in our system and/or increased consumption of stimulants, which ups our risk of overdose.

How Much Is Too Much?

When taking stimulants, no amount of alcohol is considered safe. Since alcohol and stimulants have direct interactions, even minimal amounts of alcohol can have a negative impact. While certain stimulants such as prescription and illicit drugs may cause greater harm when mixed with alcohol, any stimulant drug opens the door to potential risks and consequences. 

Any amount of alcohol with stimulants can lead to negative consequences. The truth is, however, they’re commonly combined. Cocktails like Vodka Red Bull and espresso martinis are popular drinks that mix caffeine with alcohol. If we’ve already consumed alcohol and stimulants together, what should we do?

What To Do If You’ve Mixed Alcohol and Stimulants 

We’ve learned that drinking while taking stimulants can be extremely dangerous. Since they’re commonly combined, we might have already consumed them together without knowing it. We can utilize the following three steps to prioritize our health and safety.

1. Stop drinking. We may have already consumed alcohol and stimulants together, but avoiding further alcohol consumption can limit any additional consequences. Hydrating with water or an electrolyte drink will help prevent dehydration and support cells and organs in eliminating toxic substances.

2. Monitor symptoms. Alcohol and stimulants can lead to dangerous effects together or separately. By monitoring any symptoms that may arise, we can increase our awareness of the effects that these substances have on our body. It also can help us identify if and when we need medical attention. 

3. Seek medical attention. Alcohol intoxication, drug overdose, and exacerbated side effects of mixing stimulants and alcohol can elicit unsafe effects. If you’re experiencing any severe symptoms, dial 9-1-1 to seek emergency medical assistance.

Alcohol and stimulants together can be a hazardous combination, but is there a safe way to navigate them together?

Navigating Stimulants and Alcohol Consumption Safely

In many cultures, avoiding alcohol and stimulants can sometimes be difficult. Social drinking and hustle culture are both deeply ingrained in American society, for example, which has led to the normalization of drinking alcohol and consuming stimulants. To navigate them both safely, we can implement the following practices: 

• Consult with a physician. We all have individual needs and risk factors. Consulting with our physician helps us address underlying conditions and root causes that may be driving our stimulant or alcohol consumption. 
• Quit or cut back on alcohol. In some cases, stimulants may be necessary to treat ADHD or narcolepsy. Quitting or cutting back on alcohol is the most effective method for avoiding adverse effects. 
• Prioritize sleep and rest. Stimulants are commonly used to increase our energy or wakefulness. On the other hand, alcohol can negatively disrupt our sleep patterns. By prioritizing adequate rest, we can reduce the use of stimulants and disrupt the common pattern of mixing them. 
• Find alternatives. We can identify healthier and more natural alternatives for stimulants and alcohol. Try getting some sunlight first thing in the morning for a natural energy lift. If you’re looking to wind down, try chamomile tea or take a warm bath. 

Although stimulants and alcohol are frequently combined, they are a dangerous duo. Sometimes the effects are immediate, and sometimes the harm comes later down the road. Practicing mindful consumption is beneficial not only for avoiding the adverse effects of mixing alcohol and stimulants, but for our overall health as well.

The Bottom Line

Mixing alcohol and stimulants can be tempting. The direct opposing mechanism of stimulants can combat the less-desired effects of alcohol on our body. While we may feel less intoxicated at the moment, this can actually lead us to drink more and more alcohol — leading to an unpleasant aftermath and opening the door to a host of health issues. Alcohol and stimulants have direct interactions that can be dangerous when mixed in any amount. Avoid alcohol while taking stimulants to prevent adverse effects and risk of dependence. Stay vigilant and avoid mixing alcohol and stimulants!