What Happens When You Mix Prescription Drugs and Alcohol?
You’ve probably seen this warning on medicines you’ve taken. The danger is real. Mixing alcohol with prescription drugs, even over-the-counter medications, can have unpredictable and can lead to unwanted consequences. We can help ourselves, our friends, and our loved ones by understanding the dangers and taking steps to prevent harm.
When you receive prescription drugs, whether it’s a depressant like Xanax, an opioid painkiller like oxycodone, or a stimulant like Adderall, you’ll often find strict warning labels about the risks of mixing prescription drugs with alcohol. When mixed with the effects of alcohol, many otherwise routine prescription drugs can become fatal. Relaxing with a drink or two at night is unsafe when the effects of alcohol are combined with certain prescription drugs. Some individuals are mixing prescription drugs with alcohol to intensify the effects of both substances. This can lead to substance abuse when the drugs are used together, especially in excess.
In addition to these dangers, alcohol can make a medication less effective or even useless, or it may make the medication harmful or toxic to your body. Some medicines that you might never have suspected can react with alcohol, including many medications which can be purchased “over-the-counter”—that is, without a prescription. Even some herbal remedies can have harmful effects when combined with alcohol.
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What are Prescription Drugs?
Prescription drugs are often strong medications, which is why they require a prescription from a doctor or dentist. Every medication has some risk for harmful effects, sometimes serious ones. Doctors and dentists consider the potential benefits and risks to each patient before prescribing medications and consider many different factors.
Prescription drug addiction treatment uses medication in a way not intended by the prescribing doctor. As a result, addiction is far more familiar with prescription medications such as sleeping pills and tranquilizers. Moreover, being addicted to prescription drugs is every bit as real as addictions to alcohol and illegal drugs.
Someone misusing prescription drugs may overload their system or put themselves at risk for dangerous drug interactions that can cause seizures, coma, or even death. Prescription drug addiction can be hard to beat. However, prescription drug addiction treatment programs can help users break their physical and psychological dependence on the drug.
The three Classes of Medication Most Commonly Misused Are:
- Opiates—usually prescribed to treat pain
- Central nervous system [CNS] depressants (this category includes tranquilizers, sedatives, and hypnotics)—used to treat anxiety and sleep disorders
- Stimulants—most often prescribed to treat attention-deficit hyperactivity disorder (ADHD)
Various prescription drugs have a high potential for causing drug addiction in some people, even when the medications are prescribed appropriately and taken as directed.
What are the Dangers of Mixing Prescription Drugs with Alcohol?
Problem drinking can take many forms, including dependence on drinking, drinking to extreme levels of intoxication, and mixing prescription drugs with alcohol.
Prescription drug misuse is, unfortunately, common in the U.S. Misuse includes mixing prescription drugs with alcohol to get high. Also, people who struggle with alcoholism and are prescribed medications may be unable to stop drinking while taking a prescription.
If someone is struggling with alcohol use disorder, they can experience many adverse health consequences when they mix their legal prescription drugs with alcohol.
- Depressants (Xanax, Valium) combined with alcohol have a synergistic effect, with potential for dangerous and even lethal consequences, with rapid onset of dizziness, stumbling, loss of sphincter control, memory loss and potential death.
- Stimulants (e.g., Ritalin, Adderall, Concerta) combined with alcohol conceal alcohol’s effects, so people cannot gauge their level of intoxication, which can result in over-consumption, e.g. significant impairment of coordination and judgment, alcohol blackout, pass out and potential death.
- Prescription opiates (e.g., Vicodin, OxyContin, Tylenol 3 with codeine, Percocet) combined with alcohol can result in slowed or arrested breathing, lowered pulse and blood pressure, unconsciousness, coma, and potential death.
Potential dangers can happen in three ways:
- When people do not know that there are significant drug interactions and are caught by surprise when they inadvertently drink while using prescription medication
- Intetionally mixing prescription drugs and alcohol because they mistakenly believe it will be a “better” or “enriched” intoxication
- As a tool to facilitate a crime (sexual assault, robbery, etc) by making a victim incapacitated
What are the Side Effects of Mixing Prescription Drugs with Alcohol?
Prescription drugs have various side effects when taken alone, including drowsiness, nausea, changes in blood pressure, and loss of coordination. There are also long-term side effects to prescription drug use that may include liver damage, internal bleeding, and heart problems. The side effects vary from drug to drug, so it’s important to use a prescription medication ONLY as it’s prescribed to prevent any unnecessary effects and be sure to consult your doctor if you have any questions.
While prescription drugs have side effects when taken exclusively, these effects can be exacerbated when combined with alcohol. Not only does alcohol impact the effects of prescription drugs, it can also change the performance of the medications. In some cases, alcohol can completely negate the effectiveness of prescription drugs. In other instances, it can enhance their effects. Each substance has its own list of potentially negative impacts that can be severely heightened when mixed with alcohol. Side effects may include:
- Nausea and vomiting
- Impaired breathing
- Internal bleeding
- Liver damage
- Trouble sleeping
- Heart problems
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What Prescription Drugs Should Someone Never Mix with Alcohol?
Mixing Prescription Drugs with Alcohol – Painkillers
If you’re taking ibuprofen (Motrin) or naproxen (Naprosyn, Aleve), drinking alcohol can lead to an upset stomach, stomach bleeding, or ulcers.
Drinking alcohol while taking acetaminophen (Tylenol) is also risky. Alcohol and acetaminophen are both broken down in the liver. When the liver is busy breaking down alcohol, it can’t deal with acetaminophen, and so the drug builds up in the body and can cause serious liver damage.
The greatest risk, though, is drinking alcohol with any prescription opioid painkillers, such as codeine, hydrocodone, or oxycodone. Unlike ibuprofen and acetaminophen, these are prescription medications for people dealing with severe pain from injuries, postsurgical care, oral surgery, and migraines.
Combining them with alcohol can cause excessive drowsiness, slowed breathing, and even death. Avoid alcohol completely if you’re taking any of these painkillers.
Mixing Prescription Drugs with Alcohol – Anti-Anxiety Medications and Sleeping Pills
Using alcohol while taking anti-anxiety medications or sleeping pills can cause serious problems, too. Examples of anti-anxiety medications include:
These medications are sedatives, and taken together with alcohol, can make you drowsy or even unconscious.
Mixing Prescription Drugs with Alcohol – Antidepressants and Mood Stabilizers
All antidepressants should be taken with care when drinking alcohol. The effect on your body will depend on the type of antidepressant, but the risks are real and can include:
- Worsening feelings of depression
- Problems with movements
- Alcohol liver damage
- Serious heart effects
Similar risks exist if you take alcohol with mood stabilizers and antipsychotics such as aripiprazole (Abilify), Divalproex (Depakote), or lithium.
Mixing Prescription Drugs with Alcohol – ADHD Medications
ADHD treatments such as amphetamine (Adderall), methylphenidate (Ritalin), and lisdexamfetamine (Vyvanse) can interact with alcohol, causing any of the following symptoms:
- Poor concentration
- Heart problems
- Liver damage
Mixing Prescription Drugs with Alcohol – Antibiotics
Metronidazole (Metrogel, Flagyl) is a common antibiotic, and drinking any amount of alcohol with it will cause violent nausea and vomiting. Other antibiotics such as nitrofurantoin (Macrodantin), isoniazid (Laniazid), and azithromycin (Zithromax) can all cause unpleasant reactions when mixed with alcohol.
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Mixing Prescription Drugs with Alcohol – Nitrates and Other Blood Pressure Medications
Lots of blood pressure medications and anti-angina medications (nitrates) can interact dangerously with alcohol. Common effects include:
- A faster heartbeat or arrhythmias
Mixing Prescription Drugs with Alcohol – Diabetes Medications
If you take any medications for diabetes, drinking alcohol can lead to:
- Very low blood sugar levels
- Nausea and vomiting
- Rapid heartbeat
- Sudden changes in blood pressure
These medications include insulin or pills like metformin (Glucophage), glyburide (Micronase), and glipizide (Glucotrol). Take great care with these.
Mixing Prescription Drugs with Alcohol – Coumadin
Alcohol has an unpredictable effect on warfarin (Coumadin). If you drink alcohol while taking warfarin, you will need close monitoring to make sure your blood is not too thin.
Mixing Prescription Drugs with Alcohol – Over-the-Counter Cold and Flu Treatments
Most over-the-counter cold and flu remedies such as pseudoephedrine (Sudafed), guaifenesin (Mucinex), and oseltamivir (Tamiflu) contain a mix of different painkillers, antihistamines, and decongestants, and some (like NyQuil) even contain alcohol. On their own, these medications can make you drowsy and dizzy. Mixing prescription drugs with alcohol can make the drowsiness and dizziness worse, and increase your risk of overdosing. Check the ingredients on the box before taking any of these with alcohol.
Mixing Prescription Drugs with Alcohol – Erectile Dysfunction Medications
Taking alcohol with medications like tadalafil (Cialis), sildenafil (Viagra), and vardenafil (Levitra) can significantly lower blood pressure and cause dizziness, flushing, or a headache. Alcohol can also cause erectile dysfunction, so if you’re struggling with ED, it might be best to avoid alcohol altogether anyway.
Who is Most at-Risk for Mixing Prescription Drugs with Alcohol?
Current research on undergraduate students found that 12.1% of people misused prescription drugs and alcohol. Also, 5% of current problem drinkers claim they’d mixed both prescription and illegal drugs with alcohol, not including marijuana.
The risk factors for prescription drug and alcohol abuse included the following:
- Being young, between the ages of 18 and 25.
- Being single
- Having a pattern of heavy drinking or binge drinking behaviors.
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Does Alcohol Impact Everyone the Same Way?
A lot of people think that alcohol affects everyone the same way. So, they tend to drink equally as their peers, only to end up the most intoxicated in the group. The truth is each individual experiences the effects of alcohol in a different way.
There are many factors that influence the effect of ethanol on the human body. Take a look at the guidelines below and see which factors affect your system the most.
The main, and probably the most obvious factor in how people handle alcohol is their body weight. Even if a 265-pound and a 100-pound person drinks an equal amount of alcohol, the smaller individual will become more sensitive to the effects. Their body fat and weight affect the alcohol absorption rate. Simply put, the bigger the body, the slower the absorption rate.
It will take a while for alcoholic beverages to reach the brain and alter their physical and mental functions in overweight individuals. That’s why the smaller individual will get drunk a lot faster.
Another factor is the food they eat. People who consume diets high in fat, fiber, or protein when they drink alcohol, will reduce the absorption rate. However, carbonated beverages will force the ethanol to be absorbed by the body more quickly.
Gender plays a predominant role in the way alcohol affects people. There are certain physiological differences between the female and the male body. Women tend to experience the effect of alcohol more acutely than men, even in studies accounting for body weight and height.
Type of Drink
Not every drink is equally intoxicating. Some beverages contain more alcohol or ethanol than others. The alcohol by volume (ABV) is a typical measure of how much ethanol is in one alcoholic beverage. Each beverage has an average ethanol content that affects the body differently.
For example, people who enjoy wine or beer tend to experience the effects of alcohol a little less. It’s all because of the water in the drink compared to alcohol content.
Beer and wine contain high amounts of water, which adds volume to the drink. But hard liquor is different because it is much more potent. When paired with carbon dioxide, the hard liquor accelerates the alcohol absorption rate and intoxicates drinkers a lot faster.
Mixing Prescription Drugs with Alcohol can lead to addiction and dangerous side effects, including a greater risk of overdose. People with a history of problem drinking and alcohol dependence will need to inform their doctor about these problems. In addition, it’s crucial that these individuals get help from a qualified addiction rehabilitation center. If you or someone you care about is struggling with alcohol or prescription medication addiction, please reach out to a drug abuse counselor today to explore your treatment options. Call us today here at We Level Up New Jersey to get into proper treatment. Above all, recovering from a substance use disorder does not need to be overwhelming or burdensome.
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 NIDA – https://teens.drugabuse.gov/drug-facts/prescription-drugs
 NIDA – https://archives.drugabuse.gov/news-events/nida-notes/2008/03/alcohol-abuse-makes-prescription-drug-abuse-more-likely
 NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761694/
 NIAAA – https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines