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If you are 21 or older, you can legally drink alcohol in the United States. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), over 86 percent of adults, ages 18 and older, in the US drink alcohol at least once in their lifetime, and about 56 percent report drinking alcohol at least once a month. Drinking a glass of wine with dinner or having a beer or two with friends is a normal practice for many people across the country.

Mixing Prescriptions with Alcohol Is Dangerous

However, 16 million people in the country – 15.1 million adults and 623,000 adolescents – struggle with alcohol use disorder (AUD), which used to be called alcoholism. Thousands more struggle with other forms of problem drinking, including drinking alcohol to the point of intoxication while they take, misuse, or abuse prescription drugs. Prescription misuse is very common, and it includes taking more of a drug than necessary or mixing the prescription with other dangerous drugs, including alcohol. Accidentally mixing a potent prescription drug with alcohol is risky enough, but some people struggle with addiction to prescription drugs and may mix these with alcohol.

Common side effects that can occur because of the mixture of prescription drugs with alcohol may include:

  • Stomach upset, nausea, or vomiting
  • Drowsiness, fatigue, or excessive sleep
  • Dizziness or fainting
  • Headaches
  • Blood pressure changes or heart damage
  • Changes in behavior
  • Changes in emotions or mental state
  • Loss of coordination, leading to accidents

If you mix a prescription drug with alcohol, either by accident or specifically to get high, there is a high risk of overdose or damage to the body. If you see someone experiencing a drug overdose or alcohol poisoning, it is extremely important to call 911 immediately.

There are also several chronic health problems that can be caused by mixing alcohol with prescription drugs. These may include:

  • Heart problems, stroke, or heart attack
  • Liver damage, failure, or cancer
  • Internal bleeding
  • Brain damage
  • Depression, anxiety, or other mental health problems

While these general short-term and long-term side effects can help you understand how dangerous it is to mix alcohol with prescription medications, specific kinds of prescriptions can cause specific side effects when mixed with a central nervous system (CNS) depressant like alcohol. The list below details how alcohol changes the effects of specific prescription drugs and makes them harmful.

  • Opioid painkillers: Analgesics, or prescription narcotic painkillers, are some of the most widely abused drugs in the US, leading to the opioid addiction epidemic. According to the Centers for Disease Control and Prevention (CDC), 91 people die on average every day because of an opioid overdose. This group of addictive drugs includes heroin, morphine, methadone, oxycodone, hydrocodone, and codeine.

    Narcotic prescription painkillers are dangerous enough on their own, but mixing these drugs with alcohol increases their relaxing, drowsy effects and radically increases the risk of overdose. A study published in the journal of the American Society of Anesthesiologists (ASA) in 2017 found that combining even normal prescription doses of oxycodone with the equivalent of 1-3 drinks can lead to dangerously depressed breathing. Oxygen deprivation is the cause of overdose death among people struggling with opioid addiction.

  • Benzodiazepines: These fast-acting anti-anxiety medications act on the gamma-aminobutyric acid (GABA) receptors, leading to a sense of calm that helps to relieve anxiety, panic attacks, insomnia, and even seizure disorders like epilepsy. Alcohol also acts on the GABA receptors, so many health organizations recommend supervised doses of benzodiazepines, usually long-acting Valium, to help people struggling with alcoholism taper off the physical need for alcohol.

    Because benzodiazepines and alcohol act on similar areas of the brain, people who abuse alcohol may take benzodiazepines to enhance the effects of alcohol, or vice versa. This is an extremely dangerous practice that can lead to poisoning, overdose, and death. Increased side effects, which can quickly become dangerous, include:

    • Drowsiness
    • Dizziness
    • Slowed or difficult breathing
    • Impaired motor control, leading to accidents
    • Unusual behavior
    • Memory problems or blackouts
    • Liver damage
  • Prescription stimulants: People who have attention deficit hyperactivity disorder (ADHD) benefit from prescription doses of stimulant medications, which include Ritalin, Adderall, and Vyvanse. These drugs adjust the levels of neurotransmitters in the brain, and for those with ADHD, this helps them stay focused and on task. However, many people struggle with stimulant abuse because of “study drugs,” the trend of abusing stimulant drugs to cram for a test or stay up all night writing school papers. Adolescents and young adults who abuse stimulants for these reasons do not have ADHD, so these drugs affect their brains differently, and this abuse likely leads to physical dependence and addiction.

    Many of the adolescents who began abusing stimulant drugs in school now continue that abuse in the workplace. The likelihood that they mix diverted ADHD drugs with alcohol is very high. Harmful side effects from mixing ADHD prescription drugs with a sedative like alcohol include:

    • Drowsiness and dizziness
    • Problems concentrating
    • Increased risk of heart damage or heart problems
    • Liver damage
  • Antidepressants: While antidepressant drugs, especially selective serotonin reuptake inhibitors (SSRIs), are a very important development in the treatment of depression, anxiety, and related mental health problems, these drugs should never be taken without also going to therapy sessions. Abuse of antidepressants is rare, but it does happen, especially in the form of prescription misuse.

    Mixing antidepressants with alcohol can lead to problematic effects. When mixed with alcohol, your antidepressant may be less effective, so you may feel depressed or anxious. Cognitive processes like memory or thinking can be inhibited, or you may feel very sleepy or sedated. Older classes of antidepressants, called MAOIs, can cause damage to the heart when mixed with alcohol. High blood pressure, increased risk of blood clots, and heart attack can all lead to lasting harm or death. Side effects of mixing any antidepressant with alcohol can become dangerous and may include:

    • Dizziness and drowsiness
    • Increased risk of overdose or poisoning
    • Increased feelings of depression, hopelessness, and suicidal ideation
    • Impaired motor control that can lead to accidents
    • Liver damage
  • Antipsychotics: People who take antipsychotics like Seroquel or Zyprexa require ongoing treatment because these drugs are not prescribed unless the person suffers from a condition like schizophrenia. While this mental illness can be effectively managed so the individual has a happy, healthy life, people who struggle with schizophrenia or similar psychoses are more likely to abuse all kinds of substances, especially cigarettes, alcohol, and marijuana.

    Mixing alcohol with antipsychotics makes the prescription medicine less effective, so hallucinations and delusions may return. Antipsychotics can lead to sedation, sleepiness, or excessive fatigue, and drinking too much can enhance these effects.

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    It is extremely important to take prescription drugs according to your doctor’s instructions, and for many prescription medicines, this means avoiding alcohol. Abusing prescription drugs can lead to addiction, and adding alcohol can increase the risk of severe side effects, chronic health problems, and an overdose on this mixture. If you have a history of alcohol use disorder or problem drinking, you should inform your doctor of this issue, as it can change how your physician manages prescriptions. Your doctor may refer you to addiction specialists for treatment if chronic physical harm may have been caused by underlying alcohol abuse.

    Information on Mixing Specific Prescription Drugs with Alcohol