Is It Safe to Combine Alcohol and Sedatives?
Both alcohol and sedatives function in the brain and body as central nervous system depressant substances. This means that they slow down several necessary and life-sustaining functions, such as blood pressure, respiration, and heart rate while also lowering body temperature. Sedatives help a person relax and be better able to fall and stay asleep, and alcohol can function much in the same way. Both sedatives and alcohol impact movement and coordination, and disrupt normal thinking abilities and memory functions.
When the two substances are combined, the effects of both can be enhanced, as can the potential risk factors and side effects. Benzodiazepine drugs, such as Valium (diazepam), Xanax (alprazolam), Klonopin (clonazepam), and Ativan (lorazepam), are prescription sedative medications. These drugs contain black-box warnings against concurrent alcohol use while taking them. For example, the FDA warns that people should not drink alcohol while taking Valium.
In short, sedatives and alcohol should not be combined since the possible risk factors and side effects of each substance are heightened by mixing them.
Overdose Potential and Short-Term Side Effects of Concurrent Alcohol and Sedative Use
When you combine two substances that have a similar mechanism of action in the body and brain, the side effects of each substance will be amplified. This means that when alcohol and a sedative drug are mixed, it can serve to make a person drowsier, more confused, more uncoordinated, more sluggish, less inhibited, and less likely to be able to make sound and rational decisions. A person may become intoxicated much faster than they would when taking only one of the substances, and the effects may come on quite suddenly.
Drinking alcohol while also taking a sedative can raise the risk for a potentially life-threatening overdose. Psychiatric Times publishes that according to data from 2010, alcohol was involved in nearly one-third of all emergency department (ED) visits related to benzodiazepine abuse and almost one-quarter of all benzodiazepine-involved overdose deaths. The Centers for Disease Control and Prevention (CDC) warns that six people die from alcohol poisoning every day in the United States on average.
Combining a sedative drug with alcohol can greatly increase the risk for alcohol poisoning and/or drug overdose. Signs of an alcohol or sedative toxic poisoning or overdose include:
- Nausea and vomiting
- Mental confusion
- Difficulties breathing
- Low body temperature and bluish tinge to the skin, lips, and nails
- Irregular heart rate and pulse
- Lack of motor coordination and muscle control
- Trouble staying awake and potential loss of consciousness
A drug overdose or toxic alcohol poisoning is a medical emergency that can potentially lead to coma or death, and immediate professional help should be sought if one is suspected. An overdose is not the only possible short-term side effect of combining a sedative with alcohol, however. Since combining alcohol and sedatives will enhance the effects of each substance, a person can become much more intoxicated more quickly than if they were just taking one or the other by itself.
Both sedatives and alcohol have mind-altering effects and can lead to poor decisions and risky behaviors. The rate of injury, being involved in an accident, or being the victim of a crime go up with intoxication levels. A person who is under the influence of one or both of these substances may be more likely to engage in behaviors that could be dangerous since thinking is impaired. Individuals may participate in risky sexual practices, increasing the odds for contracting a sexually transmitted or infectious disease. Mixing alcohol with sedatives can also have many lasting health, emotional, behavioral, and social side effects and consequences.
Long-Term Hazards of Mixing Alcohol with Sedatives
Both sedatives and alcohol interact with the chemical makeup of the brain, changing the way a person thinks, feels, and acts. Continued use of either one of these substances can be habit-forming, and when they are combined, the odds of developing a physical dependence on one or both goes up.
When a person drinks alcohol or abuses sedative drugs, levels of some neurotransmitters, which are the brain's chemical messengers, are altered. For instance, dopamine and GABA (gamma-aminobutyric acid) levels increase with the presence of alcohol and sedatives. Dopamine is involved in regulating moods and feeling pleasure while also helping to control body movement. GABA is an inhibitory neurotransmitter that suppresses the stress reaction, or the "fight-or-flight" response. When dopamine and GABA levels are elevated in the brain, a person is likely to feel happy and relaxed.
Over time, and with continued artificial interference from alcohol and/or sedatives, the brain may have difficulties regulating these chemicals on its own. Then, when the alcohol and drugs wear off, withdrawal symptoms can kick in. Alcohol and sedative withdrawal can be significant and even possibly fatal. The intensity of the withdrawal symptoms and cravings may make it difficult for a person to stop using alcohol or taking sedatives. Compulsive drug and/or alcohol abuse is the hallmark of addiction.
The National Survey on Drug Use and Health (NSDUH) reports that in 2016 around 20 million American adults battled addiction. Three out of every four adults who struggled with addiction battled alcohol abuse; one out of three struggled with illicit drug abuse; and one out of every nine American adults suffering from addiction struggled with abuse of both drugs and alcohol. Again, mixing sedatives with alcohol can raise the likelihood of physical dependence and may also lead to an increased risk for addiction.
In addition to a heightened risk for addiction, prolonged alcohol and sedative use can cause a number of other possible side effects, including:
- Increased rate of cardiovascular complications, such as cardiomyopathy, atrial fibrillation, myocardial infarction, and hypertension
- Raised risk for developing obesity, malnutrition, and diabetes
- Heightened odds for suffering from a stroke, dementia, or neuropathy
- Increased risk for certain types of cancers
- Damage to internal organs, including the liver and potential for developing liver diseases
- Gastrointestinal issues, such as pancreatitis and gastritis
- Mental health concerns, including depression, anxiety, and possible suicidal ideations
- Social issues, which may include homelessness, unemployment, financial struggles, criminal and/or legal troubles, becoming a victim or perpetrator of violence or aggression, and interpersonal relationship issues
The National Council on Alcoholism and Drug Dependence (NCADD) warns that excessive alcohol abuse contributes to nearly 90,000 American deaths each year. Even drinking in moderation can have negative consequences when taking medications. The CDC recommends that people taking medications that can interact with alcohol, such as sedatives, not drink alcohol at all.
Specialized Medical Detox for Polysubstance Abuse
When a person struggles with abuse of two different substances, such as alcohol and sedatives, it is called polysubstance abuse. Due to the potential for intense and even life-threatening withdrawal symptoms associated with both alcohol and sedative dependence, which are heighted by the use of both concurrently, withdrawal from these substances needs to be supervised through a medical detox program. A medical detox program can provide around-the-clock medical and mental health supervision, monitoring of vital signs, and medical management for more difficult withdrawal symptoms. Since all possible side effects are exacerbated by the use of both alcohol and sedatives together, it is important for trained professionals to manage the withdrawal process, often with the use of medications. It can be dangerous to stop using sedatives or drinking alcohol suddenly once physical dependence is in place.
The New England Journal of Medicine (NEJM) warns that in about 3-5 percent of alcohol withdrawal cases a person will suffer from delirium tremens (DTs), which is the most severe form of alcohol withdrawal. DTs may not begin right away but can start a few days after stopping drinking. With DTs a person will be severely confused, spike a fever, suffer from hallucinations and psychosis, and have seizures, which can be fatal. These withdrawal symptoms occur as the brain experiences a kind of rebound without the depressant substances suppressing brain chemistry.
Additional alcohol and sedative withdrawal symptoms can start a few hours after discontinuing drinking or drug use. These may include:
- Nausea, stomach pain, and/or vomiting
- Loss of appetite
- Blurred vision
- Trouble concentrating and thinking clearly
- Feeling of being "on edge"
- Memory troubles
- Irregularities in heart rate and blood pressure
- Difficulties sleeping and insomnia
- Possible suicidal ideations
Since alcohol and sedative withdrawal can be difficult and even potentially life-threatening, medications are often used during medical detox to manage some of the more intense side effects. Instead of stopping "cold turkey," sedative drugs may be weaned off slowly, for instance. It is important for medical providers to be aware of what substances might be in a person's system before detox begins in order to minimize complications. Generally, a drug screening is done prior to admission. Medical detox programs typically last 5-7 days on average; a person can continue straight into a comprehensive addiction treatment program following detox.
Comprehensive Treatment for Addiction
Treatment for sedative and alcohol addiction involves therapeutic methods that generally include behavioral therapy sessions as well as group and individual counseling. After a person reaches a safe level of physical stability through detox, the emotional, social, and behavioral aspects of addiction can be addressed.
Behavioral therapies aim to help people understand how the way they think influences the way they act. By changing negative thoughts, a person can positively influence future behaviors. Group therapy sessions can also teach effective communication tools, coping skills, and relapse prevention techniques. Personal triggers can be explored during individual sessions, and individuals can learn how to manage them moving forward.
Holistic methods can also be helpful as adjunctive and complementary treatment techniques that can aid in relaxation and promote healthy sleep. Things like massage therapy, chiropractic care, mindfulness mediation, yoga, spa treatments, acupuncture, fitness and nutrition programs, and expressive therapies can all enhance a person's overall wellbeing and physical and emotional health. Support groups also exist for people who struggle with polysubstance use and can be highly beneficial for long-term recovery.