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Alcohol and Other Substances

Here’s what you need to know about combining alcohol with other drugs, and the risk for multiple addictions.

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Alcohol and other substance use often go hand-in-hand with one another. Many people who misuse alcohol also struggle with other addictions, including both legal and illegal drugs. It is also common to combine alcohol with other drugs for recreational purposes, to alter or multiply the effects.

The link between alcohol use disorder and other addictions is well established, and it’s well known how dangerous this phenomenon is. As for casual recreational use, combining alcohol and other substances may not always have such serious consequences. But it certainly can, and it can be a risky, slippery slope to dependence if you do it frequently. In addition, some combinations are much riskier than others.

Below, we’ll cover what you need to know about the interactions of drugs and alcohol, what the common risks are, and what to do if you think you are addicted to alcohol and another drug at the same time.

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How Common Is It to Mix Alcohol with Other Substances? 

If you’ve ever spent time on the club or festival circuit, you know that combining alcohol with other drugs is extremely common. Many people combine marijuana, tobacco, or even psychedelics with alcohol when out with friends. 

However, the widespread use of alcohol and other substances doesn’t mean it’s safe. Depending on the combination and how much you consume, the mixture of drugs and alcohol can have anything from minor effects to fatal impacts. It’s important to arm yourself with information, and your safest bet is to avoid combining drugs completely. 

What are the Risks of Combining Alcohol and Other Drugs?

Common sense would tell us that combining opioids or cocaine with alcohol would be dangerous, but even seemingly more “light” combinations can have life-threatening consequences. 

What happens when you combine alcohol with drugs? In many cases, taking other drugs before drinking can reduce your awareness of how drunk you are, increasing your chances of injury or alcohol poisoning. Marijuana and alcohol, for example, is one of the most frequent drug combinations found in car accidents.1 In other cases, combined alcohol and drug abuse increases the likelihood of acute illness or drug-related hospitalizations. 

So, while smoking a joint and having a beer isn’t always such a big deal, it’s important to know the facts, your personal risk factors, and stay cognizant of how much you are consuming. And there are certain combinations you should always avoid. 

Alcohol Use Disorder and Other Addictions 

The issue of alcohol and substance abuse is more than just a casual phenomenon found at parties and other social events. Full-blown addiction to both drugs and alcohol is a widespread issue, and poses a major challenge for many people in recovery.

There are various reasons people may become dependent on both alcohol and another substance. To start with, there is a sense in which alcohol can serve as a “gateway drug.” Drinking breaks down people’s inhibitions, and other substances may be available in the contexts in which people drink. People may also self-medicate chronic physical or emotional pain, and seek out several substances that seem to help, including alcohol. Finally, the phenomenon of cross-addiction can play a role.

So, how common is it for people to have additional addictions alongside alcohol? Apparently, very. In one study, more than 60 percent of patients at an alcohol rehab facility also had a history of problematic drug use.2 Statistics also show that men are more likely than women to be affected by overlapping substance abuse disorders, as are those under the age of 24.3

man lighting a joint dark shot

Common Combinations with Alcohol

So, what are some of the specific effects and risks of combining alcohol with different substances? Below, we’ll look at some of the most common mixtures, and what you need to know.

Smoking and Drinking

Alcohol and tobacco are two of the most commonly combined substances—this mixture is visible almost everywhere. For many people, alcohol lowers inhibitions and makes them more willing to do things they would not do sober. This includes smoking cigarettes. In fact, more than 85 percent of people with a history of alcohol abuse also smoke. This figure is particularly striking when one considers that only around 13 percent of all Americans smoke in general.4

While both substances are normalized, both can also have deadly health consequences. While negative health impacts aren’t generally immediate, the combination can greatly increase your risk for certain types of cancer.

Read more: Smoking and Drinking

Opioids and Alcohol Use

Many people struggle with both opioid and alcohol addiction at the same time. This can be an extremely dangerous combination, skyrocketing the likelihood of fatal overdose. Approximately 20 percent of opioid overdoses each year are linked to alcohol use.5 This risk seems to be particularly elevated for people who engage in binge drinking.

Read more: Opioids and Alcohol

Cocaine and Alcohol Use

Cocaine and alcohol are also widely used together, and this combination can be extremely dangerous. Since cocaine is a stimulant and alcohol is a depressant, one might expect them to “balance” each other’s effects. But, in fact, the two can combine in the body to create a substance called cocaethylene. This can result in more extreme intoxication and multiply the risks of cardiovascular issues, reckless behavior, liver damage, and even sudden death.

Read more: Cocaine and Alcohol

LSD and Alcohol

While LSD is probably best known for its role in the psychedelic era, it remains a popular party drug to this day, and is frequently combined with alcohol. LSD can reduce a person’s ability to assess how intoxicated they are, increasing the chances of alcohol poisoning. The combination may also increase the chances of a “bad trip,” and worsen other common side effects of each substance.

Read more: LSD and Alcohol

Molly/MDMA and Alcohol

MDMA, also known as molly or ecstasy, is one of the best known club drugs in the United States, and is often found in the same context as alcohol. One of the main risks of this mixture is that it can elevate the concentration of molly in the bloodstream, and increase the risk of MDMA toxicity. The combination may also increase the risk of hyperthermia, dehydration, and organ damage.

Read more: MDMA and Alcohol

Marijuana and Alcohol Use

Many people combine alcohol and marijuana—all the more so as the legalization of marijuana spreads. In small amounts, this isn’t always dangerous. But in large amounts, as with other combinations, the two can enhance each other’s effects. This isn’t always a desirable thing: you might feel more ill from excessive drinking if you also smoke marijuana, or be more likely to drink a dangerous amount due to altered judgment. This also applies to combining delta-8 THC products with alcohol.

While there is some discussion of the use of marijuana to manage alcohol withdrawal, more research is needed before we know how useful or safe it really is.

Kratom and Alcohol Use

Kratom is a psychotropic substance originally found in Southeast Asia. Until recently, it wasn’t widely seen in the United States, but that is changing in many areas of the country. Because it is not illegal, it is relatively easy to find, and has largely been marketed as a safe way to boost your mood. This means that many people do not really think about potential risk factors, especially when combining it with alcohol. However, because both alcohol and Kratom have certain sedative properties, combining them may increase the risk of overdose.

Read more: Kratom and Alcohol

Benzodiazepines and Alcohol

Benzodiazepines, like Ativan and Xanax, are pharmaceuticals that are commonly used to treat anxiety and other mood disorders. Benzodiazepines are often used in combination with alcohol, especially among people who self-medicate problems like anxiety. Both alcohol and benzos are highly addictive. And, since both are depressants, the combination can be dangerous, or even fatal.

Read more: Benzodiazepines and Alcohol

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Treatment of Alcohol Use Disorder and Other Addictions 

Alcohol and substance use disorders remain a common problem in the United States. Many people struggle with multiple addictions at once because the underlying genetic and environmental factors for each are similar. Alcohol can also be a “gateway drug,” meaning that those who drink heavily are more likely to encounter and use other substances.

Treating alcohol use disorder (AUD) on its own can be challenging, but there are more options than ever before. At Ria Health, we combine several evidence-based strategies to help our patients change their patterns around alcohol. These include medication-assisted treatment, weekly coaching, and digital progress-tracking tools. 

While Ria only offers support for alcohol use disorder, our team has a broad knowledge of addiction treatment and can take any other challenges you have into account. We create a custom plan for each person, and treat each member as the whole individual they are. To learn more about how we can help you develop a healthier relationship with alcohol, schedule a call with a member of our team, or get started with us today.

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