Alcohol and Stimulant Drugs: Double Trouble

Last Updated: August 7, 2019

alcohol and stimulants

Some people take alcohol and drugs in conjunction, for example, cocaine and alcohol. Others mix alcoholic drinks with prescription stimulant medications, such as methylphenidate. The use of Ritalin and alcohol together is usually to reduce some of the unwanted side effects of the stimulant such as shakiness while continuing to experience euphoria and high energy levels. Less commonly, stimulants are taken to overcome the inertia and lethargy associated with heavy ethanol consumption. Just like mixing alcohol and weed is a bad idea, mixing medications like pseudoephedrine and alcohol can prove dangerous. Let’s find out more about the potential interactions between ethanol and stimulants, the scale of the problem, and treating addiction to these substances.

What Happens When You Mix Alcohol and Stimulants?

Some stimulants are illegal drugs while others are prescription medications. Alcohol, on the other hand, is easily available legally. Stimulants accelerate the firing of neurons in the human brain and spinal cord. People abuse them to experience intense happiness, improved attention, increased energy, enhanced sexual performance, and suppressed appetite. In contrast, alcohol depresses the functioning of the central nervous system. People drink alcohol to reduce anxiety and stress and unwind after a long day. The abuse of Ritalin and alcohol together is usually to blunt the undesirable effects of the stimulant, such as jitteriness and hyperactivity. Some people use them together to experience prolonged euphoria without realizing the dangers of this combination.

There is a common perception that taking a prescription drug with ethanol is less hazardous than using alcohol and cocaine.

What happens if someone takes prescription stimulants and drinks at the same time, for example, Vyvanse and alcohol? Is the result similar to Vicodin and alcohol? Ethanol dampens the effects of stimulants so that more of the drug is required to achieve the same euphoria or concentration. This can lead a person to overdose on the prescription stimulants or illegal drugs like cocaine. The converse is also true, i.e., stimulants reduce the effects of alcohol. This means if someone mixes MDMA and alcohol, they may not feel the intoxicating effects of ethanol and may drink excessively. Just like mixing shrooms and alcohol, the results can be unpredictable and dangerous.

Some of the health effects of alcohol and stimulants combined include:

  • Increased risk of heart attack, stroke, seizures, and high blood pressure
  • Increased burden on the liver, kidneys, and gastrointestinal system
  • Reduced immunity and increased risk of infections
  • Increased risk of certain cancers
  • Severely impaired cognitive abilities with poor decision making, judgment, and attention with an increased risk of accidents, altercations, and injuries
  • Long-term neurological complications with impaired memory and movement
  • Potential to develop concurrent mental illnesses
  • Tolerance, physical dependence, and addiction
  • Dangerous withdrawal symptoms with the risk of suicide attempts

Some of the health hazards of using ethanol with specific stimulants are listed below:

Ethanol and Amphetamines

The combination of amphetamines like methylphenidate and alcohol can be deadly with:

  • Violent or erratic behavior
  • Heart attacks
  • Overdose or alcohol poisoning
  • Impaired judgment and thinking
  • Enhanced side effects of both drugs including nausea, vomiting, dehydration
  • Cardiovascular problems
  • Aggressiveness and lack of inhibition
  • Poor reaction time, motor coordination, and vision
  • Increased risk of seizures

Alcohol and Cocaine

The co-abuse of these two substances results in the production of an extremely toxic substance called cocaethylene in the liver which has a three to five times longer half-life than cocaine. Other health complications of cocaine and alcohol include:

  • An 18 to 25 times higher risk of immediate death than cocaine alone
  • Increased heart rate and blood pressure
  • Hormonal effects with increased cortisol and prolactin levels
  • Liver damage
  • Compromised immunity
  • Seizures
  • Poor blood flow to the brain compared to individuals taking each substance alone
  • Negative effects on intelligence, memory, and learning
  • Increase in dopamine concentrations and alterations in reward pathways

Alcohol and Methamphetamine

Effects of alcohol and psychostimulant interaction include:

  • Alteration in methamphetamine metabolism with increased active metabolites
  • Increased euphoria
  • Increased heart rate and blood pressure
  • Damage to the brain in developing babies with prenatal exposure
  • Impairment of antioxidant enzymes

Alcohol and MDMA (ecstasy)

Combined MDMA alcohol has a number of health effects, including:

  • Cardiovascular stress and toxicity
  • Increased stimulant blood levels following ethanol intake
  • Longer duration of euphoria
  • Reinforced effect of MDMA and reduced sedative effect of ethanol
  • Learning and memory impairments
  • Impairment in dopamine reward pathways leading to increased ethanol consumption
  • Psychopathological changes due to depletion of serotonin
  • Impaired brain development with prenatal exposure in pregnant women

alcohol and methamphetamine

What Does Research on Ethanol and Stimulants Show?

Drinking is socially acceptable and many young people use prescription stimulants to improve academic and sports performance. Stimulants and alcohol have opposing mechanisms and deaden the effects of each other. Yet, these two substances can have potentially dangerous interactions just like Lexapro and alcohol. Stimulants allow people to drink more without experiencing intoxication, increasing the risk of ethanol poisoning. Alcohol reduces the effect of stimulants, leading a person to take more and more of the drug, with an increased risk of overdose. Research has revealed the serious magnitude of the problem and the dangers of using these substances in conjunction:

  • According to combined substance abuse data from SAMHSA, out of the 176 million people who reported consuming alcohol in 2015, approximately 5 million also admitted to abusing prescription stimulants.
  • study found that people who drink alcoholic drinks daily are five times more likely to use methamphetamine compared to non-drinkers.
  • Research has shown that alcohol use disorder is 75 percent higher among amphetamine-dependent patients.
  • A study conducted by behavioral scientists at the University of Kentucky found that moderate drinkers are more likely to abuse stimulants like ephedrine and alcohol and are more vulnerable to the effects of amphetamines.

Treating Stimulant and Ethanol Addiction

While most people are aware that mixing sleeping pills like Ambien and alcohol is not a good idea, not many people know that the combination of ethanol and stimulants can have serious health consequences. Treatment for dual addiction to amphetamine and alcohol requires a systematic and holistic approach.

Dependence on more than one substance can only be overcome with targeted treatment that addresses not only the physical symptoms of withdrawal but also the underlying psychological causes that lead to substance abuse.
This is why inpatient care at a specialized addiction treatment facility often produces the best results.

MDMA alcohol addiction treatment programs typically consist of detoxification with physician-guided management of withdrawal symptoms. Medications may be prescribed to reduce cravings and make the weaning process safer and more comfortable. Behavioral therapy and group interventions are used to address the root cause of the addiction. Finally, aftercare programs are essential for long-term recovery and relapse prevention. Successfully overcoming addiction to stimulants and alcohol is not easy, but it is not impossible either. With peer support, commitment, and will power, cocaine and alcohol addiction can be a thing of the past.


Brian Obinna Obodeze

Brian Obodeze

Content Writer

Brian Obinna Obodeze is a professional health-niche content developer for with six years of experience as a research writer. He is an expert in medical content development, especially in the field of addictions, general health, homeopathic medicine, and pharmaceuticals.

Brian has a bachelor’s degree in Microbiology from the University of Benin and has worked as a Lab Scientist and as a public healthcare officer. His hobbies include physical fitness, reading, and social entrepreneurship.

Medical review by Dr. Gregory Okhifun

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