The Effects of Mixing Methamphetamine and Alcohol

Alcohol is the most commonly used and abused intoxicating substance in the United States. Most adults drink alcohol, at least in moderation, and many adolescents abuse the substance illegally. Alcoholic beverages contain different percentages of ethanol, which is produced through fermenting grains or fruits. The amount of ethanol in different drinks affects how much is considered a serving.

Many people drink too much by accident because they do not understand how large a serving is. For example, one 12-ounce bottle of beer, one 5-ounce glass of wine, and one 1.5-ounce shot of hard liquor are servings. Moderate drinking is one serving for women, or two for men, once per day, six days per week or fewer. More than that, and you risk binge drinking, heavy drinking, or compulsive behaviors leading to alcohol use disorder (AUD).

By itself, alcohol can lead to serious harm, from acute problems like alcohol poisoning to chronic health problems like liver damage or cancer. However, people who struggle with other kinds of drug addiction often mix alcohol with other substances; this is polydrug abuse. It is extremely dangerous because the risks of overdose increase, side effects are unpredictable, and chronic health problems become more likely.

People who struggle with addiction to methamphetamine, whether in the form of a prescription stimulant like Ritalin or in the form of illegal crystal meth, are very likely to combine this intense stimulant with alcohol. Mixing a stimulant drug with a central nervous system (CNS) depressant, like alcohol, can temporarily relieve some of the negative side effects associated with stimulant abuse; however, on a long-term basis, these side effects will get worse faster.

What Is Meth? Why Is It Mixed with Alcohol?

Methamphetamine is a potent stimulant drug with a few approved medical uses like the treatment of attention deficit hyperactivity disorder (ADHD) and many illicit uses. According to the Drug Enforcement Administration (DEA), meth is a Schedule II substance under the Controlled Substances Act (CSA) because it has potential medical uses, but it can be very addictive and harmful. Stimulants like meth release a lot of dopamine into the brain, making the user feel good, boosting energy, and leading to paranoia or hallucinations in large doses.

Prescription versions of methamphetamine come in pill, capsule, or tablet form, and they are consumed one to two times per day based on a physician’s assessment of their patient’s needs. The drugs pass through the digestive system, so they release slowly into the bloodstream.

Illicit methamphetamines, however, are abused in different ways to cause a more rapid high. Pills may be crushed and snorted, but more often, meth is smoked or injected. This forces the drug through mucous membranes or into the bloodstream, so it binds to receptor cells in the brain quickly. This means the stimulation wears off rapidly, too.

Physical effects of meth include:

• Intense physical energy
• Wakefulness and sleeping less
• Decreased appetite, leading to weight loss and malnutrition
• Irregular heart rate
• High blood pressure
• Overheating (hyperthermia)
• “Meth mouth” caused both by eating very sugary foods and because the drug causes intense dry mouth, leading to tooth decay

Mental effects of abusing meth include:

• Aggression, mood swings, and irritability
• Anxiety or paranoia
• Insomnia or extreme sleeplessness
• Confusion
• Delusions of grandeur, or paranoid delusions
• Hallucinations
• Psychosis
• Formication – a specific tactile hallucination leading the individual to believe there are insects or ants crawling under their skin

Long-term, meth abuse leads to serious harm, including:

• Damage to nerve terminals in the brain
• Dementia similar to Parkinson’s or Alzheimer’s disease
• Chronic high blood pressure, leading to cardiovascular damage and disease
• Induced anxiety disorder or panic attacks
• Homicidal or suicidal thoughts
• Weakened immune system
• Permanent tooth damage
• Infections of the skin from picking or scratching excessively
• Other infections, including from needles or in the lungs
• Kidney and liver damage
• Extreme weight loss, leading to bone and muscle problems

Powerful stimulants like meth cause physical jitteriness, intense wakefulness, and anxiety. Stimulant abusers frequently mix alcohol with these drugs because they want to “take the edge off.” The first serving or two of alcohol can lead to relaxation and pleasure because it is a CNS depressant; this can ease feelings of anxiety, relax the heart, and make the person feel less shaky. However, these effects do not last very long, especially when combined with illicit drugs.

Concerns of Mixing Alcohol with Other Drugs

• Crystal Meth
• Mushrooms
• DMT
• LSD
• Marijuana
• Crack Cocaine
• Heroin
• GHB
• PCP
• Cocaine
• Bath Salts
• Speed
• Ecstasy
• Ketamine

The Effects and Damage from Mixing Alcohol and Methamphetamine

People who drink a lot are likely to mix caffeine, a much milder stimulant, and alcohol; people who abuse cocaine are also more likely to drink too much and mix alcohol with that stimulant. The incidence of mixing meth and alcohol is similarly high because the very short-term effects of the two drugs together can feel very good. However, mixing any stimulant with alcohol is dangerous for many reasons.

First, stimulants can mask the effects of alcohol, like sleepiness or the relaxing intoxication. This means you will feel sedated from two or more drinks and are therefore more likely to binge drink. This increases the risk of alcohol poisoning, which can be fatal. People who abuse meth and drink alcohol at the same time tend to, according to surveys, binge drink more often. In 2008, 24 percent of the meth-related emergency room admissions in the US involved alcohol poisoning.

A Columbia University research study published in 2011 examined the effects of co-administering meth and alcohol in nine adult men. While the study was small, the results can indicate the risks of these two substances in combination. The study found the following:

• Meth and alcohol combined increased heart rate and blood pressure more.
• Feelings of euphoria or intoxication were elevated.
• Adding a stimulant to alcohol abuse made the participants feel less drunk or sedated.
• Similarly, cognitive and psychomotor effects from meth were reduced with alcohol present.
• Insomnia and other sleep disturbances impacted the participants less when mixing a CNS depressant like alcohol with meth.
• Upset stomach was more likely.
• The combination led to faster tolerance to the stimulant, sedation, and euphoria, so over the course of the short study, participants needed to more of both drugs to feel the original effects.

The greatest risk of combining these two substances is cardiovascular damage. The mixture of meth and alcohol reportedly raises heart rate to 24 beats per minute more than meth alone. Short-term, this can trigger a heart attack in a person with an underlying heart problem; long-term, consistently high heart rate and blood pressure cause damage to the heart muscle, arteries, and veins, leading to damage, blood clots, hardened arteries, and other problems that can trigger a stroke, pulmonary embolism, heart attack, or heart failure.

Damage to the heart, especially increased blood pressure, increases the risk of liver and kidney damage. Alcohol directly damages the liver, which can impact the kidneys. Mixing drugs that damage both these important toxin-filtering organs will lead to failure or damage faster.

Mood disorders can be triggered by this combination, too. People who struggle with depression or anxiety are at greater risk of self-medicating with alcohol, and abusing meth can induce these mood disorders. Depression is a sign of meth withdrawal, too, so a person may begin drinking alcohol to reduce the impact of that symptom.

Overdose and Death Are the Greatest Risks

Because alcohol and meth together mask negative side effects from abusing the other substance, the risk of poisoning or overdose increases greatly. You will not feel how much of either substance you’ve consumed, so you’re more likely to continue abusing the drugs until you pass out or body systems begin to fail. Signs of alcohol poisoning include:

• Extreme confusion
• Slow or irregular breathing
• Weak or irregular heartbeat
• Low body temperature
• Cold, clammy, or blue-tinted skin
• Vomiting
• Seizures
• Unable to be woken up

Signs of a meth overdose include:

• Chest pain
• Irregular heartbeat
• Extremely high or extremely low blood pressure
• Labored or difficult breathing
• Agitation, mood swings, or restlessness
• Hallucinations
• Hyperthermia
• Psychosis
• Seizures

When the drugs are combined, heart problems, breathing trouble, vomiting, psychosis, and seizures become more likely. These conditions can be fatal immediately, so if someone overdoses on either substance, call 911. They need emergency medical attention to survive.

Mixing any drugs together is dangerous, and intoxicating and addictive substances like meth and alcohol should never be combined. If you abuse meth, alcohol, or both, get help through an evidence-based rehabilitation program now.