Abusing more than one substance, or polydrug use is common.
One study that collected data from Tennessee from 1998 to 2004 concluded that approximately 48.7 percent of the people studied engaged in polydrug abuse.
Cocaine, marijuana, and alcohol were the drugs most frequently abused.
On its own, alcohol abuse can have fatal consequences. The risk of devastating side effects, including overdose and death, increases when someone uses another drug simultaneously.
In 2015, approximately 15.1 million people age 18 and older in the U.S. had alcohol use disorder. Alcohol abuse is among the most common substance use disorders.
Using alcohol alone can increase the risk of significant health issues, such as cirrhosis, other alcohol-related liver diseases, and several cancers, including cancers of the mouth, pharynx, liver, esophagus, larynx, and breasts. In fact, in 2009 in the U.S., one in three liver transplants were due to alcohol-related liver disease.
The following are signs of alcohol intoxication:
As someone continues to consume alcohol, their blood-alcohol concentration will rise. At 0.25 percent, loss of consciousness and alcohol poisoning can occur. At 0.4 percent and above, respiratory arrest, coma, and death are possible.
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Numerous drugs are mixed with alcohol. In general, people combine alcohol with other substances to either increase the effects or balance them out.
The illicit drugs people most commonly combine with alcohol include:
People may also combine alcohol with prescription medications to intensify the high they get from certain medicines. These medications include:
In the U.S. in 2009, there were approximately 4.6 million drug-related emergency room visits throughout the country. About 14 percent of these visits were related to alcohol use with at least one other drug. The drugs most often combined with alcohol were marijuana, cocaine, and heroin.
In 2009, approximately 519,650 emergency room visits were associated with using alcohol with at least one other drug. The drugs most frequently combined with alcohol included:
It is hazardous to mix any drug with alcohol, but the most dangerous combinations involve drinking alcohol with ecstasy, opioids (prescription pain medications and heroin), and cocaine.
Ecstasy: This is a type of stimulant that causes increased serotonin production. This affects sexual activity, aggression, mood, pain sensitivity, and sleep. When someone takes ecstasy and alcohol simultaneously, the combination may reduce how intoxicated they feel, putting them at risk for overdose.
Dehydration is more likely when combining both substances. In the most severe cases, it might lead to:
Other possible effects of combined ecstasy and alcohol use include:
Opioids: Mixing opioids and alcohol may cause arrested or slowed breathing, blood pressure, and pulse; coma; unconsciousness; and death. This is because both opioids and alcohol have depressant effects on the body.
Respiratory depression is the most concerning effect. If this occurs, it reduces the level of oxygen the brain has, which can decrease its function. The brain will also start shutting down different organ systems in the body. Eventually, the lack of oxygen can result in death or brain damage.
Cocaine: People mix cocaine and alcohol to balance the effects of each drug. Cocaine is a stimulant, and alcohol is a depressant.
When these two substances are combined, cocaethylene is produced. This substance is a metabolite of cocaine. It can result in both neurotoxic and cardiotoxic effects, including:
There are several ways that mixing alcohol with drugs can impact health. Alcohol and other substances can affect each other’s distribution, excretion, absorption, and metabolism when consumed together. Depending on how much alcohol someone drinks, it can either increase or delay the absorption of the other drug the person is taking.
If alcohol delays drug absorption, the person may not experience the desired effects when they think they should. This could cause them to take more of the other drug, which could result in an overdose.
The reduction in metabolism may increase the blood concentration of the other substances a person is taking. This could result in the formation of new metabolites and boost toxicity.
When using alcohol with another drug, the side effects of each substance may be more severe. For example, cocaine can put stress on the heart. When someone is also consuming alcohol, the drug combination can result in cardiovascular toxicity, which increases stress and pressure on the heart.
Other common effects of combining substances include:
When combining substances, the risk of overdose is higher. This is partially due to one masking the effects of the other. For example, if someone is taking Adderall and alcohol, the Adderall may mask the symptoms of alcohol intoxication. This can result in people inadvertently taking more of a drug than they usually would.
If someone using alcohol and another drug overdoses, it can be harder to treat the overdose. For example, if someone is using heroin and drinking, and they overdose, naloxone can only reverse the heroin component of the overdose.
Treating polydrug use that involves alcohol and illicit drugs can be challenging. Because of this, it is necessary for people to seek help at a professional treatment facility. The treatment team can create a care plan focused on this type of polysubstance abuse.
Polysubstance use may also amplify the symptoms of a co-occurring mental health disorder. A survey conducted in 2014 concluded that in the U.S., approximately 7.9 million people have both a substance use disorder and a mental health disorder at the same time.
Cases of polydrug abuse present a more complicated treatment situation. As a result, they are often recommended for inpatient care initially.
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