According to research done by the Centers for Disease Control and Prevention, about 55% of adults in the United States are using prescription medication. The latest available data from the 2019 National Survey on Drug Use and Health (NSDUH) says that approximately 55% of adults in the United States reported consuming alcohol in a typical month.

Why is that important? 

Even though both of these activities are legal, they can still be dangerous, especially when combined. It’s critical that a person who is using more than one substance understands the potential negative consequences of mixing drug classes.

What happens when alcohol is combined with commonly used prescription medication?


Opioids interrupt the pain messages in the receptors of the muscles, organs, or skin, in the spinal cord, and in the brain. They replace the body’s natural “feel good” chemical and produce a chemical-induced sense of well-being. Opioids include opioid prescription pain relievers, such as Oxycodone, OxyContin, Codeine, or Morphine. 

Opioids cause the user’s breathing to slow. When combined with alcohol, side effects increase. It is also important to note that a person may not experience the same side effects each time that they combine alcohol with opiates. A person could take depressants and opiates together one time and have no negative side effects, and could then experience an overdose the next time.


Depressants lower your body’s basic functions and brain activity by “depressing” the nervous system. They usually cause a feeling of relaxation or drowsiness. Depressants include prescription tranquilizers, prescription sedatives, and inhalants. Alcohol is also classified as a depressant.

When alcohol is combined with another depressant drug, the effects are multiplied. The greatest immediate risk of using alcohol and another depressant drug is the increased risk of overdose. 


Stimulants work on the brain and central nervous system to temporarily speed up, or “stimulate,” mental and physical processes. They usually increase alertness, mood, and energy. Stimulants include illegal drugs like cocaine, but also commonly prescribed medication such as Ritalin or Adderall, and caffeine.

Alcohol acts on the body in the opposite way that stimulants do. When used at the same time, the stimulant often masks the effects of alcohol. This means that the user is more likely to consume higher, and dangerous, amounts of alcohol. Higher levels of blood alcohol can result in significant impairment of coordination and judgment, blackout, and potential death.

The alcohol may also mask the effects of the stimulants, resulting in the user taking more of the stimulant drug to achieve the same effects.

Mixing stimulants with alcohol increases the toxic effects on the body. The combination of drugs is more likely to cause cardiovascular side effects and problems, such as high blood pressure and heart attack, increased metabolism, seizures and stroke.

The combination can also severely impair cognitive abilities, resulting in poor decision-making, judgment, and inability to focus. There is an increased risk of accidents, altercations, and injuries as well as a higher potential for developing mental illnesses or having long-term issues with memory or movement.


Hallucinogens affect thinking processes and perceptions, including a person’s perceptions of time and distance and space. They may make the user see or feel things that aren’t there or perceive them differently than they are. Hallucinogens are unpredictable and risky. Only one hallucinogen, Ketamine, has been approved for medical use, and in very restricted applications.

Since the effects of hallucinogens are unpredictable, the ways in which hallucinogens will react with alcohol are also unpredictable. Ketamine is a hallucinogenic but it also acts in the body as a depressant. Mixing ketamine with another depressant like alcohol intensifies the effects and the risks of overdose, slowed breathing or respiratory failure, and organ damage.


Although marijuana doesn’t really fit into the “prescription drug” category, due to the rise in medical marijuana use, we felt that it would be valuable to include it here. 

Marijuana doesn’t easily fit into any one of these drug classes as it has depressant, stimulant, and hallucinogenic effects. 

The hallucinogenic effects come from THC. The percentage of THC in marijuana can vary, depending on the type (i.e. concentrate, edible, etc…) or strain of the marijuana. CBD and some types of medical marijuana may have very little of the THC component. 

However, aside from the hallucinogenic effects, people also react differently to marijuana, some experiencing more of the stimulant effects and others more of the depressant effects. This means that combining marijuana with alcohol can also have unpredictable effects. It can compound the depressant effects of alcohol, making overdose more likely. Or it can mask the depressant effects of alcohol, making the user more likely to consume higher, and dangerous, amounts of alcohol.

Other Drugs covers four drug classes: opioids, depressants, stimulants, and hallucinogens. It can be used as a prevention course, to help non-users make educated and good decisions when facing the pressure to use drugs. It can also be used as an intervention course, to help users make a plan for change. All of 3rd Millennium courses use a motivational interviewing style and incorporate evidence-based practices for behavior change, like personalized feedback and norms perception correction.