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Alcohol is a legal substance in the United States. People aged 21 and older can purchase and consume alcohol, although government regulations control how high blood alcohol levels can be to safely drive, when a bar or restaurant must cut a patron off from alcohol consumption, and how safe it is for a person to consume alcohol and controlled substances, like prescription or over-the-counter medications.
Consuming alcohol, even in moderate amounts, with any other drug can be very dangerous. It is important to understand moderate alcohol consumption, but it is also important to understand the negative effects of mixing alcohol and other intoxicating substances.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines different types of drinking, and whether they are likely to lead to problems with drinking or whether these consumption patterns can be managed in a healthy and safe way.
A person with a low risk of alcohol use disorder meets the following NIAAA guidelines:
Research through NIAAA shows that about two in every 100 people meet the criteria for safe drinking. Again, although alcohol is legal in the US for adults aged 21 and older, too many people abuse alcohol in some way.
The Centers for Disease Control and Prevention (CDC) reports that moderate, safe drinking is one drink per day for women and two drinks per day for men. This standard is not intended as an average over several days; drinking two drinks or more per hour is considered binge drinking even if the person does not consume alcohol for several days afterward.
Medical research shows that some kinds of alcohol, like beer or wine, may offer some health benefits when consumed in very moderate amounts. This is a hotly debated topic, but some evidence suggests health benefits, including:
In contrast, problematic drinking – which includes consuming alcohol with controlled substances – can increase the risk of all of these conditions, among many other health problems.
Mixing alcohol, even in moderation, with any controlled substance is dangerous. A controlled substance in the United States is defined by its schedule according to the Controlled Substances Act. Schedule I drugs are illicit and have no medical purpose; Schedule II substances are addictive and often abused but can still be prescribed for limited medical reasons; and so on. Schedules help the government define how addictive a substance is versus how important it is for medical purposes and how easy it should be for the public to have access to the drug.
However, any of the drugs scheduled per the CSA can be dangerous or cause serious side effects when mixed with alcohol. For example, benzodiazepines are Schedule IV, so they are not considered very dangerous; however, they can greatly enhance the effects of alcohol on the body, leading to extreme intoxication, dangerous side effects, and a higher risk of alcohol poisoning after fewer drinks.
Alcohol and illicit drugs like cocaine or marijuana can be very dangerous too. Central nervous system depressants, like marijuana or opioids, create a relaxed high; alcohol intensifies that sensation but also increases the serious side effects, like nausea, dizziness, cognitive and memory problems, mood depression, and changes to breathing and heart rate.
People who abuse stimulants, like amphetamines or cocaine, may ingest alcohol to modulate the intensity of the stimulant’s side effects; twitching, anxiety, and paranoia are all side effects from taking illicit stimulants at recreational doses, while heart palpitations, breathing problems, memory issues, hallucinations, delusions, and stroke are all risks from taking too much of a stimulant drug. Mixing alcohol with these drugs may reduce some of these sensations, but it can increase the risk of heart damage, stroke, breathing problems, overheating, and organ damage, especially to the liver and kidneys.
Even if a person follows guidelines for moderate drinking, alcohol can become dangerous when combined with any controlled substance. Organ damage becomes more likely, and side effects can become more intense or dangerous. People taking prescription medications should not drink while on these substances. People who ingest drugs for nonmedical reasons and consume alcohol at the same time are engaging in polydrug abuse.