Mixing Amphetamines and Alcohol
An amphetamine is a potent medication that have a stimulant effect on the central nervous system. The trade names of drugs classified as amphetamines include the familiar drugs Adderall, Dexedrine, and Vyvanse as well as numerous generic drugs. Amphetamines have several medicinal uses that include:
- The treatment of attention deficit hyperactivity disorder(ADHD)
- The treatment of the sleep disorder narcolepsy
- The treatment of issues with obesity or use as weight loss supplements
- The treatment of issues associated with extreme lethargy due to specific types of medical conditions, such as stroke, head injury, etc.
Amphetamines are also used illicitly as drugs to produce euphoria, as cognitive enhancers or study aids, and as athletic performance-enhancing drugs. The use of amphetamines primarily affects the neurotransmitters dopamine and norepinephrine, although other neurotransmitters are also affected.
When used under the supervision of a physician and for therapeutic reasons, amphetamines can promote attention control, reduce hyperactivity, reduce daytime sleepiness associated with narcolepsy, and curb appetite. They also have side effects of producing mild to intense levels of euphoria or feelings of wellbeing, increased wakefulness, obvious stimulating effects, and appetite reduction. In high doses, numerous side effects can occur, including issues with psychosis, cardiovascular effects, and even seizures.
Individuals who use amphetamines illicitly or for recreational purposes typically use much larger doses than the doses that are prescribed for therapeutic uses, and this results in the potential for more serious side effects. Amphetamines are classified as Schedule II controlled substances by the Drug Enforcement Administration (DEA).
Amphetamine Abuse
Per the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2015, about 17.2 million individuals over the age of 12 admitted to using stimulant drugs; of these individuals, 11.3 million used amphetamine products. Of the individuals using amphetamine products, approximately 4.8 million reported misusing amphetamines at least once.
Stimulant drugs have relatively high rates of misuse and abuse compared to many other prescription drugs. Misuse of a drug does not necessarily imply that the individuals develop a substance use disorder (abuse or addiction), but it does imply that the individual uses the drug for reasons, or under circumstances, that are not as prescribed.
Males who reported misusing amphetamines most often did so in order to stay awake or focus better. Females are more likely to report misusing amphetamines to assist with weight loss.
Individuals who develop abuse issues with amphetamines would be diagnosed with a stimulant use disorder. According to the American Psychiatric Association (APA), the prevalence of stimulant use disorders as a result of amphetamine abuse is 0.2 percent among individuals over the age of 12. The prevalence rates are generally the same for individuals between the ages of 12 and 17, and those over age 18. However, the prevalence in females between the ages of 12 and 17 is higher (0.3 percent) than it is for males in any age group (0.1 percent).
Amphetamine and Alcohol Abuse
According to SAMHSA, of the nearly 176 million people who reported consuming alcohol, nearly 5 million also reported misusing prescription stimulants in 2015; this includes any type of prescription stimulant medication. Research indicates that abuse of amphetamines is not uncommon in individuals who have a diagnosis of an alcohol use disorder. For instance, epidemiological data collected in 2008 indicated that 0.8 percent of men with an alcohol use disorder and 2.2 percent of women with an alcohol use disorder also have a co-occurring stimulant use disorder as a result of amphetamine abuse.
Other data indicates that among the estimated 175.8 million people aged 12 or older who reported consuming alcohol, 4.9 million also reported that they also misused any type of a prescription stimulant (2.8 percent of past-year alcohol users). Data collected by SAMHSA between 1999 and 2008 indicated that there was a 76 percent increase in overdose cases admitted to emergency departments and involved the use of alcohol and prescription medications. A research article published in the Journal of Studies on Alcohol that focused on college students (sample size slightly over 4,500) indicated that about 4 percent of the sample had simultaneously used alcohol in conjunction with stimulant medications like amphetamines.
Data collected by APA, SAMHSA, and other organizations has consistently indicated that the most common substance abused in conjunction with other types of drugs is alcohol. Use of alcohol with any type of prescription medication or illicit drug results in a number of potentially unsafe situations. Nearly every prescription medication warns that the medication is not to be used with alcohol yet many individuals ignore the risks and continue to use alcohol in conjunction with other medications or potential drugs of abuse.
The Dangers of Mixing Amphetamines and Alcohol
Individuals who combine alcohol with amphetamines are combining drugs that have opposite mechanisms of action. Alcohol is a central nervous system depressant, which means that it slows the functions of the neurons in the central nervous system, whereas amphetamine is a central nervous system stimulant, which speeds up the functions of the nerves in the central nervous system.
Alcohol use results in the facilitation of the inhibitory neurotransmitter GABA (gamma-aminobutyric acid) and the suppression of the excitatory neurotransmitter NMDA (N-methyl-D-aspirate), a subtype of glutamate, the most prominent excitatory neurotransmitter in the central nervous system. Amphetamines increase the availability of excitatory neurotransmitters, such as norepinephrine and glutamate, and also increase the availability of dopamine.
The combination of a central nervous system depressant and a central nervous system stimulant results in numerous reactions.
- Individuals using amphetamines for medicinal reasons along with alcohol counteract the effects of the amphetamine. Because the doses used for medicinal purposes are typically relatively low, even a small amount of alcohol can cancel out the effects of a stimulant.
- For individuals who are using amphetamines for their psychoactive effects (in order to get high), when they are used in conjunction with alcohol, the effects of the stimulant medication are also deadened. However, because an individual’s system will naturally metabolize alcohol before metabolizing other substances, individuals who use alcohol to deaden the effects of amphetamines may begin to take more and more amphetamine in order to achieve the stimulating effects. This can lead to a potential overdose on the amphetamine.
- Opposite effects can also occur. Individuals who are taking stimulants in conjunction with alcohol will typically not feel as intoxicated as they normally would feel given the level of alcohol they have consumed. This may result in an individual drinking more and more alcohol. Individuals can suffer from severe issues, such as alcohol poisoning or even alcohol overdose, as a result of this practice. Research suggests that individuals who combine alcohol with amphetamines will often drink far more alcohol than they can normally tolerate and may suffer serious effects as the result of this increased alcohol consumption as opposed to overdosing on stimulants; however, both scenarios are certainly possible.
- Cognitive effects occur as a result of abusing amphetamines or alcohol alone. When an individual combines these drugs, there is increased potential for issues with behavioral control, poor judgment, poor emotional control, significantly reduced rational thinking, and an increased risk for accidents. For instance, individuals who combine amphetamines and alcohol have poor emotional control and may become belligerent, hostile, and aggressive even though they are normally not this way. People who combine these drugs may engage in risky behaviors as a result of a loss of inhibitions.
- Obviously, individuals who mix these two drugs will suffer numerous issues with reaction times, coordination, and ability to operate machinery. These physical effects combined with significant declines in their cognitive abilities can result in potentially serious issues when an individual operates an automobile or other machinery.
- Other physical effects that can also occur as a result of combining these drugs that include nausea and vomiting. The use of either of these drugs can result in dehydration, and combining them increases this risk. Dehydration can be potentially fatal.
- When individuals combine amphetamines and alcohol, there is an increased risk to develop neurological issue, such as seizures. Seizures occur when there is unrestrained firing of neurons in a particular area of the brain. This unrestrained firing results in an individual becoming convulsive, confused, and losing control, and in some cases, this situation can be fatal. Significant brain damage can occur in anyone who has a seizure.
- Other organ systems are affected as a result of the combination of amphetamines and alcohol. For instance, combining these drugs produces severe cardiac stress that can include irregular or increased heartbeat, increased blood pressure, and the increased potential to develop a stroke or heart attack. Individuals with pre-existing conditions that make them more likely to develop a stroke or heart attack are at an even higher risk. Chronic abuse of alcohol and amphetamines may result in significant issues with arterial sclerosis, chronic high blood pressure, and heart disease.
- Combining these drugs puts a significant burden on the gastrointestinal system, the liver, and kidneys. Chronic use of alcohol and amphetamines can result in significant liver or kidney damage that may not be reversible (e.g., cirrhosis of the liver). There is also a significant increase for the development of ulcers in individuals who combine these drugs over the long-term.
- Long-term abuse of alcohol and amphetamines can lead to the development of other chronic neurological issues, such as damage to the central nervous system, the peripheral nervous system, and even the development of dementia.
- Individuals who combine these substances run the risk of developing psychological symptoms, such as depression, anxiety, and psychosis, while under the influence of the drugs. Issues with depression and anxiety may persist after one has stopped using the drugs. For some individuals, the development of significant psychiatric problems, such as suspiciousness, paranoia, and even full-blown psychosis, can occur as a result of chronic use of amphetamines and alcohol in combination.
- Of course, individuals who chronically abuse alcohol and amphetamines in combination run the risk of developing complicated issues with a substance use disorder. Amphetamines are not believed to produce physical dependence; however, individuals who develop a stimulant use disorder often have serious psychological issues once they discontinue their use of the drug. Alcohol is a drug that can result in the development of a severe form of physical dependence that may require intensive medical treatment if the person attempts to quit drinking. People who develop substance use disorders as a result of polysubstance abuse often have very complicated presentations and require intensive and integrated treatment.
Other issues that can result from chronic use of alcohol and amphetamines include significant losses in productivity at work or school, significant damage to personal relationships, and significant financial issues.
The serious effects that can occur as a result of combining amphetamines and alcohol are not necessarily the result of chronic abuse. For example, an article reported in the Journal of the American Board of Family Medicine presented the case of a healthy, 20-year-old college student who had been taking the prescription medication Adderall for ADHD. The individual combined the Adderall with alcohol on one occasion and suffered a significant heart attack. While such events are certainly rare, there is no way to predict who will develop severe adverse effects as a result of combining a serious controlled substance like an amphetamine with alcohol on even one occasion. The safest approach is to avoid combining these drugs at all.
Conclusions
Using amphetamines and alcohol together is a potentially dangerous practice even when the drugs are used in small amounts and only used occasionally. Individuals using amphetamines for medicinal reasons counteract the effects of the amphetamines when they combine them with alcohol. Individuals who use alcohol and amphetamines in conjunction in order to achieve psychoactive effects of the drugs run the risk of experiencing severe and even potentially fatal effects as a result of this combination.