Alcohol combinations
From the happy combination to the severe danger

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Red light: Look out !

Alcohol and tobacco

Data on the general population reveal that smokers drink more than non-smokers; that drinkers smoke more than non-drinkers; that alcohol abuse is associated with heavy tobacco use; and that the vast a majority of alcoholics smoke. Alcohol and tobacco seem to make the “perfect” couple.

Three explanations have been offered regarding the correlation between drinking and smoking:

  • Both have similar contextual risk factors, i.e. they are both associated with “time out.” Until just recently, they were the two main products found in locations where people relax and enjoy themselves, particularly where alcohol is available.
  • Drinking and smoking share the same genetic and psychiatric risk factors.
  • The astonishing aspect of the alcohol-tobacco connection is the association between episodic drinking and occasional smoking. Many social or weekend smokers experience a sudden and acute craving for a cigarette when they are drinking excessively. Similarly, people who quit smoking often find themselves starting up again during a night of heavy drinking. Such phenomena are caused by the pharmacological interaction between alcohol and tobacco, and are characterized by an intense physical need to smoke.

Alcohol and drugs

The combination of alcohol and drugs or illegally obtained medication is observed most commonly among drug addicts. In the general population, thrill-seekers and young people – who have a pronounced taste for new experiences – are most at risk for this dangerous mix.

Alcohol and drugs are generally combined to enhance the pleasurable effects of one or the other, or to diminish such unpleasant effects as anxiety or drowsiness. Whatever the reason, the combination of alcohol and drugs creates a pharmacological interaction that can be extremely dangerous and even deadly.

One of the great dangers in combining alcohol and drugs is that the effects are impossible to predict.37 So many factors can influence the results that it is not possible to consider both substances together with any accuracy. Among other things, the effects of the mix will depend on the mix itself, the dose, how it is administered, the order in which the substances are taken and the sociocultural circumstances, as well as the person’s age, sex, weight, nutritional condition, physical health and psychological state.

Alcohol and medication

Some medications, in particular over-the-counter products like painkillers, may hinder the elimination of alcohol, increase or mask their effects, or cause unpredictable reactions. Conversely, alcohol can make medications less effective or interfere with their elimination. Anyone taking medication should be properly informed about contraindications before drinking alcohol at the same time. It is important to remember that, like alcohol, medications are eliminated by the liver, and as a general rule, it is better not to drink while taking medication.

Alcohol and cannabis

When taken together, a synergy is produced, increasing the sedative effects of both the alcohol and the cannabis. Judgement, reaction time and coordination are obviously affected and driving is out of the question.

Because cannabis inhibits the part of the brainstem responsible for vomiting, combining it with alcohol can be particularly dangerous, and even deadly. When people drink too much and are in danger of alcohol poisoning, the body’s natural response is to vomit. By inhibiting the vomit instinct, cannabis thus increases the danger of alcohol poisoning.

Alcohol and other illicit drugs

Only 2.5% of the general Québec population use cocaine, speed, ecstasy and hallucinogenic drugs. A strong warning must be issued against combining such narcotics, stimulants and hallucinogens with alcohol.

These combinations can produce an antagonism in which the properties of one substance suppress or attenuate the effects of the other. This can be extremely serious, as people may be unable to detect the impact of the substances they are taking. In other words, they may not feel as pronounced a “high” even though the physical effects of the drugs and alcohol on various organs and functions will be the same. The combination of alcohol and stimulants can create an additive synergy that increases the risks of overdosing on either substance. For example, drinking alcohol with a stimulant like cocaine increases the speed with which alcohol spreads throughout the body, which means it reaches the brain more quickly. The result is a significant increase in blood alcohol content, as if the person had drunk very quickly.

Purple light: severe danger

All the various aggravating and attenuating factors notwithstanding, the most dangerous alcohol-drug combinations are those in which alcohol – which is a sedative – is mixed with another sedative, such as a barbiturate, a benzodiazepine or an antihistamine. The sedatives sold by drug dealers include PCP (Mescaline, Mess, Horse, Angel Dust, TH) and ketamine (Special K, Vitamin K, Ket, Ketty).

When alcohol is combined with these psychotropic drugs, a mutually reinforcing synergy is created in which the combined sedative effect is greater than if the two substances were taken separately. Such combinations can severely depress the central nervous system, with consequences ranging from confusion to unconsciousness to death.

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