Marijuana: When it comes to drugs, alcohol, and marijuana are among the most commonly used substances. But what really happens when they team up? If you aren’t careful, the duo can lead to a case of the spins or green out, two reactions that can turn a fun night out into a nauseated night in. It’s also important to remember that people can have very different reactions to the same mix of alcohol and marijuana. If you’re out in a group, one person’s reaction might be very different from yours. Drinking before using marijuana can intensify its effects. This is because alcohol increases the absorption of marijuana’s main psychoactive ingredient, THC. This generally results in a stronger high, leading some individuals to experience a green out. A green out refers to a range of unpleasant physical symptoms that can result from a strong high, including sweating, dizziness, nausea, and/or vomiting.

Cocaine: It belongs to a class of drugs known as stimulants, which tend to give a temporary illusion of limitless power and energy that leave the user feeling depressed, edgy, and craving more. Alcohol, being a depressant, has effects that are opposite those of stimulant drugs (e.g., slowed reaction time, reduced inhibitions, increased sleepiness). There are many reasons people may mix these drugs together, but it can be very dangerous to do so. For example, people often mix these substances together because one will, allegedly, reduce negative symptoms from the other. Alcohol also enhances the euphoric effects of many substances, since it acts indirectly on GABA receptors, thereby increasing the release of some neurotransmitters. Mixing cocaine with alcohol can lead to impulsive and violent behavior, paranoia, seizures, and unclear thinking. These negative side effects, among others, are all good reasons to steer clear of putting yourself in the driver’s seat at any given point in time.

Opioids: Taking opioids, such as oxycodone or morphine, in combination with alcohol can have severe consequences. Because opioids and alcohol are both depressants, the effect of each substance is intensified when taken together than when taken separately. Combining alcohol and opioids can result in a number of dangerous side effects, including extreme lack of inhibition, unusual behavior, and dizziness. Alcohol enhances the sedating effects of opioid medications, leading to increased drowsiness and, eventually, loss of consciousness. Additionally, loss of coordination can occur, which is why it is extremely dangerous to drive under the influence of these substances, especially when they are combined.

Heroin: When mixed together, alcohol and heroin can cause extreme drowsiness, mood swings, uncontrollable vomiting, and a severe lack of inhibitions. Both substances depress the same neurotransmitter within the brain, which can slow down normal bodily functions to the point of failure. Heroin can also intensify the effects of alcohol and lead to lower tolerance. Users experience greater intoxication when alcohol is mixed with narcotics, which makes it easier to drink excessively and get alcohol poisoning. Due to the sedating effects of both central nervous system depressants, taking alcohol and heroin together can result in several serious adverse reactions. It is never safe to combine the two substances, as they are both addictive drugs that impact mood, behavior, and cognitive function. When used together, their sedative properties only increase. This effect can slow or even stop your breathing. Once you’re in this state, simple tasks like getting up to call 911 are impossible. Aside from causing harm to yourself, you may decide to drive or engage in other questionable behaviors that put your relationships and the lives of others at risk.

Energy Drinks: Mixing energy drinks with alcohol can also have a synergistic effect on your body. Energy drinks are high in caffeine, ginseng, and taurine, among other herbal ingredients. Reduced fatigue mixed with the behavioral impairment of alcohol may lead you to make poor decisions or take risks that you would not normally take. The high caffeine content in energy drinks may make you believe that you are less intoxicated than you actually are. Although you may think mixing a depressant (alcohol) with a stimulant (caffeine) would be a positive combination, caffeine does not offset any of the effects of alcohol.