Meth and Alcohol Causes Severe Side Effects, Even When It’s Prescription

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The National Survey of Drug Use and Health (NASDUH) reveals that the number of people with a methamphetamine use disorder has increased by 62% between 2015 and 2019. Frequent users, or those who used at least 100 days in the prior year, rose by 66%.¹

Researchers estimate that 77% of people who have an amphetamine use disorder also have alcohol use disorder.²

What Is Methamphetamine?

Meth, or methamphetamine, is a stimulant. Prescription forms of methamphetamine are approved by the Federal Drug Administration (FDA) to treat narcolepsy and attention deficit hyperactivity disorder (ADHD). The approved brand name is Desoxyn. Desoxyn may also be used off-label to induce weight loss.

Methamphetamine in any form, including Desoxyn, has a high potential for misuse. Meth is classified as a Schedule II by the US Drug Enforcement Agency (DEA). The majority of illicit meth is manufactured using prescription or over-the-medication substances—like cold or flu medicine—combined with dangerous household or industrial chemicals—which can include antifreeze, battery acid, lye, or others.

Meth may be manufactured as white pill or powder. Crystal meth, which is an illegally altered version of Desoxyn, looks like glass crystals. Individuals may swallow, smoke, snort, or inject meth.³

What Are the Risks of Mixing Alcohol and Meth?

Mixing meth and alcohol causes an interaction that may lead to a surge of euphoria that is more intense than if you use them separately. The interaction happens when alcohol and meth flood the dopamine receptors in the brain’s reward center. The feeling of euphoria is temporary, however, and can lead to changes in brain structure that may become permanent.

Other risks include:^4,5

• Neurobiological deficits, or abnormal function in a specific area of the body caused by issues with the brain, spinal cord, muscles, or nerves
• Increased risk of mood disorders, which include major depression and bipolar disorder
• Neurocognitive impairment, or decreased mental function not related to mental illness
• Neuropsychiatric disorder, or disease related to both mental and brain health such as ADHD and seizure disorders
• Increased risk of certain cancers
• Cardiovascular disease
• Liver and pancreatic disease
• Pulmonary issues, or conditions affecting the lungs and respiratory system

Individuals who use meth via injection are also more vulnerable to infectious disease due to the risk of exposure to blood and nonsterile needles. Chronic alcohol use may also affect the immune system, potentially increasing the risk of viral or bacterial infections.

If you are pregnant, the risks of mixing alcohol and meth include premature delivery and placental abruption (i.e., the placenta separating from the uterine wall prematurely), and the baby may have problems in size, heart, and brain functioning.⁶ Alcohol use during pregnancy is also linked to fetal alcohol syndrome disorders (FASDs).

What Are the Short-Term Side Effects of Alcohol and Meth?

You may experience specific side effects when mixing alcohol and meth that are distinct and different from the effects each substance produces when used separately. These side effects can occur even when taking Desoxyn as prescribed if you use alcohol other than as recommended by your doctor.

Short-term side effects include:⁷

• Increased blood pressure
• Decreased feelings of sedation, which could contribute to sleep disturbances like insomnia
• Altered performance of tasks
• Decreased social engagement
• Increased heart-related events
• Decreased sleep time

More immediate effects of mixing meth and alcohol include:⁸

• Injuries and accidents
• Poor judgment and decision-making
• Trouble breathing
• Emotional outbursts or sudden changes in mood
• Digestive problems
• Loss of appetite
• Hyperthermia, or an abnormally high body temperature

What Are the Long-Term Side Effects of Alcohol and Meth?

Short-term side effects worsen the longer you misuse meth and alcohol. Combining these substances can lead to psychological and physical conditions. Some conditions may heal once you stop misusing the substances. Other chemical and physiological changes may become permanent.

Mixing alcohol and meth chronically over a long period of time may lead to:⁹

• Heart muscle injury, such as alcoholic cardiomyopathy
• Irregular heartbeat
• Stroke
• Alcoholic hepatitis
• Cirrhosis
• Paranoia
• Hallucinations, or experiencing sensations that do not match reality
• Severe dental problems

Long-term risks also include the development of a polysubstance use disorder—or addiction to both meth and alcohol. You are also at high risk of overdose and serious withdrawal symptoms.

Who Is at Risk for Problematic Use of Alcohol and Meth?

Certain characteristics may put one individual at higher risk to develop chronic use of alcohol and meth. You are most at risk if you:¹⁰

• Have past trauma or multiple traumas—Traumatic experiences are associated with higher incidents of paranoia and hallucinations. Trauma is also a risk factor for developing an addiction and may need separate treatment in addition to addiction treatment.
• Live with family members who use substances—Substance use in your home increases access to substances, may lead to a chaotic home environment, and may facilitate relapse when you try to use substances less or stop using substances. These factors may lead to using substances more often or for a longer period of time, which increases the risk of serious side effects.
• Are exposed to substances as a child or teenager—Research indicates that individuals who first use addictive substances at a young age are at higher risk of problematic substance use and addiction later in life.
• Have an underlying mental health disorder—Patterns of repeated substance use often begin as a way to “self-medicate” the symptoms of an undiagnosed or untreated mental health condition. For example, alcohol and meth may temporarily reduce the distress of depressive symptoms.
• Have an underlying physical condition—Chronic substance use can also happen in response to undiagnosed or untreated medical conditions causing pain or distress, such as chronic pain. In the case of both meth and alcohol, the substance may also be used in an attempt to manage eating behaviors, change body weight or composition, or as a disordered eating behavior.

No risk factor predicts or guarantees patterns of substance use or how your recovery journey will progress.

You can counterbalance risk factors with protective factors. You can build protective factors by entering recovery, seeking support, learning early recovery and relapse prevention skills, and implementing self-care into your daily routine. Protective factors can include:

• Choosing a sober living environment—A sober living program, new apartment, or living situation with sober family or friends can reduce the risk of new or continued substance use.
• Seeking peer support from others in recovery—Peer support groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) provide social support that many people find helpful when confronting the challenges associated with reducing substance use.
• Completing educational or vocational goals—Progressing in your life, including by pursuing education, a new job, or even a new hobby, can help you feel purposeful and connected to others. Additionally, working on these goals can help put you in new places, away from areas you associate with substance use.
• Seeking treatment for addiction—If you do not feel that you can control your substance use, that your substance use has affected multiple areas of your life, or that you experience negative symptoms when you do not use substances, you may have an addiction. Professional treatment can be an important part of getting sober and reducing the risk of short– and long-term side effects of using alcohol and meth.

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What Is Polysubstance Overdose?

When mixing meth and alcohol, you are at risk of overdose. Ingesting too much of any substance much at once may lead to acute, or immediate, overdose, while a long period of heavy use can lead to a chronic overdose. This means that symptoms of overdose can occur suddenly or over a long period.

The NASDUH shows that methamphetamine overdoses tripled between 2015 and 2019, rising from 5,528 to 15,489.¹

Acute polysubstance overdose symptoms are:^{11, 12}

• Chest pain
• Irritability
• Coma
• Heart attack
• Trouble breathing
• Stroke
• Seizures
• Disorientation
• Slowed heart rate
• Extreme changes in body temperature

At the first signs of unusual behaviors, call 911. All overdoses are a medical emergency. Overdose can lead to coma and be life-threatening without medical intervention.

What Are the Withdrawal Symptoms of Alcohol and Meth?

One of the criteria used to evaluate whether someone has polysubstance use disorder is determining if they experience withdrawal symptoms when they stop or decrease how much of any substance they use.

Withdrawal syndrome occurs when your body has become dependent on meth and alcohol to function. For some, withdrawal symptoms are mild. For others, they are severe and interfere with daily functioning.

Methamphetamine withdrawal symptoms may include:¹³

• Depression or other mood changes
• Excessive sleep
• Dysphoria, or profound feelings of unease or dissatisfaction that aren’t improved by activities that would usually regulate mood
• Psychomotor decline, or reduced physical abilities

Methamphetamine withdrawal symptoms are not life-threatening. However, some alcohol withdrawal symptoms can be medically significant. Many people choose to withdraw with medical supervision.

Medically significant withdrawal symptoms related to alcohol may include:¹³

• Tremors
• Hyperthermia, or abnormally high body temperature
• Alcoholic hallucinations
• Alcoholic sweats, or diaphoresis
• Severe muscle spasms or cramps
• Tachycardia, or abnormal heart rate
• Seizures

A very rare side effect of alcohol withdrawal is delirium tremens (DT), which is a medical emergency characterized by convulsions, hallucinations, confusion, high blood pressure, and cardiovascular symptoms.

How Is Managing Polysubstance Addiction Managed?

Entering treatment for designed for the treatment of individuals who have used multiple substances simultaneously is recommended.

Your treatment team will also likely recommend that you start with medical detox in a hospital setting with physician supervision. Withdrawal symptoms can be intense, and medical detox gives you access to medicine that eases withdrawal symptoms and cravings. After detox, you can step down to inpatient and outpatient services. Many rehab programs require that you be abstinent before entering treatment.

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Treating co-occurring ADHD

A few areas of treatment may require special consideration. For example, if you have ADHD.¹⁴

Researchers study medications to treat co-occurring ADHD and substance misuse, especially stimulant misuse. Results vary but using a delayed-release stimulant can reduce the risk for misuse.

Non-stimulant medicines are also available for ADHD treatment, such as atomoxetine, tricyclic antidepressants, and clonidine. A wake-promoting agent typically used for narcolepsy called modafinil can treat ADHD also. Combining medication with behavioral therapy offers a more comprehensive treatment plan for co-occurring disorders.¹⁴

Children and adolescents prescribed stimulants for ADHD are at higher risk of developing a substance use disorder than their peers without ADHD. Researchers suggest implementing psychotherapies as the first line of treatment rather than stimulants. These studies suggest that finding ways to engage individuals in treatment, connect them with multiple support resources, and provide family therapy can reduce the need for medication management.¹⁵

Treating co-morbid stimulant and depressant misuse

When treating a polysubstance disorder where one substance is a depressant—like alcohol—and one substance is a stimulant—like meth—requires a team of professionals.

Protocol for stimulant withdrawal is to monitor through observation. Alcohol withdrawal requires greater care since symptoms can potentially become life-threatening.

Benzodiazepines and antipsychotics are a class of medications used to treat both meth and alcohol withdrawal. A complete medical health screening to test for glucose levels, vitamin levels, potential infections, and other conditions that could increase the severity of withdrawal are also done early in withdrawal treatment and then as needed.

Replenishing nutrients will likely be needed since both stimulant and depressant misuse can lead to malnourishment.¹⁶

Treating the whole person

Many people mixing meth and alcohol also have other symptoms. If left untreated, those conditions could be triggers for relapse. Integrative treatment based on an individual’s needs may include:¹⁷

• Matching an individual with the right level of care
• Helping individuals resolve physical, psychological, legal, social, and vocational issues
• Encouraging an individual to stay in treatment longer
• Providing a wide range of therapies, including behavioral and group therapies
• Treating family members to contribute to recovery, get help based on their individual needs, and heal individually and as a whole
• Supplementing therapies with medication assistance, if beneficial
• Modifying an individual’s treatment plan as needed and when new treatments can provide more benefits

If you, or someone you know, is mixing meth and alcohol, recovery is possible. There are numerous types of treatments available. We can connect you with a specialist who can connect you with the best options. We are here 24/7 to take your call at 800-948-8417 Who Answers? .

Resources

1. National Institute of Health. (2021, October 05). Trends in U.S. methamphetamine use and associated deaths.
2. Singh, A. K. (2019, March 07). Alcohol Interaction with Cocaine, Methamphetamine, Opioids, Nicotine, Cannabis, and γ-Hydroxybutyric Acid. Biomedicines, 7(1), 16.
3. National Institute on Drug Abuse. (2019). Methamphetamine DrugFacts.
4. Radfar, S. R. & Rawson, R. A. (2014). Current Research on Methamphetamine: Epidemiology, Medical and Psychiatric Effects, Treatment, and Harm Reduction Efforts. Addiction & Health, 6(3-4), 146-154.
5. Rehm, J. (2011). The Risks Associated with Alcohol Use and Alcoholism. Alcohol Research & Health: The Journal of the National Institute on Alcohol Abuse and Alcoholism, 34(2), 135-143.
6. National Institute on Drug Abuse. (2019). What Are the Risks of Methamphetamine misuse During Pregnancy? Methamphetamine Research Report.
7. Kirkpatrick, M. G., Gunderson, E. W., Levin, F. R., Foltin, R. W., & Hart, C. L. (2012, July 01). Acute and Residual Interactive Effects of Repeated Administrations of Oral Methamphetamine and Alcohol in Humans. Psychopharmacology, 219(1), 191-204.
8. Substance Abuse and Mental Health Services Administration. (2016). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington (D.C.): U.S. Department of Health and Human Services.
9. Schulte, M. T. & Hser, Y. I. (2014). Substance Use and Associated Health Conditions Throughout the Lifespan. Public Health Reviews, 35(2).
10. Whitesell, M., Bachand, A., Peel, J. & Brown, M. (2013). Familial, Social, and Individual Factors Contributing to Risk for Adolescent Substance Use. Journal of Addiction, 2013, 579310.
11. S. National Library of Medicine. (2021). Methamphetamine overdose. MedlinePlus.
12. National Institute on Alcohol Abuse and Alcoholism. (2021). Understanding the Dangers of Alcohol Overdose.
13. Gupta, M., Gokarakonda, S.B. & Attia, F.N. (2021). Withdrawal Syndromes. Treasure Island (F.L.): StatPearls Publishing.
14. Carpentier, P. J., & Levin, F. R. (2017). Pharmacological Treatment of ADHD in Addicted Patients: What Does the Literature Tell Us?. Harvard Review of Psychiatry, 25(2), 50-64.
15. Zulauf, C. A., Sprich, S. E., Safren, S. A., & Wilens, T. E. (2014). The Complicated Relationship Between Attention-Deficit/Hyperactivity Disorder and Substance Use Disorders. Current Psychiatry Reports, 16(3), 436.
16. Pasha, A. K., Chowdhury, A., Sadiq, S., Fairbanks, J., & Sinha, S. (2020, May 21). Substance Use Disorders: Diagnosis and Management for Hospitalists. Journal of Community Hospital Internal Medicine Perspectives, 10(2), 117-126.
17. National Institute of Drug Abuse. (2020). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).