Mixing Alcohol and Weed: Why and How Alcohol and THC Interact

Mixing alcohol and weed can be a dangerous combination. These substances interact in your body and magnify each other’s effects, increasing health and safety risks.

How Do Alcohol and Cannabis Interact?

Alcohol and cannabis impact your body in similar ways. Both have depressant effects on your brain, which means that they slow down brain activity.1 Cannabis may also worsen alcohol’s effects on your central nervous system, increasing the depressant effects and increasing the risk of overdose.2

You might use the terms cannabis and marijuana interchangeably; however, they actually refer to two different things. 3

Cannabis is the term for all products that come from the plant Cannabis sativa. This plant contains over 500 different chemical substances.

In cannabis, the chemicals that produce the drug-like effects are called cannabinoids. There are a few different cannabinoids; you might be familiar with the main ones, tetrahydrocannabinol (THC) and cannabidiol (CBD).

The term “marijuana” refers to products from the cannabis plant that specifically contain large amounts of THC. Both alcohol and THC cause intoxication and their depressant effects cause a decrease in response time and lower memory, attention, and coordination.1

CBD is another chemical compound in the cannabis plant.4 Research has found that mixing alcohol and CBD can lead to significant damage to motor abilities such as balance and coordination.5

While some states have legalized marijuana for medicinal and/or recreational use, marijuana is still classified as a Schedule I drug at the federal level. Schedule I substances are considered to have no proven medical or therapeutic use.

The Food and Drug Administration (FDA) has not approved the cannabis plant—or marijuana itself—for medical use. Rather, it has approved some drugs that contain some cannabinoids to treat forms of epilepsy, effects of cancer chemotherapy, and for loss of weight and appetite for people with HIV/AIDS.5

While some CBD products are being marketed for their health benefits, the FDA is continuing to research CBD.5 The FDA has not endorsed any CBD formula for medical or therapeutic use.

The synthetic substance K2, or “spice,” is also sometimes included this is category. However, K2 is an illicit substance that does not come from the cannabis plant and is, instead, made using other plant matter and psychoactive chemicals, which can include dangerous substances like household cleaners. K2 is a Schedule I designer drug and is not considered safe in any amount, especially because the user cannot know the ingredients or strength of the chemicals used to manufacture a certain batch of K2.6

Both natural and synthetic cannabinoids are mind-altering substances and, despite common misconception, are addictive.

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Why Do Alcohol and Cannabis Interact?

Research has only fairly recently found why alcohol and cannabis may interact. Your brain has its own cannabinoid system and its role is to regulate brain chemistry. THC excites reward system because it attaches itself to the cannabinoid receptors in it.1

Research has found that alcohol also interacts with the cannabinoid system in your brain. Furthermore, if you are physically dependent on alcohol, alcohol may even make changes to your cannabinoid system.1

Because alcohol and weed are both depressants that act on the brain’s cannabinoid system, taking them at the same time may have a dramatic effect on your brain chemistry.

Does the Order in Which I Use Alcohol and Weed Matter?

There is little research on what happens if you drink alcohol first and then use cannabis, and vice versa. The studies that have been conducted have only examined drinking alcohol first and then using weed. These studies are mostly pre-2000 and include small numbers of participants, but they may provide some preliminary insight into how mixing weed and alcohol at different times affects the side effects.

A 1992 study found that when participants drank alcohol first and then used marijuana, alcohol levels in their blood were lower compared to the participants who did not use weed after drinking.7

This result indicates that it is possible that you could feel less drunk if you use weed after drinking. This can be problematic because: 7, 8

  • You may drink more alcohol. This can lead to dangerous blood alcohol levels because your body doesn’t give you warnings of how much alcohol you have actually had.
  • You may use more weed. Contrary to popularized myths, you can ingest enough THC to cause acute health emergencies, including loss of consciousness, derealization or complete detachment from your surroundings which is sometimes called “greening out,” panic attacks requiring medical care, cardiac events, and vomiting that cannot be stopped using medication.
  • You may feel as though you are sober enough to drive, swim, or participate in other activities that are not safe while intoxicated. However, a 1988 found that participants who smoked weed about 15 minutes after drinking had a reduced ability to drive a car compared to those who did not use weed.

Effectively, researchers think that marijuana can cause changes to the way alcohol impacts you. Therefore, it is risky to use both substances simultaneously.

What Are the Risks of Mixing Marijuana and Alcohol?

Because combining alcohol and cannabis can amplify their impact.

Short-Term Effects

When combining alcohol and weed, you may experience:9

  • Heavy vomiting, which may not be able to be controlled medically and may continued for an undetermined amount of time
  • Strong paranoia, or undue suspiciousness of others and profound feelings of dread that do not match reality
  • Decreased motor control and coordination
  • Decreased mental concentration

In addition, weed suppresses the gag reflex; thus, you may not be able to throw up alcohol when your body needs to. This in turn can lead to a rise of blood alcohol to dangerous levels, leading to alcohol poisoning.9

Long-Term Effects

Researchers analyzed data from the National Alcohol Survey taken in 2005 and 2010 found that survey participants who used alcohol and weed simultaneously were more likely to:2

  • Engage in more drunk driving
  • Experience more negative consequences in their relationships with others
  • Drink more heavily
  • Drink more frequently
  • Have self-injurious behaviors

Who Is at Risk of Severe Effects from Combining Alcohol and Cannabis?

Analysis of the data from the National Alcohol Survey found that people who were more likely to take alcohol and weed simultaneously were:2

  • White
  • Men
  • Those who used cannabis at least monthly
  • Those aged 18-29
  • Those who frequently binge drank
  • Those who used alcohol and didn’t have partners

Various factors could determine the severity of the effects you experience from mixing marijuana and alcohol. These include the following.

Tolerance

Tolerance to a substance means that your body has gotten used to the presence of it and therefore your brain compensates a certain level of it being in your body. As a result, you do not feel intoxicated even though you are because your body can perform major functions. Just like with alcohol, it is possible to develop a tolerance to cannabis.10

Tolerance is a well-documented contributing factor to developing an addiction because it encourages continued use of the substance in increasingly higher amounts over time.

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The higher your tolerance for alcohol or marijuana, the greater the amounts of it you are likely to consume to feel the same effects, which can lead to dangerous levels of it in your system. This could lead to severe impairments to functioning and a higher risk of overdose. Overdose is a medical emergency that can lead to brain damage from loss of oxygen, coma, or death.

Amount of Time Between Use

The more time in between having an alcoholic drink and using weed, the lower the chances of them interacting as strongly. It may be on the lower-risk side to wait to use weed an hour or more after drinking since your body can metabolize one standard drink per hour.8

Method of Use

Smoking and vaping cannabis cause faster absorption of THC by your body compared to using edibles.3 In other words, if you eat a brownie that has weed after drinking, the weed will be absorbed slower than if you smoked or vaped it. As a result, the overall alcohol-weed interaction in your system could be reduced.

However, use of edibles with alcohol could be unpredictable as many people do not feel the effects of the THC for a long period of time. This may lead to eating more of the edibles or drinking more alcohol—which could increase the severity of the alcohol interaction—or mean that the interaction occurs when you don’t expect it to.

Concentration of Either Substance

The potency of either substance can also impact the level of alcohol and weed concentration in your blood.8 For instance, a beer has lower alcohol per volume and you tend to drink it more slowly than a shot. Your body, therefore, absorbs it more slowly, leading to lower blood alcohol levels.

Concerning weed, the lower the concentration of it in the liquid that you vape or brownies you eat, the lower the concentration of it will be in your body.3

What Does All This Mean for Me?

The exact risks of mixing marijuana and alcohol, or other cannabinoids and alcohol, are not well studied. However, you can avoid and identify health emergencies to protect yourself and those around you if you choose to use either of these substances recreationally or you have a prescription for medical marijuana.

Use Risk Prevention Strategies

It is safest to avoid mixing alcohol and weed. This is the case even if you use medical marijuana since THC and alcohol have been found to interact.1 It is not currently known if there is any completely safe level of alcohol and THC in the brain’s cannabinoid system.

Mixing alcohol and weed can be risky.

However, if you choose to mix them, reduce your risk of serious side effects from mixing weed and alcohol by:3,6,7

  • Waiting an hour or more to use weed after drinking alcohol
  • Using low concentration forms of cannabis
  • Using cannabis strains you are familiar with and know the effects of on your body
  • Drinking moderately by limiting yourself to one standard drink per hour and avoiding shots and drinking games
  • Following the instructions of your prescribing doctor if you take medical marijuana

Know How to Recognize an Emergency

It is important to know when to seek immediate medical attention for problems that can arise from mixing alcohol and weed. Seek immediate help if you or someone you know experiences:

  • Breathing problems
  • Intense nausea and vomiting
  • Diarrhea
  • Severe stomach cramps
  • Chest pain
  • Being awake but unresponsive
  • Limpness
  • Seizures
  • Confusion
  • Agitation or paranoia
  • Slow or erratic pulse
  • Choking sounds
  • Blue lips or fingernails
  • Pale or clammy face
  • Unconsciousness

These signs of overdose or THC toxicity are a medical emergency. Do not leave the person unattended until after help arrives.

Seek Treatment for Substance Misuse

If you are concerned about your level of alcohol or cannabis use, seek treatment from a mental health provider who works with substance use issues. This treatment may include formal treatment, such as rehab, and community resources, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA).

The sooner that you start treatment, the lower the chances of your misuse worsening over time. Early treatment can also lead to higher treatment success, such as reduction of substance use, abstinence, improved psychological functioning, and improved quality of life.11

For assistance with finding addiction treatment providers, please call 800-839-1686Who Answers? for 24/7 help from our specialists.

Resources

  1. Pava, M.J., & Woodward, J.J. (2013, May 01). A review of the interactions between alcohol and the endocannabinoid system: Implications for alcohol dependence and future directions for research. Alcohol, 46(3), 185-204.
  2. Subbaraman, M.S., & Kerr, W.C. (2015). Simultaneous vs. concurrent use of alcohol and cannabis in the National Alcohol Survey. Alcohol Clinical and Experimental Research, 39(5), 872–879.
  3. National Center for Complementary and Integrative Health. (2019). Cannabis (Marijuana) and Cannabinoids: What You Need to Know.
  4. Consroe, P., Carlini, E.A., Zwicker, A.P., & Lacerda, L.A. (1979). Interaction of cannabidiol and alcohol in humans. Psychopharmacology, 66(1), 45-50.
  5. S. Food and Drug Administration. (2020, March 5). What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD.
  6. S. Drug Enforcement Administration. Spice/K2, Synthetic Marijuana.
  7. Lukas, S.E., Benedikt, R., Mendelson, J.H., Kouri, E., Sholar, M., & Amass, L. (1992). Marihuana attenuates the rise in plasma ethanol levels in human subjects. Neuropsychopharmacology, 7(1), 77-81.
  8. Perez-Reyes, M., Hicks, R.E., Bumberry, J., Jeffcoat, A.R., & Cook, C.E. (1988). Interaction between marihuana and ethanol: Effects on psychomotor performance. Alcoholism Clinical and Experimental Research, 12(2), 268-276.
  9. UC Santa Cruz. (2016, January 29). Common Alcohol and Drug Combinations. Student Health Outreach and Promotion.
  10. Ashton, C.H. (2018, January 02). Pharmacology and effects of cannabis: A brief review. The British Journal of Psychiatry, 178(2), 101-106.
  11. National Institutes of Health. (2020, June 03). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).

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