Adderall and Alcohol

Even though the instructions on nearly every prescription medication warn against mixing the medication with alcohol, it is alarmingly surprising how many individuals do not understand the dangers of mixing these drugs. There are several general precautions when it comes to mixing drugs unless instructed to do so by a physician.

  • Mixing medications with alcohol can result in the effectiveness of the medication being lessened.
  • When one mixes drugs of similar types, the effects of both drugs are enhanced. This includes potentially dangerous side effects.
  • When one mixes drugs that have different actions, the effects of one drug reduce the effects of the other. This means that it is much easier to take extremely high and dangerous amounts of the drugs.
  • Mixing drugs and alcohol results in a number of unpredictable potential effects, including issues with seizures and other life-threatening effects.
  • Because different people have personalized responses to drugs and alcohol, certain individuals may present with very peculiar effects that are not readily recognized as caused by the particular drugs or medications in question. When individuals mix substances, it becomes even more difficult.
  • Chronic mixing of different types of drugs can result in complicated presentations of physical dependence.

Adderall

 

Adderall is a combination of amphetamine and dextroamphetamine used in the treatment of attention deficit hyperactivity disorder (ADHD) and the sleep disorder narcolepsy. Adderall comes in both an immediate-release form and an extended-release form. The extended-release form of the drug was developed so children would only have to take the drug once in the morning.

All forms of Adderall are central nervous system stimulants and classified as Schedule II controlled substances by the United States Drug Enforcement Administration (DEA), indicating that while the drug does have medicinal uses, it is also highly susceptible to being abused and can result in the development of physical and/or psychological dependence. All drugs classified as Schedule II substances by the DEA can only be purchased legally with a prescription from a physician, and their distribution is tightly monitored and controlled. The major effects of Adderall result in increases in the availability of the neurotransmitters norepinephrine and dopamine in the central nervous system.

Mixing Adderall and Alcohol

 

Alcohol is a central nervous system depressant that results in the suppression of excitatory neurotransmitters (particularly glutamate) and enhancement of inhibitory neurotransmitters (particularly GABA). When an individual mixes alcohol and Adderall, they are mixing drugs with different mechanisms of action. The most immediate effect of mixing alcohol and Adderall is to decrease the stimulant effects of Adderall and also decrease the central nervous system effects of alcohol. Individuals who abuse Adderall often grind the drug up and snort it, which results in a much quicker availability of the drug in the individual’s system. Drinking alcohol while snorting Adderall helps to curb these effects (often referred to as “taking off the edge”).  Thus, a person who is drinking alcohol to reduce its effects is obviously taking far too much Adderall. Individuals who abuse the drugs together typically do so in order to be able to take increasingly higher amounts of the drugs and to “party” for lengthy periods of time.

Because the medicinal effects of Adderall occur at lower doses, even drinking small amounts of alcohol while using Adderall for ADHD or narcolepsy can inhibit the medicine’s effectiveness.

Of course, abusing these drugs in amounts that are in excess of what would normally be recommended or typically deemed as safe leads to a number of other potentially dangerous interactions.

  • The perception that one is not as intoxicated from alcohol or as “wired” from Adderall can lead the person to consume more of either substance. This is because the drugs have basically opposite effects and counteract one another. This can lead to increased potential for an individual to overdose on either drug; however, the more likely scenario is that one will taken far too much alcohol as opposed to using far too much Adderall.

  • Mixing alcohol and Adderall can increase the risk that one will develop alcohol toxicity (alcohol poisoning).

  • Mixing these two drugs can result in issues with judgment that can lead to accidents. Individuals may display issues with increased aggression, increased apathy, or decreased inhibitions that can lead to very poor decisions or other forms of destructive behavior.

  • Many individuals have extreme episodes of nausea and vomiting after mixing these two drugs. This can lead to potentially dangerous issues with dehydration.

  • Mixing the two drugs results in a particularly stressful situation for an individual’s cardiovascular system. There is an increased risk for the development of heart attack or stroke when one mixes these drugs. Chronic mixing of alcohol and Adderall may lead to serious cardiovascular conditions, such as arteriosclerosis or stroke.

  • Mixing these two drugs results in the increased potential for neurological issues, such as the development of seizures. Seizures occur when the activity of certain areas of the brain gets out of control. Seizures developing from drug use are particularly concerning as there is a potential for serious neurological damage and fatalities.

  • There are a number of potentially negative psychological effects that can result from mixing these two drugs. These effects may include issues with anxiety, severe depression, the development of hallucinations, and the development of paranoid delusions. Individuals who are intoxicated and develop these symptoms may not be able to rationally deal with them and may be open to the potential for self-harm due to potential accidents, issues with poor judgment, and even potential suicidality.

  • Continuing to mix alcohol and Adderall can result in the development of physical dependence and a potential substance use disorder to one or both drugs. The withdrawal process from either substance is uncomfortable, and individuals who chronically abuse these drugs and develop symptoms of physical dependence on both drugs have very complicated withdrawal syndromes. It is also important to note that the withdrawal syndrome associated with moderate to severe alcohol dependence can be potentially fatal.

A case study reported in the Journal of the American Board of Family Medicine in 2009 highlights the potential risks of mixing even small amounts of Adderall and alcohol. An individual with no history of cardiovascular disease mixed Adderall and alcohol and suffered a myocardial infarction (heart attack). The authors of the article report that taking Adderall with alcohol increases the risk of having a serious cardiovascular issue, such as a heart attack, even if the person does not have significant risk factors for heart disease. This case study highlights the notion that when one mixes different drugs, the side effects of both drugs are enhanced as well as the potential for particular effects that normally would not occur from using either drug individually.

Conclusions

 

Mixing Adderall and alcohol is not safe in any amount. The untoward effects of both drugs are enhanced when these drugs are mixed, and any medicinal effects of Adderall are decreased. Even individuals who take Adderall to treat ADHD or narcolepsy are advised not to drink alcohol in any amount. Individuals who abuse alcohol and Adderall often take significantly higher amounts of both substances than individuals who take Adderall for medicinal reasons or drink alcohol socially. This results in an increased potential for dangerous interactions to occur.