You’ve probably seen this warning on medications you’ve taken. Mixing
alcohol with certain medications can cause nausea and vomiting, headaches,
drowsiness, fainting, or loss of coordination. It also can put you at risk for
internal bleeding, heart problems, and difficulties in breathing (1). Alcohol
(ethanol) is one of the most widely consumed psychoactive substances in the world (2). Despite its social
acceptability, simultaneous use of alcohol
and medications can lead to serious pharmacologic and clinical
consequences. Alcohol use remains prevalent across populations, including patients undergoing drug therapy. Chronic ethanol exposure alters gene
expression related to mitochondrial
function, immune signaling, and neurotransmitter systems (5).
How Alcohol Affects the Body
Ethanol acts as a central nervous system (CNS) depressant, by enhancing
GABA activity, inhibiting glutamate, and boosting dopamine.
In the liver, it’s metabolized by alcohol dehydrogenase and CYP2E1, which are both key players in drug metabolism.
Alcohol disrupts the neurochemical and autonomic systems, causing irregular emotional and stress
responses, decreased heart
rate variability, and chronic headaches or mood swings.
These effects can drive individuals to drink more to relieve stress,
reinforcing addiction. Alcohol also impairs neurological functions like sleep,
body temperature regulation, and coordination. It affects the hypothalamus,
leading to heat loss, disrupted REM sleep, and insomnia during withdrawal (6).
 |
Figure 1: A diagram showing
the effects of ethanol on the CNS (6) |
The impact of alcohol consumption on chronic and acute health
outcomes is largely
determined by the total
volume of alcohol
consumed and the pattern of drinking, especially those patterns which
are associated with the frequency of drinking (3). Chronic alcohol use
damages the cerebellum, resulting in poor muscular coordination, staggering,
and peripheral neuropathy. Over time, alcoholics may develop nerve damage
and partial paralysis. Neuropsychological tests reveal
cognitive impairments such as poor learning, memory loss, and
personality changes. (6)
 |
Figure 2: A figure showing
the Pharmacokinetics, Determinants of BAC and Predicting BAC
(7) |
When Two Drugs Collide
Mixing alcohol with other depressants, for example benzodiazepines, opioids, or sleep aids, can lead to additive CNS effects, increasing risks of respiratory depression and overdose. Even small amounts of alcohol can quickly intensify sedation. Combining substances intensifies their effects, increasing the risk of overdose, injury, organ damage, and risky behaviors. Alcohol mixed with these depressants can cause severe health problems, including slowed breathing, impaired judgment, and brain or organ damage. These combinations also raise the likelihood of developing substance use disorders (4).
The effects of alcohol vary across different population groups. For example, when a woman drinks, the alcohol in her bloodstream typically reaches a higher level than a man’s even if both are drinking the same amount. This is because women’s bodies generally have less water than men’s bodies, showing that a given amount of alcohol is more concentrated in a woman’s body than in a man’s. As a result, women are more susceptible to alcohol-related damage to organs such as the liver. Older generations are also at a higher risk for alcohol-medication interactions. Aging slows the body’s ability to break down alcohol, so therefore alcohol remains in a person’s system longer. Older people also are more likely to take a medication that interacts with alcohol and oftentimes they need to take more than one of these medications. (1)
Conclusion
By Alyssa Colemen, a Master’s of Medical Science student at
the University of Kentucky.
References
1. Harmful interactions: Mixing alcohol with medicines. (n.d.-b). https://www.niaaa.nih.gov/sites/default/files/publications/Harmful_Interactions.pdf
2. MacKillop, J., Agabio, R., & Feldstein Ewing, S. W. (2022, December 22). Hazardous drinking and Alcohol Use Disorders. Nature reviews. Disease primers. https://pmc.ncbi.nlm.nih.gov/articles/PMC10284465/
3. World Health Organization. (n.d.). Alcohol. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/alcohol
4. Centers for Disease Control and Prevention. (n.d.). Drinking alcohol while using other drugs can be deadly. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/about-alcohol-use/other-drug-use.html
5. Ethanol metabolism - an overview | sciencedirect topics. (n.d.-a). https://www.sciencedirect.com/topics/neuroscience/ethanol-metabolism
6. Griffith, C. (n.d.). The Neural Effects of Alcohol. Open Access Text. https://www.oatext.com/the-neural-effects-of-alcohol.php
7. Goldman, M. R., Molina-Castro, M., & Etkins, J. C. (2025, October 1). Recent advances in alcohol metabolism: From the gut to the brain. Physiological reviews. https://pmc.ncbi.nlm.nih.gov/articles/PMC12345593/
8. U.S. Department of Health and Human Services. (n.d.). Alcohol-medication interactions: Potentially dangerous mixes. National Institute on Alcohol Abuse and Alcoholism.https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on- alcohol/alcohol-medicatio n-interactions-potentially-dangerous-mixes
This article is extremely useful especially for college students. There have been many times where I have overheard someone I know mention that they are on a medication like antibiotics, SSRIs or even acetaminophen as they are drinking alcohol, and they do not understand the potential adverse effects they could experience as a result. I have also seen people mix energy drinks with alcohol unknowing of the harm they could be doing to their body. If more people knew about the dangers I am sure this would occur a lot less. Overall the article is very informative and useful for all populations, not just college students.
ReplyDeleteHi Alyssa! I like how you clearly connected the pharmacological effects of alcohol to real clinical risks, especially the way it alters drug metabolism through liver enzymes. The section on population differences was also a great addition. I feel like people tend to overlook how physiology changes the level of harm. Overall, this was a strong explanation of why those warning labels are more than just suggestions.
ReplyDeleteAlyssa, I really appreciate that you chose this topic because I think it’s something many people aren’t fully aware of. There are so many misconceptions about alcohol use, especially when it comes to mixing alcohol with medications. This is particularly common in settings like festivals, where people may experiment with combining substances recreationally. It’s so important for people to understand how alcohol affects the body, especially when other drugs are involved, because, as you explained, these interactions can be extremely dangerous.
ReplyDeleteHey Alyssa,
ReplyDeleteGreat post! It's well written and an interesting topic. I think you did a wonderful job explaining why combining alcohol with certain medications can lead to dangerous outcomes. I like that you mentioned how longterm use of alcohol can impact mitochondrial function and immune signaling. I never knew that CYP2E1 is the enzyme alcohol competes with. It's really important for people to understand these interactions and I wonder if warning labels should be altered to emphasize this more.
Hi Alyssa! Your blog post really highlights why mixing drugs and alcohol can have some bad effects. I feel like this is a good topic for college students to be made aware of because many of them do not know this stuff and the potential dangers from mixing. I like how you talk about all the side effects of alcohol by itself and then go into explaining its possible effects when combining with drugs. Also, comparing groups different absorption rates with drinking and drugs was a good addition to understand it effects everyone in different ways and can be more fatal for some than others. This really points out the long-term and short-term effects that can come from alcohol and drug combining as well as making it aware that people need to be consulting their doctors if they are going to be mixing the two.
ReplyDeleteHi Alyssa! I think this blog is great for your target audience. It is great for people our age, as well as all ages, to know facts regarding alcohol use and medication administration. I think lots of people forget alcohol and different drugs have mechanisms once they enter the body, they do not just "disappear". The Tylenol pathway involving alcohol is also extremely interesting. Your blog was very well explained!
ReplyDeleteHi Alyssa, I really enjoyed reading your blog because I do research about AUD and alcohol abstinence effects, and I honestly had no idea that the combination of some drugs with alcohol could increase the likelihood of developing substance use disorders. I also think this is a very important topic because I feel like most people see alcohol as a harmless drug, but when combined with different kinds of medications it can be very toxic and even deathly. I also love that you mentioned the sex differences in how our bodies process alcohol because that's a really big factor on how we are affected.
ReplyDeleteHi Alyssa! This is very well written post about such an important topic. So often alcohol and its many interactions are not addressed enough especially in clinical interactions. When I have been prescribed medications it is rare that the physician or pharmacist will address any drug interactions, especially with alcohol, and a warning is usually only on the bottle and very small. You write this article in a very approachable way, so those who are not well-versed in science or medicine could easily understand why alcohol can potentially have severe interactions with drugs. I also did not know how many drugs can amplify sedation when combined with alcohol or the risk of overdose, SUD, and organ failure. Great job!
ReplyDeleteHey Alyssa, I think you did a great job discussing alcohol and its link to negative consequences with combined with medications. I like how you emphasized the social nature of alcohol and how it is widely accepted in our society, even though it is a drug. I don't think enough people realize this, which contributes to addiction and combination with other substances. I also liked how you mentioned multiple areas of the brain it affects and different classes of drugs it has interactions with. Alcohol misuse can manifest in many ways, and manifold more when combined with drugs. This is important information people need to be aware of, especially young people like us.
ReplyDeleteHi Alyssa! This topic is incredibly important and often overlooked by people who take medications. You did a great job explaining how alcohol works on the CNS and then going into how alcohol combined with certain drugs can have negative effects. I really liked the specific example of how drinking alcohol while taking depressants can be dangerous. There are so many more drugs that also interact with alcohol, and I think it is incredibly important for patients to be aware of these possible interactions before starting a new medication. Overall, good job and I really enjoyed reading about your topic!
ReplyDeleteHey Alyssa, great topic choice! I think this one is extremely important because alcohol consumption is extraordinarily common, and a lot of people that I know who drink alcohol often do so with other medications. I have learned more and more about drug-drug interactions over the last couple of years, and think it should be something everybody is familiar with. I like how you related it to the clinical issues that are involved, because I feel like certain medications need more obvious warnings, or clinicians need to really enforce the severity of consuming alcohol with certain medications to prevent unnecessary deaths or health issues. Some people just do not know how dangerous the interaction with benzodiazepines or opioids can be, and posts like these need to be more common online.
ReplyDeleteHi Alyssa! I really enjoyed this post and feel like it is very relevant for the college-aged population. I loved how you discussed the pharmacological outcomes of drinking with certain medications and how harmful this can be to our bodies. I often see people try to take medications such as acetaminophen after a night of drinking without knowing how damaging that can be to their liver. I also appreciated that you noted how there are differences in outcomes for certain populations, specifically women. Overall, great job!
ReplyDeleteAlyssa, this is such a relevant topic and should be posted around campus!! a lot of students are out on their own in the world and may not understand the gravity of how things can interact when they mix pharmacologically. this is a frequent time when students begin to come of age to drink and get on different medications, what a dangerous combination! i don't think the general public is educated enough on the significance of this and how detrimental it can be to our health!
ReplyDeleteI've previously heard about how dangerous it can be to mix alcohol and caffeine due to the fixed rate of degradation of alcohol, and caffeine being a stimulant but your information only adds to how seriously we need to think about alcohol and mixing it with other substances!
Thank you for bringing awareness to this and I hope it spreads!
Alyssa,
ReplyDeleteThis was an amazing topic choice, especially for college students. I remember talking with my provider before I began my freshman year on my own, and luckily, she was extremely informative and insistent on stressing the importance of paying attention to alcohol consumption levels and interactions with any medications I take. You did a phenomenal job explaining the mechanisms of alcohol within circulation - especially when highlighting the development of substance use disorders. Because of the ideology and practice surrounding alcohol consumption in our world, posts such as this are extremely important. I loved that you touched on mixing different stimulants, and other drugs of abuse, with alcohol and the dangers (returning back to the importance of this post for college students today). Overall, great work, and I hope you continue to write great pieces such as this in the future!
Alyssa, this is a great choice of topic given the environment that we, as college students, are in. Many people do not realize the true risk of alcohol until a bad experience has occurred. You did a wonderful job explaining the alcohol at the pharmacological level. I did not know about women's alcohol levels being higher due to there being less water in their bodies. I knew this to be an effect never actually learned why this was. At first, I thought it could have an effect do different enzyme activity between men and women as we have learned about. This is a topic that truly needs so much awareness. I hope that we, as pharmacology students, will take the time to educate our friends and peers. This is a true danger that can lead to serious consequences if not consumed responsibly.
ReplyDeleteAlyssa, I think this is a highly relevant topic that is not discussed enough in the general public! I like that you included that biological effects differ between sexes. Speaking about the interactions that alcohol has with other drugs is very important, and I think it added an additional layer to the piece! I appreciated the seriousness of this blog, as there should be more awareness spread about the effects of alcohol on your health. It was not written critically, but rather in a cautionary, informative tone that any reader would appreciate. The pictures were a bit blurry but still legible! Well done overall.
ReplyDeleteHi Alyssa,
ReplyDeleteThis was a great post, especially considering how relevant it is not just for college students, but for many of us who are pharmacology minors. Drug-drug interactions are so important to consider and study, and we often don't think about them much. Certain medications are very common and we don't stop to think how indulging in social drinking could be interacting with those medications. I have epilepsy, so I knew that benzodiazepines are not to be taken with alcohol. However, I never stopped to think about my other daily medications. I take a pill for my acne- how might that be affected by alcohol consumption? Are there interactions I may be unaware of? This was a great topic to bring to discuss, and I think it should be made aware to a wider population of students and young adults. Great job on this post- it was well researched!
Hi Alyssa, this was really informative and really needed. I think a lot of people underestimate how significant alcohol-medication interactions can be, especially because alcohol is so normalized socially. I appreciated how you connected pharmacology to real world consequences. This kind of information should be emphasized more, especially for teens who may not think twice about drinking while taking common medications.
ReplyDeleteHey Alyssa,
ReplyDeleteThis was an awesome choice of topic! I think as college and graduate students we are exposed to alcohol more than most populations. Mixing medications with alcohol can be deadly and can lead to many lifelong complications. I think not only talking about the effects of alcohol but also alcohol when combined with other substances will be very helpful for all of us in PHA 422G because it will allow us to better understand what we are possibly putting into our bodies and what it is truly doing. Great Job!!
Hello Alyssa!
ReplyDeleteThis article is extremely informative and is fitting for a college campus environment. Many individuals do not know the risks of drinking while taking other CNS depressant medications, and even if they are aware, the risks are not taken very seriously. For example, over the course of my college career, I have surprised many people by informing them that acetaminophen and alcohol should not be consumed together because of their combined reliance liver clearance, which can put stress on the liver. Despite acetaminophen being a widely ingested and relatively harmless drug in day-to-day life, many individuals were completely unaware of the complications associated with that substance combination. This leads me to believe than many more people are not aware of the drug interactions between their medicine and alcohol, which very well may be worse than the interaction of acetaminophen and alcohol. I really appreciated your discussion of vulnerable groups and why alcohol is metabolized or tolerated differently between them. It was a great way to tie in pharmacological concepts, and the overall subject was fantastic too.
Hi Alyssa,
ReplyDeleteThis was so good! It's an excellent summary of the dangers of mixing alcohol with medications, emphasizing that alcohol acts as a powerful CNS depressant by enhancing GABA activity. The most threatening risk is the additive CNS depression that occurs when combined with other sedatives. This increases the likelihood of respiratory depression and overdose. I didn't know alcohol worsened drug clearance, while chronic use leads to cerebellum and nervous system damage. These risks are heightened in women and older adults because of physiological differences in processing time and concentration..
Hi Alyssa,
ReplyDeleteI really appreciated how you provided a ground work by explaining the serious impacts of alcohol use without drugs being in the mix to better highlight the serious consequences of combining the two. I also really liked how to addressed the differences between men and women as this is something that can have serious effects, but is often overlooked. Your conclusion did a great job of clearly summarizing the message you were attempting to portray. Overall, well done!