Mixing Meth With Alcohol: A Terrible Combo

The Dangers of Mixing a Stimulant With a Depressant

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The prospect of mixing meth (methamphetamine) and alcohol probably seems foreign to most of us, but please allow me to put this combo in perspective. Have you ever been out drinking and smoked a cigarette (or five)? Or, have you ever cut whiskey, rum or some other type of liquor with Coca-Cola or some other more caffeinated beverage like Red Bull? Albeit in a legal and more restrained manner, mixing a stimulant (nicotine or caffeine) with alcohol (a depressant) is similar to mixing meth (a stimulant) with alcohol.

(Technically, nicotine has both stimulant and depressant properties, but you get the picture.)

Unfortunately, the number of people who drink regularly and smoke crystal meth is scary with one study pegging daily drinkers as five times more likely to smoke meth. (I know ... I know ... relative rates can be misleading and are a hallmark of bad science journalism. How about this factoid instead: 5 percent of meth smoking is attributable to daily intoxication. Still pretty scary.) Moreover, we know little about this potentially deadly combination.

Why Alcohol and Meth Together?

As any addiction specialist can attest to, polysubstance abuse is common. People mix together all types of drugs to titrate highs (think cocaine, Molly, and marijuana). Mixing meth and alcohol is no different.

Specifically, researchers believe that people who mix alcohol and meth do so in order to counteract the depressant effects of alcohol and still maintain its euphoric effects.

In 2008, 24 percent of methamphetamine-related emergency department visits involved alcohol intoxication, too.

The Research on Mixing Alcohol and Meth

In a more interesting example of how our tax money goes on to fund research--specifically research done by the National Institute on Drug Abuse--in 2011, researchers from Columbia University and the New York Psychiatric Institute periodically administered solutions of alcohol mixed with methamphetamine to 9 adult men.

These men were housed in a residential laboratory at New York Psychiatric Institute for 20 days. (I'm picturing a bizarro take on Rehab with Dr. Drew, but instead of drying folks out, researchers intoxicated participants in the name of science.)

Put your mind at ease ... it's not like these participants had never before indulged in alcohol and illicit stimulants. Instead, adult participants were recruited who had reported past amphetamine use and recent alcohol use. Moreover, participants were screened and excluded for separate medical and psychiatric illness.

Participants were monitored and tested in a variety of ways including breath alcohol concentrations; cardiovascular, subjective, and cognitive/psychomotor performance; and objective sleep measures.

Here are some findings from the study:

  • Co-administration of alcohol and meth increased cardiovascular measures (think increased heart rate and blood pressure) and feelings of euphoria.
  • This drug combination made participants feel less drunk or sedated.
  • Meth counteracted some of the cognitive and psychomotor impairment caused by alcohol.
  • Taken together, these drugs produced fewer sleep disruptions than meth alone.
  • Participants developed tolerance to the drug combination as the study proceeded, diminishing some of the side effects listed above.
  • Except for increased heart rate and some upset stomach, participants experienced few residual effects.

This study had definite limitations. First, the administration of the meth-alcohol combination in no way mimics real world scenarios. More specifically, as a Vince Gilligan aficionado, I know that people either smoke or snort meth in an unregulated manner. Moreover, alcohol is usually consumed in an unregulated manner, too. Second, the study includes only 9 participants. (Undoubtedly, this study serves as a prelude to future, much-needed research on the subject.) Third, people in the study were allowed to smoke cigarettes, introducing nicotine as a confounding variable. (And smoke cigarettes they did--people actually smoked more when taking the drug combo.)

Results from this study suggest that when taken together, meth and alcohol act in a fashion different from either drug taken alone. Meth and alcohol's contradictory effects are concerning for at least two reasons. First, people who use both drugs simultaneously may drink more alcohol in order to feel more inebriated or feel its accustomed effects thus leading to alcohol toxicity. Second, people who end up drinking more while high on meth may underestimate cognitive impairment and get behind the wheel of a car or other heavy machinery thus putting not only the user but others at risk, too.

The distinct combined effects of meth and alcohol should serve as an ominous reminder to health-care professionals that various permutations of polysubstance misuse are clinical beasts of their own which should be considered in every patient who enters lying supine on a gurney through the ER doors. For the rest of us, this study probably means something different: Mixing certain drugs (illicit, prescription and nonprescription) could result in distinct side effects that may be deadly especially if you have other psychiatric or medical conditions.

Selected Sources

Article titled "The suspected association between methamphetamine (‘ice’) smoking and frequent episodes of alcohol intoxication: data from the 1993 National Household Survey on Drug Abuse" by DM Carolyn and co-authors published in Drug and Alcohol Dependence in 2000.  Accessed on 3/4/2015.

Article titled "Acute and residual interactive effects of repeated administrations of oral methamphetamine and alcohol in humans" by MG KIrkpatrick published in Psychopharmacology in 2012.  Accessed on 3/4/2015.

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