Mixing Adderall and Alcohol: Risks, Timeline, And Important Facts

Can I Drink While Taking Adderall?

Generally speaking, doctors advise you to avoid drinking alcohol when you have Adderall in your body. Adderall contains two ingredients, amphetamine and dextroamphetamine, which enhance alertness and focus. The FDA approved Adderall for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy.[1]

Due to the risk of misuse, Adderall is classified as a Schedule II controlled substance. A Schedule II controlled substance is defined by the DEA as a drug with high potential for abuse, but also with useful medicinal properties.[2] Examples of Schedule II drugs include oxycodone (OxyContin), hydrocodone (Vicodin), fentanyl, methadone, Ritalin (methylphenidate), cocaine, morphine, opium, codeine, and hydromorphone.

Alcohol is a depressant. Drinking alcohol with a stimulant does not cancel each other out. Some individuals believe that since a stimulant provides alertness and a depressant creates relaxation, the effects of each would balance out safely.

However, the effects of both substances are changed when combined. Combining alcohol with a prescription stimulant can produce unpredictable, potentially life-threatening results, even at doses typically deemed acceptable individually.[3]

Does Adderall Make You Feel Less Drunk?

Adderall can make drinkers feel less sleepy than they would normally feel. Since many drinkers feel most aware when they’re sober, drinkers may continue to drink longer than normal due to the perceived reduced level of drunkenness caused by the stimulant.

Why Binge Drinking Is Especially Dangerous With Adderall

Since drinkers cannot recognize how drunk they truly are, the risk of alcohol poisoning or other harmful activities increases. Additionally, excessive drinking can lead to dehydration and overheating; Adderall may worsen dehydration while increasing the risk of overheating.[4]

Understanding the Interaction Between Adderall and Alcohol

When you take Adderall, you increase dopamine release in your brain and norepinephrine release throughout your body.[5] Norepinephrine helps your brain become more focused and attentive. At the same time, alcohol affects your central nervous system (CNS), causing depression in both areas of the CNS: the brain and spine. This action doesn’t balance out; instead, it creates an unpredictable mixture of stimulation and depression in the CNS.

Why Do People React Differently to Mixtures of Adderall and Alcohol?

Your response to the mixture of Adderall and alcohol is determined by several variables:[6]

• The dose of Adderall you take
• The number of drinks you consume
• Whether the medication is immediate-release or extended-release
• Your size
• Any other prescription medications you’re taking
• Liver function; your general health status
• Pre-existing heart conditions.

Heavy chronic drinking can damage the liver over time, and combining it with any additional substance adds further strain on the body. That’s another reason two individuals can drink the same amount and react completely differently.

What Risks Increase When You Combine Alcohol With Adderall?

Elevated Cardiovascular Risk

Taking a stimulant along with alcohol will likely increase your heart rate and blood pressure, and possibly cause an irregular heartbeat.[7] This combination places more strain on the cardiovascular system than either substance produces on its own.

Long-term use of alcohol-stimulant combinations puts additional stress on your cardiovascular system.[8] Although rare, this combination has been linked to heart attacks, and those with pre-existing heart conditions run a greater risk of having this combination prove deadly.[9] SAMHSA reports that combining a stimulant with alcohol is a form of polysubstance use that carries elevated health risks.

Elevated Risk of Alcohol Poisoning

Drinking enough to reach toxic levels of alcohol consumption can easily happen without realizing it when consuming alcohol with a stimulant. Because Adderall masks the typical signs of intoxication (i.e., feeling tired), a person may keep drinking until they reach toxic levels.

Poor Decision-Making and Injury Risk

Alcohol impairs judgment, and when combined with a stimulant, it also gives the illusion of improved control over decisions. Thus, the combination increases impulsiveness and the danger of reckless driving, falls, unsafe sex practices, etc.

Increased Dehydration and Heat Stroke

Both dehydrate, although through slightly different mechanisms. Since dehydration is increased, if the individual is physically active (e.g., running, hiking), they may suffer from heat stroke.[9] Heat stroke occurs when an individual’s internal temperature becomes dangerously high due to severe dehydration.

Why Does Binge Drinking Increase Danger

There are two major risks associated with mixing Adderall and alcohol. First, there is a heightened risk of alcohol poisoning (toxicity). Second, there is an elevated risk of poor decision-making and injury. Drinking excessively within a limited timeframe significantly elevates both of the previously mentioned risks.

How Long After Taking Adderall Can I Drink?

There is not a universal “safe” waiting period for taking Adderall prior to drinking alcohol, or a waiting period after drinking to take Adderall.[10] The time it takes for Adderall to lose effectiveness varies depending on several factors, including dose size, formulation (extended-release vs. immediate-release), body weight or size, liver function, other prescriptions you are currently taking, and any underlying heart or other health issues.

Most importantly, some people may begin to experience fatigue or drowsiness after stopping Adderall. Drinking during this “comedown” phase may exaggerate the drowsiness rather than alleviate it.

Is Adderall With Beer Safe?

It is possible that some individuals believe beer is safer than hard liquor because it is typically lower in alcohol content per serving than spirits. However, what ultimately matters is not what type of beverage you choose to drink while taking Adderall, but rather how much total alcohol you drink. Moderately drinking (i.e., 1–2 servings per occasion) will still pose risks when combined with taking Adderall. Additional factors such as dehydration from lack of sleep, spacing drinks over a longer time frame, etc. Can also increase your risk.

Why Mixing Adderall With Alcohol Is Different From Other Medications

The primary concerns about combining Adderall and alcohol apply to other prescription stimulants used for treating ADHD as well. Similar to Adderall, these medications can mask the effects of intoxication as well. However, unlike sedative or anti-anxiety medications (which compound sedation), the effects of combining a prescription stimulant with alcohol are far more unpredictable.

Doctors’ recommendations tend to be to avoid the combination altogether rather than to determine a universally “safe” amount.

What Warning Signs Require Immediate Medical Help?

Go immediately to an ER or call 911 if any of the following occur:[12]

• Severe chest pain
• Difficulty breathing
• Seizure(s)
• Confusion
• Loss of consciousness
• Extreme hyperthermia (very high body temp)
• Persistent vomiting
• Blue lips or skin

Don’t wait; call 911 or seek medical attention right away.

When Is It Time to Seek Help?

While periodically mixing a prescription stimulant and alcoholic beverages does not automatically imply that you have developed a substance abuse disorder, the associated habits indicate professional help may be needed.

Habits indicating a problem include:

• Drinking solely in order to counteract the effects of the prescription medication
• Requiring more alcoholic beverages or prescription medication in order to obtain desired effects
• Continuing to engage in the combination despite experiencing adverse consequences

Additionally, abrupt cessation of either substance after prolonged use may induce withdrawal symptoms.

Professional evaluations assess your situation in light of all relevant circumstances. Based on the results of these assessments, professional evaluators will suggest appropriate treatment options for you, including inpatient treatment programs, structured outpatient programs, or medically supervised detoxification programs.

Evidence-based treatment options address all aspects of you as a person, not merely specific behaviors, and are tailored to your unique needs.