Adderall & Alcohol: Understanding the Risks

What Happens When You Mix Alcohol & Adderall?

Adderall and alcohol affect the brain and body in different ways. Adderall is a stimulant medication that can lead to wakefulness, increased focus, and decreased impulsivity. Alcohol is a depressant substance that can lead to relaxation and sedation. Both Adderall and alcohol can have severe side effects if not taken appropriately, and these side effects can be worsened when taken together. Both Adderall and alcohol have warnings about their use alone by the CDC and FDA with recommendations not to take them together.^1,4,5

Side effects of Adderall may include:⁶

• Dizziness
• Nervousness
• Anxiety/paranoia
• Abdominal pain
• Changes in sex drive
• Increased heart rate
• Elevated blood pressure
• Headache
• Nausea
• Vomiting
• Diarrhea
• Weight loss
• Agitation

Side effects of alcohol use may include:¹

• Loss of balance
• Slurred speech
• Reduced reaction time
• Impaired judgment
• Memory problems
• Increased heart rate
• Elevated blood pressure
• Dehydration
• Increased risk of liver problems
• Increased risk of cancer
• Alcohol poisoning

The side effects of Adderall and alcohol alone can be dangerous, but this risk is worsened when these substances are combined.

Adderall & Alcohol Interactions

Combining Adderall and alcohol can have dangerous consequences. This can lead to immediate and long-term consequences. Also, taking a stimulant medication such as Adderall can lead to masking of the intoxication effects of alcohol, causing individuals to consume more alcohol than they normally would.

Severe side effects of mixing Adderall and alcohol include:

• Impaired judgment: Adderall can mask the sedative side effects of alcohol leading to increased consumption. This can cause impaired judgment leading to a higher likelihood of engaging in risky behaviors.
• Dehydration: Both alcohol and Adderall can cause dehydration alone, with the combination intensifying this effect. Dehydration can lead to electrolyte problems, dizziness, and kidney problems.
• Heart failure: Both of these medications can cause elevations in heart rate and blood pressure. When combined, these risk increases leading to excess strain on the cardiovascular system and a risk of heart failure.
• Alcohol poisoning: By masking the effects of alcohol intoxication leading to increased alcohol consumption, an individual’s risk for alcohol poisoning is significantly elevated.
• Mental health problems: Adderall and alcohol can worsen mental health problems, including depression and anxiety disorders. When combined, this can lead to increased feelings of sadness, agitation, and risk of suicidal thoughts.

Alcohol & ADHD

Some individuals are more likely to engage in the concurrent use of Adderall and alcohol. For example, young adults, such as college students, are more likely to misuse prescription stimulants with alcohol.⁸ Those with a history of substance abuse are also more likely to combine medications with alcohol.

Mixing Adderall and alcohol may be done when someone is unaware of the potential side effects. Adderall can cause euphoria when taken inappropriately, and some individuals may combine the Adderall with alcohol seeking a heightened euphoria. Others, such as those with major depressive disorder, may combine these substances to escape negative feelings and manage stress.

Adderall is a stimulant medication used to treat attention deficit hyperactivity disorder (ADHD). Some studies have shown that ADHD can increase the risk for substance abuse disorders, although the reason for this is unknown.⁹ For those with alcoholism, there may be an increased risk of concurrent stimulant abuse.

Can You Ever Drink While Taking Adderall?

There is no recommended time between taking Adderall and drinking alcohol. Even when skipping a dose, the effects of Adderall may still linger. The half-life of a drug is the time for half of the medication to be eliminated from the body, and medications are considered to still be present in the body until 4-5 half-lives. The half-life for Adderall is between 10-13 hours, meaning that Adderall is present in the body for at least 40 hours.

While taking a lower dose of Adderall may lead to a lower risk of some side effects, it does not completely eliminate the potential dangers when combined with alcohol. Everyone responds differently to medications such as Adderall, and the interaction with alcohol can still lead to worsened side effects. Because of this, extreme caution should be taken for those who are prescribed Adderall when consuming alcohol.

Alcohol and Adderall can both individually lead to addiction and abuse. Because these medications have some opposing effects on the body, higher doses are needed to achieve the same effect when the medications are taken together. This can greatly increase the risk for addiction and abuse and overdose, and a higher dose can worsen the symptoms of withdrawal when these medications are discontinued.

Can Adderall & Alcohol Kill You?

Mixing Adderall and alcohol can lead to increased alcohol consumption, which increases the risk of alcohol poisoning and lethal overdose. The amount of alcohol leading to overdose varies depending on several factors, including gender, weight, age, and tolerance. This risk is furthered for those engaging in binge drinking, which alone increases the risk of alcohol overdose.

Risk Factors for Abusing Adderall & Alcohol

Several risk factors can contribute to the development of substance abuse disorders such as Adderall and alcohol abuse. Substance abuse risk factors include a genetic disposition, use of these substances at an early age, peer/social pressure, and mental health disorders. The signs that someone may have a substance abuse disorder include mood/personality changes, the need to take higher doses to achieve the same effect, and the need to take these substances to prevent withdrawal symptoms.

Symptoms of an Overdose of Adderall & Alcohol

If you or someone you know is under the influence of these substances and experiencing severe side effects/overdose, call 9-1-1 or visit the nearest emergency room immediately. Overdosing on these substances can have severe life-altering and life-threatening consequences.

If you suspect that someone has overdosed on these substances, it is important to act swiftly and have them see a medical professional immediately. Some individuals under the influence, such as high-functioning alcoholics, may not realize the extent of the situation and it can be challenging to address your concerns with them. However, it is important not to underestimate the severity of the situation when an overdose occurs and to prioritize the individual’s well-being by seeking immediate medical care.

Symptoms of an overdose of Adderall and alcohol include:

• Chest pain or irregular heart rate
• Confusion and disorientation
• Severe agitation and aggression
• Seizures
• Loss of consciousness or coma

Treating an Alcohol & Adderall Overdose

When seeking immediate medical care for alcohol and Adderall overdose, treatment depends on the extent of the overdose. Healthcare professionals will assess the symptoms, monitor vital signs, obtain labs as needed, and provide necessary treatments. These treatments may include administering IV fluids and providing medications to counteract the negative effects.

After the initial treatment, individuals may require continued monitoring of their vital signs and mental health. Depending on the situation, an individual may require referral to addiction treatment programs, mental health providers, therapy, and support groups.

Seeking Professional Help

If you are concerned about the interactions between Adderall and alcohol, talk with your psychiatrist/physician about potential alternative treatments. If you do not see a psychiatrist or need a new psychiatrist, online psychiatry options are available.

For those who are concerned about alcohol use, many different treatments are available, including inpatient and outpatient treatments, support groups, and therapy. Intensive outpatient treatment can be particularly helpful. This offers a comprehensive treatment approach to address multiple disorders at once, such as substance abuse disorders and mental health conditions. Inpatient outpatient treatment can also address cross addiction, which is when an individual has problems with two or more addictions.

Questions to Ask Your Health Team About Alcohol & Adderall Use

When starting or changing the dose of Adderall, have an honest conversation with your healthcare provider regarding your alcohol use. Those unaware of how Adderall affects their body are at an increased risk for adverse effects. Discussing your concerns and asking questions is the best way to educate yourself on the risks of Adderall and alcohol use.

Questions to ask your doctor about alcohol and Adderall include:

• Is there a safe amount of alcohol I can consume with Adderall?
• If someone wants to drink, should they stop taking Adderall for the day?
• Is there ADHD medication that isn’t negatively affected by alcohol?
• What should I do if I drink anyway and have an adverse reaction?
• Can drinking alcohol with Adderall increase the risk of addiction or substance abuse?
• What warning signs should I look out for if I decide to drink alcohol while taking Adderall?
• Can alcohol worsen any underlying conditions that Adderall is prescribed to manage?
• Does my health history increase the risk of side effects when combining alcohol and Adderall?
• How can I limit the side effects when drinking alcohol while taking Adderall?
• Are there any long-term effects of using Adderall and alcohol together?

In My Experience

In my experience, Adderall is an effective medication, and many of my patients with ADHD are prescribed Adderall to manage their symptoms. It is always important to talk to your doctor about alcohol use if being prescribed Adderall and to follow their guidance and recommendations. For someone who takes Adderall, it is important to closely monitor alcohol consumption to prevent yourself from accidentally drinking too much. This is especially true when first starting Adderall or when adjusting the dose.

For Further Reading

• ADHD Medication Side Effects: Everything You Need to Know – Choosing Therapy
• Modafinil Vs Adderall: How Do They Compare?
• Adderall: Uses, Side Effects, & Interactions
• How to Get Prescribed Adderall: Everything You Need to Know
• Mixing Alcohol & Concerta: What Are the Dangers?
• Adderall Withdrawal: Symptoms, Duration, & How to Cope