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Marijuana & Alcohol: Understanding the Risks

Published: January 4, 2023 Updated: January 26, 2023
Published: 01/04/2023 Updated: 01/26/2023
David Tzall, PsyD. Headshot
Written by:

David Tzall

PsyD
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Are the Effects of Mixing Weed & Alcohol?Mixing Weed & Alcohol
  • Does Taking Weed or Alcohol Before the Other Matter?Taking One Before the Other
  • Increased Risks of Mixing Alcohol & WeedIncreased Risks
  • Preventing Bad Reactions From a Weed & Alcohol MixHow to Prevent Bad Reactions
  • How to Cope With the Negative Effects of Mixing Weed & AlcoholTips for Coping
  • When to Seek Medical AttentionWhen to Seek Medical Attention
  • When to Seek Therapy & Addiction CounselingCan Therapy Help?
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Marijuana & Alcohol InfographicsInfographics
David Tzall, PsyD. Headshot
Written by:

David Tzall

PsyD
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD

Mixing marijuana and alcohol can be a destructive combination. Combined, these substances are associated with higher consumption levels than when used alone. Additionally, the mixture can be harmful to the individual and community as a whole. Simultaneous use is associated with increased motor vehicle collisions, injuries, and risky sexual behavior.1

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What Are the Effects of Mixing Weed & Alcohol?

Alcohol and marijuana alone can cause a buzz and impair a person’s emotional and cognitive functioning. Each substance can get a person high. However, there is a complementary effect when taken simultaneously. One substance is used to complement and enhance the other. This means that the person will likely get high quicker, stay impaired longer, and feel it more intensely. A person is likely ingesting both to ensure their high is intense and long-lasting to potentially help alleviate other mental and emotional health concerns.

Alcohol and marijuana are both depressants and decrease inhibition. Combining multiple depressants is risky as a depressant slows down the central nervous system. Messages to and from the brain take longer to reach their target. A person may be less likely to remember or appreciate how much they have taken, leading to a potential overdose or engaging in binge drinking behavior.

Side effects of weed include:

  • Headaches
  • Dry mouth
  • Loss of coordination
  • Memory issues
  • Fatigue
  • Drowsiness

Side effects of alcohol include:

  • Impaired coordination
  • Blackouts
  • Alcohol poisoning
  • Weakened immune system
  • Slurred speech
  • Dehydration

Does Taking Weed or Alcohol Before the Other Matter?

It matters greatly whether you ingest alcohol before weed or weed before alcohol. Each substance will have a different effect on one another concerning strength and effect on the body.

Drinking Alcohol Before Consuming Marijuana

Consuming alcohol before smoking marijuana will likely get you higher with greater intensity. Alcohol increases the absorption of THC in cannabis products by priming liver enzymes.2 Essentially, marijuana gets absorbed faster, leading to a quicker, potentially greater, high. Greater absorption means it will take less marijuana to get one high. If someone is unaware of this combination during simultaneous use, it can lead to deadly side effects. Something else to be mindful of is the effect that alcohol has on the blood-brain barrier (BBB). Increased alcohol use can compromise the BBB, potentially allowing more harmful chemicals or drugs to enter the brain. This compromise is another reason for the increased effects of marijuana.

The amount of alcohol you consume, your history of use and tolerance, along with the type of alcohol can all have an effect on marijuana use. While there does not appear to be research on the amount of time between the substances, the sooner the two are linked are likely to have the greatest effects. A person should also be careful about experiencing a “greening out,” which happens after a person ingests too much marijuana.

Consuming alcohol before smoking weed may increase symptoms such as:

  • Sweating
  • Dizziness
  • Vomiting
  • Chills

Smoking Weed Before Drinking Alcohol

Smoking marijuana before alcohol comes with its own associated risk and issues. As with alcohol, marijuana’s active ingredient, THC, changes how the drugs are metabolized and absorbed. Smoking marijuana before drinking alcohol can slow down the rate at which alcohol leaves the GI tract.

A big risk factor is drinking more than you intended and feeling the effects later. Alcohol lowers inhibitions by affecting neurotransmitters in the brain, which send the body messages. Alcohol affects cognitive processing, so you may not feel as high or buzzed with the normal amount you usually drink, and it may not be until it is too late to recognize that you are in trouble.

Smoking weed before can alter the effects of alcohol consumption, such as:

  • Delayed feeling of being drunk
  • Reduced gag reflex
  • Dehydration

Other Factors to Consider

The effects of smoking and drinking together are impacted by many variables and factors, such as when and how people take each substance and individual differences. Differences can include gender, weight, substance tolerance, and history of substance use. Not everyone will react similarly to simultaneously using alcohol and weed. Given the disparities and the chance that it might affect you differently, it is always best to heed any and all risk factors as you don’t know your response.

Factors that influence how a person is affected by mixing weed and alcohol include:

  • Tolerance to either alcohol or marijuana
  • Type of Marijuana
  • Type of alcohol
  • Interval between consumption
  • Use of other substances
  • Medications
  • History of prior use
  • Diet

Help For Reducing Drinking, Drying Out, And Staying Sober

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Increased Risks of Mixing Alcohol & Weed

The combination of marijuana and alcohol will intensify the adverse side effects of one another and lead to potentially harmful side effects.4
Short-term and long-term health effects are a reality. Short-term effects can include sleep disturbances and social consequences. Long-term effects can include depression and increased and frequent substance use.4 Several risk factors of substance abuse cause some people to abuse substances like alcohol and weed.

Mixing alcohol and weed can produce adverse effects such as:

  • Impulsive behaviors
  • Liver damage
  • Sleep disturbances
  • Mood disorders (anxiety and depression)

Increased Risk of Dependence & Substance Use Disorders

Research is mixed on whether alcohol and marijuana are used together for the purpose of substitution (one drug can pharmacologically replace the other drug) or complementation (one drug enhances the effects of the drug).5 It may be difficult to determine whether someone is dealing with addiction versus dependence. It is known that alcohol and marijuana have a synergistic effect and can increase the risk of substance use disorders such as alcoholism, marijuana addiction, or cross addiction.6

Impaired Cognitive Functioning

Simultaneous use was found to be associated with greater subjective negative physiological and cognitive effects (i.e., feeling clumsy, confused, dizzy, and having difficulty concentrating).7 However, research remains mixed on cognitive and structural brain issues due to combining both substances.8

Higher Rate of Driving Under the Influence

Driving buzzed is no different than driving drunk or stoned. It may even be easier to believe you are fine to drive when you have combined the two substances due to a belief that you did not drink or smoke as much as you perceive. Even when you don’t feel as drunk from smoking marijuana, your motor skills are still just as impaired, if not more. Recent studies have demonstrated that marijuana can increase brake latency, lateral position errors, and distance variability in simulated and closed-road driving tasks.9

Moreover, laboratory studies have suggested that driving under the influence of both alcohol and marijuana produces additional detrimental effects, with low levels of alcohol increasing peak THC blood concentration and co-administration of both drugs increasing the risk of diminished driving performance.10

Preventing Bad Reactions From a Weed & Alcohol Mix

Strategies exist to reduce the physical and cognitive effects of combining alcohol and marijuana. Planning and organization can greatly reduce how one substance interacts with the other. This is wildly important given the negative effects that combining the two can have on an individual.

Strategies you can implement to reduce the risks of mixing weed and alcohol include:

  • Waiting an hour between consuming the two substances: The longer the period between the two, the less likely they have a chance to interact with one another.
  • Using standardized units of alcohol and THC: Using measurements like a standard drink and ounces of marijuana may ensure that you are ingesting a regulated amount.
  • Following medical THC guidelines: Knowing the strain of marijuana and its potency can help know how much is too much.
  • Limiting weekly consumption: Limiting the amount of alcohol to healthy guidelines may limit the need or amount of marijuana that is consumed.
  • Knowing how to sober up: Drinking water in between alcohol can limit the negative effects. Eating can also dampen the effects of either substance.

How to Cope With the Negative Effects of Mixing Weed & Alcohol

If you have mixed weed and alcohol and experience an uncomfortable or negative reaction, there are some ways to cope until the effects wear off.

Here are some tips for handling the effects of mixing weed and alcohol:

  • Staying calm: This can help manage any feelings of anxiety or “freakouts.” Remain in a safe space and breathe deep breaths.
  • Sitting and lying down: Siting can help with any motion sickness and prevent you from falling down. Lying down may be helpful to get your physical bearings, and you are in a position to sleep if need be.
  • Eating and drinking for blood sugar: Eating will delay the absorption of the substances and prevent you from feeling light-headed or dizzy.
  • Staying hydrated: Alcohol and marijuana can lead to quick dehydration. Drinking water or a sports drink can help stave off dehydration, a headache, or a hangover.
  • Walking: If you are not seriously impaired and can walk and move without safety concerns, it can help maintain focus and get the blood flowing through your system.
  • Talking to someone: Speaking to a friend can help ground you. Another person may also look out for you and help give you water or food.

When to Seek Medical Attention

Combining alcohol and weed can make it difficult to distinguish between greening out or alcohol poisoning when someone has consumed too much alcohol. Ingesting too much or too soon can result in medical emergencies that require immediate attention. It is best to be safe and seek out medication attention if you are unsure, as alcohol poisoning is a dangerous condition that cannot be resolved independently.

Greening out or increased marijuana ingestion may not require the same level of medical intervention. Marijuana has fewer short-term irreversible health effects. The risk of marijuana toxicity is real but less likely to be as lethal as heavy alcohol consumption.

If you or someone you know is exhibiting these signs of alcohol overdose when mixing with weed, seek immediate medical attention:

  • Confusion
  • Vomiting
  • Damp skin
  • Bluish pale skin
  • Seizures
  • Passing out
  • Slurred speech
  • Impaired coordination and movement
  • Irregular or slow breathing

When to Seek Therapy & Addiction Counseling

It is a personal decision when the person seeks substance use counseling. It may take only a few times of getting sick, blacking out, or having other harmful medical and social effects before they seek care. However, someone may continuously experience the negative and deleterious effects and never seek care as they feel it is under control and they do not have a substance use disorder.

Overall, it is a major sign that someone needs care when it impairs/disrupts the person’s life or others. When it starts to interfere with personal, professional, and social obligations is a sign that your substance use has gotten out of control and perhaps time to find a therapist. At the same time, someone may use alcohol or weed within healthy and normal limits and still seek out care as they may see the effects it can have in the future or for health and personal reasons. Impacts on daily functioning may include lying to others, being late for appointments/work, increasing the frequency and intensity of use, stealing to increase drug or alcohol habits, and other individuals expressing concern regarding your use.

Inpatient versus outpatient rehab treatment will need to be considered based on your needs and how much time and resources you can provide. The structure of an inpatient facility, detox, or rehab may be the catalyst a person requires to stop using. Outpatient treatment can be found through personal referrals, an internet search, or an online therapy directory.

Final Thoughts

Some people may use weed and alcohol to achieve a cross-faded experience, but the risk of combining the two can be dangerous. Although it is best not to combine the two, carefully monitor and limit your consumption if you do so and seek medical attention should alcohol poisoning be apparent.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Drinking Moderation

Sunnyside – Want to drink less? Sunnyside helps you ease into mindful drinking at your own pace. Think lifestyle change, not a fad diet. Develop new daily routines, so you maintain your new habits for life. Take a 3 Minute Quiz.

Find A Rehab Center (Free & Confidential) – Call (855) 236-2993

Get help breaking your addiction at a comfortable living facility. Treatment for alcohol, opioid, heroin, and behavioral addictions including eating disorders. Most rehab centers work with multiple insurers. To find out your benefits call: (855) 236-2993

Opioid Use Treatment

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Choosing Therapy partners with leading mental health companies and is compensated for marketing by Rehab.com, Sunnyside, Online-Therapy, and Bicycle Health.

For Further Reading

  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov
  • 15 Best Books on Alcoholism and Recovery
  • 11 Best Addiction Recovery Apps
  • 15 Best Addiction Recovery Blogs
  • 9 Best Sobriety Apps
  • Marijuana & Anxiety: Connections, Potential Benefits, & Risks
  • Alcohol & Anxiety: Connections & Risks

Marijuana & Alcohol Infographics

The Combination of Weed and Alcohol   Increased Risks of Mixing Alcohol & Weed   Seek Immediate Medical Attention for Yourself or a Loved One If There Is:

10 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Gunn, R. L., et al. (2018). Marijuana use is associated with alcohol use and consequences across the first 2 years of college. Psychology of addictive behaviors: journal of the Society of Psychologists in Addictive Behaviors, 32(8), 885–894. https://doi.org/10.1037/adb0000416

  • Rebecca, L. & et al. (2015). Controlled Cannabis Vaporizer Administration: Blood and Plasma Cannabinoids with and without Alcohol, Clinical Chemistry, Volume 61, Issue 6, 1 June 2015, Pages 850–869, https://doi.org/10.1373/clinchem.2015.238287

  • Pimentel, E., et al. (2020). Effects of drugs of abuse on the blood-brain barrier: a brief overview. Frontiers in neuroscience, 14, 513.

  • Subbaraman, M. S., & Kerr, W. C. (2015). Simultaneous versus concurrent use of alcohol and cannabis in the National Alcohol Survey. Alcoholism, clinical and experimental research, 39(5), 872–879. https://doi.org/10.1111/acer.12698

  • Subbaraman, M. S. (2016). Substitution and Complementarity of Alcohol and Cannabis: A Review of the Literature. Substance use & misuse, 51(11), 1399–1414. https://doi.org/10.3109/10826084.2016.1170145

  • Lee, C. M., et al. (2020). A Daily Study Comparing Alcohol-Related Positive and Negative Consequences for Days With Only Alcohol Use Versus Days With Simultaneous Alcohol and Marijuana Use in a Community Sample of Young Adults. Alcoholism, clinical and experimental research, 44(3), 689–696. https://doi.org/10.1111/acer.14279

  • Lee, C.M., Cadigan, J.M., & Patrick, M.E. (2017). Differences in reporting of perceived acute effects of alcohol use, marijuana use, and simultaneous alcohol and marijuana use. Drug and Alcohol Dependence, 180, 391–394.

  • Jacobus, J., et al. (2009). White matter integrity in adolescents with histories of marijuana use and binge drinking. Neurotoxicology and teratology, 31(6), 349–355. https://doi.org/10.1016/j.ntt.2009.07.006

  • McCarthy, D. M., Lynch, A. M., & Pedersen, S. L. (2007). Driving after use of alcohol and marijuana in college students. Psychology of addictive behaviors, 21(3), 425.

  • Arterberry, B. J., Treloar, H., & McCarthy, D. M. (2017). Empirical Profiles of Alcohol and Marijuana Use, Drugged Driving, and Risk Perceptions. Journal of studies on alcohol and drugs, 78(6), 889–898. https://doi.org/10.15288/jsad.2017.78.889

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David Tzall, PsyD. Headshot
Written by:

David Tzall

PsyD
Headshot of Dr. Kristen Fuller, MD
Reviewed by:

Kristen Fuller

MD
  • What Are the Effects of Mixing Weed & Alcohol?Mixing Weed & Alcohol
  • Does Taking Weed or Alcohol Before the Other Matter?Taking One Before the Other
  • Increased Risks of Mixing Alcohol & WeedIncreased Risks
  • Preventing Bad Reactions From a Weed & Alcohol MixHow to Prevent Bad Reactions
  • How to Cope With the Negative Effects of Mixing Weed & AlcoholTips for Coping
  • When to Seek Medical AttentionWhen to Seek Medical Attention
  • When to Seek Therapy & Addiction CounselingCan Therapy Help?
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Marijuana & Alcohol InfographicsInfographics
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