For better or worse, Adderall (or other prescription amphetamines) and alcohol are a pretty common combo. Some people just happen to mix the two, as their morning dosage of Adderall lingers on till their afternoon happy hour. Others mix them intentionally, using Adderall as a means of combating the sleepiness that alcohol can induce. Is any of this actually safe?
Not really, but as with most recreational or prescription drug interactions, there are ways of reducing harm.
For people who are prescribed Adderall, much of the risks of mixing it with alcohol are mitigated by time. If you take it in the morning, its effects will have likely worn off by the late afternoon or evening. Most amphetamines come in two forms, immediate release and extended release. The former loses its potency after four hours, while the latter can last around eight hours. With either, it’s generally safe to drink alcohol once these time periods are over.
The consequences of mixing alcohol and Adderall while it’s still active in your system can vary. It’s particularly dangerous for people with heart or blood pressure issues, as it can cause your blood pressure to rise or lead to an irregular heartbeat. Because Adderall is an upper and alcohol is a downer, the body is receiving conflicting messages about how to function. In rare cases, this can even cause strokes or seizures.
But most commonly, amphetamines can almost trick you into thinking you’re not as drunk as you really are, leading you to drink even more. Some people also don’t eat as much when they’ve taken Adderall, leaving their stomach lining without the proper coating of food needed to process alcohol more slowly. As such, alcohol can be even more potent on Adderall than without.
To make the combination safer, it’s a good idea to eat a meal before drinking, even if you don’t feel hungry. Limiting or at least attempting to be mindful of one’s alcohol consumption is wise, too. Always assume that you’re drunker than you feel, and definitely don’t let the Adderall trick you into feeling confident enough to drive or do anything dangerous.
Taking amphetamines while drinking might be surprisingly mainstream, but it’s still considered unsafe even by the most open-minded drug safety people. TripSit, a harm reduction group dedicated to providing services to keep those who use drugs safe, gives the combo a “caution” label. “If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover,” their online fact sheet states.
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Notably, their chart features dozens of other drug combinations that, while they may seem less common, are actually considered safer than alcohol and Adderall. Mixing DMT and MDMA, for example, is considered low-risk and even synergistic. Just because taking uppers while drinking might be normalized, that doesn’t mean it’s completely harmless.