Mixing Weed and Alcohol: Effects and Risks

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Weed – also known as marijuana or cannabis  – is the most commonly used illicit substance in the United States. Approximately 50 million Americans (18% of the population) have used weed in some form. Thirty percent of people who endorse marijuana use are diagnosed with cannabis use disorder. This number may be even higher for those who start using before age 18.

Depending on age, anywhere from 2.4% to 15.3% of adults admit to the simultaneous use of weed and alcohol, especially among young adults. When combined, the effects of both substances are intensified, leading to more significant physical and mental impairment. Individuals who misuse alcohol and drugs are more likely to develop severe dependence that leads to overdose.

If you or someone you love is combining marijuana and alcohol and are looking for support in quitting, Guardian Recovery can help. Our marijuana detox program is part of our broader treatment for drug and alcohol detoxification. From initial medical detox to aftercare planning, our knowledgeable, experienced clinicians will navigate you through each step of your recovery. Contact us today to speak with a treatment advisor 24/7 who can give you more information about our comprehensive, individualized services. Read on to find out more about the relationship between weed and alcohol.

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The Effects of Mixing Alcohol & Marijuana

The effects of mixing alcohol and marijuana are more intense than either substance on its own.

Alcohol’s impact on the body is well-studied. Brain chemicals, called neurotransmitters, are responsible for mood, energy levels, sleep, stress, pain, and other bodily functions. Several of these neurotransmitters are implicated in alcohol use.

The central nervous system (CNS), consisting of the brain and spinal cord, is altered in numerous ways by drinking. Alcohol reduces brain activity as a CNS depressant, leading to slow breathing, decreased blood pressure and heart rate, sleepiness, delayed reaction time, loss of coordination, and feelings of happiness and relaxation.

Weed impacts the same reward system in the brain as alcohol. The psychoactive component of marijuana responsible for its physical and mental effects is delta 9-tetrahydrocannabinol (THC). This compound promotes euphoria and relaxation but impairs the ability to concentrate, learn, or accurately perceive time. Cannabis also increases blood pressure, heart rate, and appetite while lowering the respiratory rate.

Alcohol and marijuana independently exert effects on neurotransmitters such as GABA, dopamine, serotonin, and endogenous opioids. When combined, these two substances impair thinking ability, motor coordination, memory, and pain perception. Although marijuana use can delay alcohol absorption, drinking immediately after smoking cannabis enhances blood levels of THC. As a result, people who smoke weed and drink simultaneously intensify the physical and behavioral effects of both substances.

Side Effects of Mixing Alcohol & Weed Include:

  • Slower breathing
  • Lower heart rate
  • Nausea and vomiting
  • Lower body temperature
  • Impaired judgment
  • Impaired physical coordination
  • Confusion

What Are the Risks of Mixing Weed & Alcohol?

The risks of mixing weed and alcohol include significant levels of impairment and a higher chance of injury or self-harm. Individuals who combine alcohol and drugs are more likely to meet a greater number of diagnostic criteria for severe substance use and psychiatric disorders. As a result, these people are at increased risk for fatal substance overdose and suicide.

The effects of alcohol and marijuana especially impact driving ability. People who use both tend to feel less impaired than they would with just one substance. However, they have an objectively greater degree of impairment when combining agents.

An estimated one-third of drivers who simultaneously consume alcohol and cannabis admit to getting behind the wheel within two hours of ingestion. The risk of motor vehicle crashes is higher with weed and alcohol combined, as opposed to either substance alone.This mix of mind-altering substances is particularly problematic among young adults, because they are more apt to engage in reckless driving behavior under the influence.

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What is Greening Out?

Greening out refers to signs and symptoms associated with marijuana overdose. It is directly correlated to THC levels. People using weed for the first time or in greater amounts than usual are susceptible to this acute sickness. Smoking marijuana is up to 2.6 times more potent than consuming it in other forms, such as brownies or teas.

Too much THC overstimulates the brain and its neurotransmitters. These chemical messengers are responsible for mood, memory, appetite, and perceptions of pain. Most individuals with experience greening out report it is an uncomfortable, frightening sensation.

Symptoms of Marijuana Toxicity or “Greening Out” Include:

  • Panic or intense fear
  • Depression
  • Rapid heart rate
  • Low blood pressure that causes lightheadedness
  • Trouble breathing and chest tightness
  • Muscle twitching
  • Dry mouth
  • Severe nausea and vomiting
  • Psychosis

Although uncommon, research suggests cannabis-induced psychosis is five times more likely in people who use high-potency marijuana compared to those who do not use weed. Individuals with a family history or genetic predisposition for developing psychotic disorders (i.e., schizophrenia or bipolar disorder) may experience symptoms of psychosis with excessive marijuana use. These include paranoia, delusions of grandeur, auditory or visual hallucinations, irritability, and out-of-body experiences (depersonalization).

Can You Overdose on Alcohol & Marijuana?

Overdosing on alcohol and marijuana is possible, particularly if you are consuming larger quantities than usual. Their additive depressant effects on the CNS can quickly lead to potentially dangerous health problems.

Indicators of Alcohol & Marijuana Overdose Include:

  • Respiratory depression (slow, irregular breathing)
  • Very low heart rate
  • Very low blood pressure
  • Delirium
  • Lethargy
  • Loss of consciousness
  • Cool, clammy skin
  • Excessive sweating
  • Pale skin
  • Blue lips or nails
  • Vomiting causing airway obstruction
  • Seizure

Treatment for overdose involves monitoring the heart and maintaining a clear airway to prevent choking. Oxygen, intravenous (IV) fluids, and stomach pumping may be necessary for life-threatening overdoses. Otherwise, symptomatic treatment for nausea, pain, and behavioral disturbances is often sufficient.

If someone you know is experiencing any of the symptoms listed above after ingesting any substance, call 911 or go to the emergency department immediately.

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Overcoming the combination of marijuana and alcohol use may feel overwhelming. For complete recovery, you need to find an environment to help you quit both substances. At Guardian Recovery, we aim to address all forms of substance use. Our evidence-based programs utilize 12-Step Immersion and Relapse Prevention Training to guide you toward sobriety.

Our admission process is simple: Once you reach out, we will provide a free, no-obligation health insurance benefit check and complimentary assessment. The entire process takes just 15 minutes at one of our local facilities. Contact Guardian Recovery today for more information about how we can help you heal.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://www.cdc.gov/marijuana/data-statistics.htm#:~:text=Marijuana%20is%20the%20most%20commonly,at%20least%20once%20in%202019.&text=Recent%20research%20estimated%20that%20approximately,marijuana%20have%20marijuana%20use%20disorder.
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399000/
  3. https://pubs.niaaa.nih.gov/publications/aa76/aa76.htm
  4. https://jnnp.bmj.com/content/jnnp/75/suppl_3/iii16.full.pdf
  5. https://opentext.wsu.edu/biopsychological-effects-alcohol-drugs/chapter/chapter-11-alcohol/
  6. https://nida.nih.gov/publications/drugfacts/cannabis-marijuana#:~:text=Physical%20Effects&text=These%20problems%20include%20daily%20cough,in%20people%20who%20smoke%20marijuana.&text=Increased%20heart%20rate.,to%203%20hours%20after%20smoking.
  7. https://nida.nih.gov/news-events/nida-notes/2021/06/using-alcohol-marijuana-together-exacerbates-negative-consequences-young-adults
  8. https://www.iihs.org/news/detail/people-who-combine-alcohol-and-marijuana-often-drive-afterward
  9. https://cdaclinics.com.au/wp-content/uploads/CDAu-Greening-out-v3.0.pdf
  10. https://www.ncbi.nlm.nih.gov/books/NBK430823/
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811144/
  12. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-dangers-of-alcohol-overdose
  13. https://my.clevelandclinic.org/health/diseases/16640-alcohol-poisoning#management-and-treatment

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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