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BC’s Responsible Beverage Service Program

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Alcohol Effects


Alcohol with Other Drugs

The effects of alcohol in combination with other drugs

The effects of alcohol in combination with other drugs

The presence of alcohol in conjunction with other drugs often intensifies effects. This is particularly the case when alcohol is joined with other depressants, due to their common capacity to slow down a person’s central nervous system. The impact can go beyond just making the person less coordinated or drowsier. Heart and breathing rate can sometimes become reduced to such an extent that the individual falls into a coma and these crucial functions stop.

Examples of Possible Indicators of Combined Alcohol and Other Drug Use

Intensified sedation, excessive dizziness
(especially older people)
Alcohol and antihistamines
(cold and allergy medications)
Intensified sedation
Significantly slowed breathing
Cold bluish skin
Loss of consciousness
Alcohol and narcotic pain relievers or heroin
Severe drowsiness
Depressed or even arrested cardiac & respiratory functions
Alcohol and sedatives or hypnotics
(tranquillizers, sleeping pills)
Intensified impairment in concentration, perception, reaction and control
Alcohol and cannabis
Intensified euphoria
Sudden heart, respiratory failure
Alcohol and cocaine
Reduced feeling of intoxication resulting in overconsumption (binge drinking)
Reduced drowsiness due to caffeine acting as a stimulant (wide awake and drunk)
More at risk for dangerous behaviours
Alcohol and energy drinks
combining alcohol with other drugs

Some illegal drugs, such as cannabis, and prescription medicines, such as cough syrups, can increase intoxication levels significantly, making people appear more intoxicated than they should for the amount of alcohol consumed. Driving after combining alcohol with other drugs can substantially increase the risk of a motor vehicle accident. In addition, the risk of accidental injury—such as falls among the elderly, or overdose—is greatly increased when some types of drugs are used in combination with alcohol.

Alcohol interactions with other drugs can bring about quite unpredictable effects. Servers need to apply careful vigilance, observing patrons not just for intoxication but also for a real exaggeration of initial and more protracted symptoms normally associated with alcohol intake:

  • euphoria instead of just relaxation and giddiness,
  • worse dizziness,
  • slow reflexes,
  • slurred speech,
  • blurred vision,
  • disorientation or
  • extreme drowsiness.

Have emergency numbers (including the BC Poison Control Centre) in a place where all staff has quick access in case you need to call for help.

Mistaking a medical condition or disability for intoxication

Occasionally patrons may exhibit what seem like signs of intoxication but are actually symptoms of a medical condition. Such symptoms may be very similar to that of intoxication and an initial assessment is important to determine whether the guest has a medical condition or is in fact intoxicated.

Asking guests whether they feel ill and checking for medical alert bracelets can help you determine whether someone is ill or has a medical condition. Medical conditions that may produce symptoms that mimic intoxication include diabetes, hypoglycemia, epilepsy and Alzheimer's. Discontinuing service and helping the guest to receive medical attention can be lifesaving in some instances.

Patrons with physical and mental disabilities can also exhibit symptoms that may be confused with alcohol intoxication. Examples of such disabilities include: cerebral palsy, visual impairments, speech impediments, acquired brain injuries, and mobility impairments.

It is important to be aware and sensitive to patrons and take care that you or your staff do not inadvertently discriminate against guests whose medical conditions or disabilities make it seem as if they are intoxicated.