Understanding How Medications Can Mimic Alcohol Intoxication
Certain medications can produce side effects that are strikingly similar to the effects of consuming alcohol. This phenomenon occurs because both alcohol and these specific drugs act as central nervous system (CNS) depressants [1.6.2, 1.8.2]. The CNS, which includes the brain and spinal cord, controls most functions of the body and mind. When its activity is slowed down or 'depressed,' it can lead to symptoms like drowsiness, poor coordination, slurred speech, and confusion—all hallmarks of being drunk [1.3.2, 1.8.5].
These effects are primarily caused by the medication's influence on neurotransmitters in the brain, particularly gamma-aminobutyric acid (GABA) [1.2.2, 1.2.4]. GABA is the main inhibitory neurotransmitter, meaning it reduces neuronal excitability. Alcohol enhances GABA's effects, leading to the calming, sedating, and intoxicating feelings it produces [1.2.4]. Many medications that cause drunk-like symptoms work on these same GABA receptors, essentially creating "alcohol in a pill form" [1.2.2, 1.2.3]. This is why it's crucial to understand which medications carry these risks and to be aware of their potential for impairment.
Benzodiazepines: Potent Sedatives
Benzodiazepines, often called 'benzos,' are a class of drugs prescribed for anxiety, insomnia, seizures, and muscle spasms [1.2.2, 1.3.2]. Common examples include diazepam (Valium), alprazolam (Xanax), and lorazepam (Ativan) [1.3.2, 1.4.3]. Like alcohol, these drugs enhance the effect of the neurotransmitter GABA at the GABA-A receptor, resulting in a sedative and calming effect [1.2.2].
The signs and symptoms of benzodiazepine use can closely mirror alcohol intoxication and include drowsiness, slurred speech, lack of coordination (ataxia), memory problems, and confusion [1.3.2, 1.4.2, 1.4.3]. In cases of overdose or toxicity, these effects become more severe, potentially leading to extreme sedation, respiratory depression, and loss of consciousness [1.4.1, 1.4.5]. The risk of life-threatening overdose increases dramatically when benzodiazepines are combined with other CNS depressants like alcohol or opioids [1.4.2, 1.10.2].
Opioid Painkillers
Opioids are powerful painkillers prescribed for moderate to severe pain. This class includes medications like oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and fentanyl [1.3.3, 1.5.1]. Opioids can cause significant cognitive impairment and side effects that make a person appear intoxicated [1.5.1, 1.5.2].
Common effects include drowsiness, confusion, mental slowing, and slurred speech (dysarthria) [1.3.5, 1.5.1]. Chronic opioid use has been associated with long-term cognitive decline and an increased risk of dementia [1.5.3, 1.5.4]. The sedative effects of opioids are a major risk factor, and when combined with alcohol, the depressive effects on the respiratory system are amplified, which can be fatal [1.10.2].
Muscle Relaxants
Muscle relaxants are used to treat muscle spasms and pain. Medications like cyclobenzaprine (Flexeril) and carisoprodol (Soma) also act as CNS depressants [1.6.3, 1.6.4]. Their side effects can easily be mistaken for drunkenness. Users may experience significant drowsiness, dizziness, weakness, and impaired thinking [1.6.1, 1.6.3]. Combining muscle relaxants with alcohol is particularly dangerous because both substances slow brain activity, compounding the effects and increasing the risk of severe sedation, respiratory depression, memory problems, and overdose [1.6.2, 1.10.3].
Anticonvulsants (Anti-Seizure Medications)
Many medications used to control seizures, known as anticonvulsants or antiepileptics, can cause side effects that mimic intoxication. Antiepileptic toxicity often presents with a triad of symptoms: CNS depression, ataxia (unsteady gait and lack of coordination), and nystagmus (involuntary eye movements) [1.7.2].
Drugs like phenytoin, carbamazepine, gabapentin, and even levetiracetam can cause these effects [1.7.1, 1.7.5]. For example, gabapentin can cause confusion, foggy thoughts, and dizziness, while phenytoin can lead to ataxia even at therapeutic doses [1.3.4, 1.7.1]. These symptoms are typically reversible but highlight the fine line between a therapeutic dose and a toxic one.
Comparison of Medications Causing Drunk-Like Symptoms
| Medication Class | Common Examples | Primary Use | Common Drunk-Like Side Effects |
|---|---|---|---|
| Benzodiazepines | Diazepam (Valium), Alprazolam (Xanax), Lorazepam (Ativan) [1.3.2] | Anxiety, Insomnia, Seizures [1.2.2] | Slurred speech, drowsiness, poor coordination, confusion, memory issues [1.3.2, 1.4.3] |
| Opioids | Oxycodone (OxyContin), Hydrocodone (Vicodin), Morphine [1.3.3] | Pain relief [1.3.3] | Drowsiness, confusion, slurred speech, mental slowing, impaired judgment [1.3.5, 1.5.1] |
| Muscle Relaxants | Cyclobenzaprine (Flexeril), Carisoprodol (Soma) [1.6.3] | Muscle spasms, pain [1.6.3] | Dizziness, extreme drowsiness, weakness, impaired thinking, unsteadiness [1.6.1, 1.6.3] |
| Anticonvulsants | Phenytoin (Dilantin), Gabapentin (Neurontin), Levetiracetam (Keppra) [1.7.1, 1.7.5] | Seizure control, nerve pain [1.7.1] | Ataxia (poor coordination), dizziness, drowsiness, confusion, nystagmus [1.7.2, 1.7.4] |
| Antipsychotics | Quetiapine (Seroquel), Olanzapine (Zyprexa) [1.3.1, 1.10.2] | Schizophrenia, Bipolar Disorder [1.3.1] | Drowsiness, dizziness, difficulty concentrating, impaired judgment [1.10.3] |
| Certain Antidepressants | Amitriptyline, Trazodone [1.3.3, 1.10.3] | Depression, Anxiety, Insomnia [1.3.3] | Drowsiness, dizziness, impaired memory and thinking [1.3.3, 1.10.3] |
The Danger of Combining Medications and Alcohol
Mixing alcohol with any medication that acts as a CNS depressant is extremely dangerous [1.10.1]. Alcohol intensifies the side effects of these drugs, such as drowsiness, dizziness, and loss of coordination [1.10.4, 1.10.5]. This combination can severely impair a person's ability to drive or operate machinery safely and greatly increases the risk of falls and serious injuries, particularly in older adults [1.10.1]. More critically, the combined depressive effect on the central nervous system can slow breathing and heart rate to dangerously low levels, leading to overdose and death [1.6.2, 1.10.2].
Conclusion
A wide range of common medications, from benzodiazepines and opioids to muscle relaxants and anticonvulsants, can make a person seem drunk. This is because they share a common mechanism with alcohol: depression of the central nervous system [1.8.2]. These drunk-like symptoms—including slurred speech, confusion, drowsiness, and poor coordination—are significant side effects that can impair daily functioning and lead to dangerous situations. It is vital to be aware of these potential effects, to read medication labels carefully, and to never mix these drugs with alcohol without explicit medical guidance. If you experience these symptoms, consult a healthcare provider immediately.
For more information on drug interactions with alcohol, you can visit the National Institute on Alcohol Abuse and Alcoholism (NIAAA): https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines [1.10.1].
