Cross Fading: What You Need to Know About Mixing Cannabis and Alcohol

Las Vegas attracted over 42 million visitors in 2015, and these visitors will continue to increase as the legal adult-use marijuana industry begins to develop in Nevada in 2017. The vast majority of these visitors are over the age of 21. With such a high number of potential consumers, many of whom will have extremely limited experience with marijuana consumption, it should be expected that some consumers will mix their cannabis products with alcohol. With the legalization of marijuana in a place so commonly associated with alcohol consumption, a significant public health question is raised. What are the effects of mixing cannabis and alcohol?

The most important thing to remember when it comes to the effects of mixing marijuana and alcohol is that there is a lot we don’t know. There have been extensive studies conducted on the effects of marijuana and alcohol, but those studies looked at each being consumed separately. Studies on the combined effects of marijuana and alcohol are extremely limited and much of what we know comes from anecdotal evidence.

Mixing cannabis and alcohol or “cross fading” will become an increasingly common practice with the legalization of marijuana. Consumers mix cannabis and alcohol to intensify the effects of the first drug consumed or to increase their intoxication level. While many people have safely consumed these products together, it is important to educate consumers that the effects can vary from person to person and can be unpredictable in some people. In addition, the order of use can play a significant role in the effects that individuals experience when mixing the two substances. Likewise, the route of cannabis consumption, whether taken orally or inhaled, will likely play a significant role in the experience.

Alcohol is a central nervous system depressant while marijuana can produce a variety of different effects. Alcohol can increase tetrahydrocannabinol (THC) absorption in the body, which could increase the intensity of the effects from cannabis. When alcohol is consumed with cannabis far higher blood levels of ‘delta 9 THC’ and its primary active metabolite ’11-hydroxy-THC’ (11-OH-THC) are reached for a given level of consumption. Mixing alcohol and cannabis can also increase the likelihood that one or both substances will be overused. This can especially be problematic when mixing alcohol and edibles, since edibles produce delayed-onset effects that can be more intense than those experienced with inhalation consumption.

Cannabis and alcohol are significantly different products, with cannabis comprising of more than 400 active and potentially active chemicals while the only mind-altering, physiologically active compound in an alcoholic beverage is alcohol. While some may believe “grass before beer, you’re clear”, there are no scientific studies that validate that claim and it is important to stress that the effects of cannabis can vary from person to person. In some people, cannabis use can induce psychotic symptoms such as panic, anxiety, and paranoia, which can become intensified when combined with alcohol.

Both alcohol and cannabis consumption can cause ‘orthostatic hypotension’, which is low blood pressure that occurs when an individual stands or sits up. This can result in decreased blood flow to the brain and syncope or fainting. It can occur suddenly and unpredictably, with little to no warning signs, even quite a while after the last consumption of either drug as the alcohol and/or THC is absorbed, the blood levels of these compounds rise, the blood vessels dilate and the blood pressure suddenly falls. Depending on what the individual is doing and where they are standing or even sitting when this occurs will likely determine whether this results in an embarrassing story or a serious problem. The authors have both witnessed this side effect occur in otherwise completely healthy individuals.

“Greening out” is a term used to describe when a person feels sick after smoking cannabis. When it occurs, a person may get pale and sweaty, become dizzy or have the spins, and may even might experience nausea or vomiting. These effects are then followed by a desire to lie down. While greening out is not commonly experienced following cannabis consumption, it is much more likely to occur if a person has been drinking alcohol. These effects could become harmful if a person has consumed too much alcohol.

A major concern raised when discussing cannabis and alcohol consumption is the potential for impaired driving. The effects of operating a motor vehicle under the influence of alcohol have been well documented over the past 30 years. The combination of cannabis and alcohol will significantly impair a person’s judgment, motor skills, and decision-making ability. Therefore, it is extremely important to educate consumers on the dangers of operating motor vehicles under the influence of alcohol and/or cannabis.

Another significant concern that comes with mixing alcohol and cannabis is the potential for vomiting from too much alcohol combined with the antiemetic properties associated with cannabis. When someone consumes too much alcohol, the body’s defense mechanism is vomiting. Cannabis possess anti-nausea and anti-vomiting properties, which could prevent someone from expelling excess alcohol from their body. If a consumer drinks too much alcohol, concomitant cannabis use could prevent vomiting and may increase the likelihood that someone chokes on vomit or succumbs to the effects of alcohol poisoning.

As Nevada transitions from a medical-use to an adult-use state, it is important to remember that a significant number of Nevada cannabis consumers will be extremely inexperienced in their use and knowledge of cannabis consumption. Unfortunately, we do not know very much about the combined effects of cannabis and alcohol. Therefore, it is critical to educate consumers about the effects of cannabis consumption and the potentially harmful effects that might arise when mixing cannabis with alcohol. While many people have mixed the two substances without significant adverse events, consumers (especially novice ones) should be discouraged from mixing cannabis and alcohol.

For more information about Ace Analytical, visit aceanalytical.com or call (702) 749-7429.