Patterns and Effects of Alcohol and Psychostimulant Co-administration: a Brief Review of Pharmacological Considerations and Subjective Responses

Alcohol is commonly used with various illicit and prescription drugs that have psychostimulant properties, but the reasons for this remain incompletely understood. Evidence from community samples of drug users suggest that when alcohol is co-administered with many psychostimulant drugs, its initial use typically precedes the onset of psychostimulant use and that co-administration is often associated with increased alcohol consumption. There is growing experimental evidence that alcohol and psychostimulant co-administration can result in significant pharmacological interactions as well as in the production of positive subjective effects but that the specific nature of the interactions may depend on factors such as the orders, routes, and doses of the substances administered. In this paper, we aim to review similarities and differences in the effects of alcohol co-administration with the psychostimulants cocaine, amphetamine, methylphenidate, and 3,4-methylenedioxymethamphetamine (MDMA) and to link these to their patterns of use by drug users in the natural environment.