Dangers of Mixing Uppers and Downers

“Uppers” and “downers” are casual terms that refer to how a specific substance acts on the central nervous system (CNS). Uppers are stimulants, and downers are depressants. Uppers commonly include cocaine, amphetamine, and methamphetamine. Downers include sedatives such as benzodiazepines and barbiturates.

In addition to sedatives, other substances have depressant effects, such as alcohol, muscle relaxers, sleep aids, and opioids. People report using downers to reduce the undesirable effects of stimulant drugs, and a person might take an upper to overcome sedation. Initially, it appears that this could be a reasonable way to relieve the adverse effects of these substances, but, unfortunately, it increases the risk of dire health complications.


What Are Uppers?

Uppers or stimulants act on the CNS to increase blood pressure and heart rate. They also boost the production of dopamine and norepinephrine, two chemical messengers that induce feelings of well-being and reward. Uppers can also increase alertness and focus, extend wakefulness, and reduce appetite.

In addition to illicit drugs such as cocaine and meth, prescription stimulants commonly abused include Adderall, Ritalin, and Concerta—three medications primarily used to treat ADHD. MDMA (Molly, Ecstasy) is also a stimulant, but it is often placed in its own category due to the hallucinations and altered sensory perceptions it is known to induce.

Other side effects of uppers include the following:

  • Dizziness
  • Sweating
  • Insomnia
  • Headache
  • Muscle tension
  • Jaw clenching
  • Tremors
  • Chest pains
  • Heart palpitations

Combining two stimulants can also be dangerous, as the effects of all the drugs in a person’s system are compounded. A life-threatening overdose could occur that may include aggression, hypertension, dehydration, hyperthermia, heart failure, and seizure activity. Overdose can occur even in first-time users, depending on the amount of drug used in one sitting.


What Are Downers?

As the name implies, downers induce the opposite effect of uppers. Downers reduce heart rate and lower blood pressure, as well as impair alertness and focus. Examples of prescription downers include Ambien, Lunesta, Ativan, Klonopin, Valium, and Xanax, among others.

Other side effects of downers include the following:

  • Sedation
  • Muscle relaxation
  • Drowsiness
  • Dizziness
  • Trembling
  • Lowered inhibitions
  • Impaired coordination
  • Impaired memory
  • Lethargy

Different kinds of downers can impact different processes in the body. As such, they are typically classified into three subgroups: alcohol, opiates/opioids, and sedatives/hypnotics.

Depressants that are prescribed for anxiety or sleep disorders are often referred to as sedatives or tranquilizers. Opioids come in both prescription and illicit forms (e.g., oxycodone and heroin, respectively). Opioids are technically categorized as painkillers but also have depressant properties. Furthermore, alcohol is legal to consume in the U.S. for those over 21 years of age and readily available at many stores.


CNS Depression

An overdose of depressants can transpire when a person ingests excessive amounts of drugs or alcohol, and it can trigger potentially lethal CNS depression. Symptoms of a depressant overdose may include the following:

  • Slurred speech
  • Impaired cognition
  • Blurred vision
  • Impaired motor skills
  • Slow or stopped breathing
  • Respiratory arrest
  • Unconsciousness
  • Coma
  • Death

Alcohol, antidepressants, hypnotic sedatives, sleep aids, painkillers, and other depressant substances can cause CNS depression, especially when multiple types of substances are used in combination.


Risks of Combining Stimulants and Depressants

As noted, many people will use a depressant to come down from a stimulant high or vice versa. They may also be seeking a particular type of high such as that induced by a speedball (cocaine and heroin).

Mixing cocaine, amphetamine, or methamphetamine with opioids such as heroin is extremely risky. Indeed, this speedball combination was reported as the cause of death for actors John Belushi, River Phoenix, and Chris Farley, among others.

But, dangerous drug interactions can also happen accidentally for those who take other medications for pain, depression, ADHD, or anxiety. An adverse interaction is especially likely if a person consumes alcohol while using these drugs. Sometimes people use uppers and downers together oblivious to the dangers of mixing them.


In addition to potentially deadly overdoses, upper-downer cocktails have been associated with many other health risks, such as the following:

1) The combined effects is a minimization of the symptoms of either substance, thus creating the illusion that the person is not as intoxicated as they actually are. Stimulant effects may motivate the user to continue partying longer and also underestimate their level of intoxication. Uppers can conceal warning signs that profound CNS depression is occurring while downers might mask a dangerously accelerated heartbeat.

As a result, a person may end up using more of a stimulant substance than intended, especially if it is combined with alcohol. The body’s default reaction to excessive alcohol intake is to induce unconsciousness. Because stimulants prevent this from happening, a person can drink more alcohol without passing out. If other depressants are added, the person faces the risk of slipping into a coma or dying of an overdose.

2) Combining alcohol and cocaine is especially dangerous. Alcohol alters the way in which the body breaks down cocaine, resulting in a chemical called cocaethylene. Cocaethylene is more poisonous than either cocaine or alcohol alone, and it also stays in the body longer. As a result, the heart and liver are subjected to prolonged stress, and sudden death can occur even several hours after using cocaine with alcohol.

3) Stimulants cause dehydration, and this dehydration can be made worse by consuming alcohol. When a person is not properly hydrated, he or she may experience dizziness, diarrhea, vomiting, and disorientation. If the dehydration persists, vital organs can be damaged, and death can occur. Dehydration may be further amplified by the physical exhaustion and strain on multiple bodily systems that results from using substances with conflicting effects.

4) The push-pull effects of using opioids and stimulants together can result in an irregular heart rate, heart failure, and death.

These are just a few of the complications that could result from combining uppers and downers. Every person is unique, and some may encounter different side effects than others.


Getting Help for Addiction

A significant risk of using uppers and downers together is that a person may become addicted to multiple drugs concurrently. A person with an addiction to a substance may resort to the abuse of another in a misguided attempt to control the symptoms of the original addiction. However, this never works, and instead can drive a person into a self-perpetuating cycle of substance abuse, making each addiction worse than it would be on its own.

If an addiction to one or more substances occurs, professional treatment offers the most efficient path to recovery. Do not try to stop using any of these drugs abruptly or “cold turkey.” Depending on the substances of abuse, you could experience significant pain and discomfort, and, in some cases, withdrawal can even be life-threatening.

Importantly, rehab centers such as Recovery By The Sea can provide medical and emotional support during detox and will ensure that patients are as safe and comfortable as possible. If you have questions about rehab and treatment, our admissions coordinators are available 24/7 to provide answers and offer guidance.

Please do not continue to make the dangerous decision to continue using uppers and downers—the risks far outweigh any perceived benefits. If you or someone you love are struggling to overcome an addiction, we can help. Call us today and start your journey to a new life without drugs or alcohol!


READ THIS NEXT: Signs of Overdose and What to Do


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