Category: Health & Safety

Using Alcohol, Cannabis & Other Substances Safely

Alcohol, cannabis, prescription medication, and other substances can affect judgment, coordination, breathing, memory, mood, and physical health. The effects vary depending on the substance, amount, strength, method of use, medications, health conditions, and whether multiple substances are combined.

The safest choice is not to use substances that are illegal, not prescribed to you, or likely to impair your ability to function safely. Some people should avoid alcohol, cannabis, or other substances completely because of their age, pregnancy, medical conditions, medications, recovery goals, or risk of addiction.

If you do use a substance, practical precautions can reduce—but not eliminate—the chance of overdose, poisoning, impaired driving, falls, unsafe decisions, medication interactions, and other serious harm.

This guide is not intended to encourage substance use or explain how to obtain illegal drugs. Its purpose is to help people recognize risks, make safer decisions, respond to emergencies, and find support without shame.

Know What You Are Taking

Before using any substance, know:

• What it is
• How much you are taking
• How strong it is
• How it may affect you
• How long the effects may last
• Whether it can interact with medication
• Whether it is legal where you live
• Whether it came from a reliable, regulated source
• What to do if you have a bad reaction

Never take medication prescribed to another person. Do not accept pills that are loose, unlabeled, or obtained outside a licensed pharmacy.

Counterfeit pills may look like legitimate prescription medication while containing fentanyl or another unexpected substance. You cannot reliably identify the contents of a pill, powder, or liquid by its appearance, taste, or smell.

Legal Does Not Mean Risk-Free

Alcohol and cannabis may be legal for certain adults in some locations, but legality does not mean that a product is harmless.

Legal substances can still:

• Impair driving
• Interact with medication
• Increase the risk of falls and injuries
• Worsen certain mental health symptoms
• Affect judgment and consent
• Lead to dependence or addiction
• Cause poisoning when taken in excessive amounts
• Be unsafe during pregnancy
• Harm children or pets if stored improperly

Cannabis remains illegal under federal law, and state laws vary regarding possession, age, purchase, employment, housing, and driving.

Follow the laws where you live and where you travel.

Understand Alcohol Serving Sizes

The amount poured into a glass is not always equal to one standard drink.

In the United States, one standard alcoholic drink contains approximately 0.6 ounces, or 14 grams, of pure alcohol. This is approximately:

• 12 ounces of beer at 5% alcohol
• 8 ounces of malt liquor at 7% alcohol
• 5 ounces of wine at 12% alcohol
• 1.5 ounces of 80-proof liquor at 40% alcohol

A large glass of wine, strong craft beer, mixed drink, or tall can may contain more than one standard drink. Checking the container size and alcohol-by-volume percentage can help you understand how much alcohol you are actually consuming. Centers for Disease Control and Prevention

Alcohol affects people differently. Body size, age, food, medication, health, biological differences, drinking speed, and previous alcohol use can all change its effects.

Do not rely on another person’s tolerance to decide what is safe for you.

Less Alcohol Generally Means Less Risk

No amount of alcohol is completely free from health risk. Drinking less reduces many of the risks associated with drinking more.

Some people should not drink alcohol, including people who:

• Are pregnant or may be pregnant
• Are under the legal drinking age
• Plan to drive or operate equipment
• Take medication that interacts with alcohol
• Have certain liver, heart, stomach, neurological, or mental health conditions
• Are unable to control how much they drink
• Are recovering from alcohol use disorder
• Have been instructed not to drink by a healthcare professional
• Will be responsible for a child or another person who requires close supervision

If you choose to drink:

• Decide your limit before you begin.
• Count standard drinks rather than glasses.
• Drink slowly.
• Alternate alcoholic drinks with water or another nonalcoholic beverage.
• Eat before and while drinking.
• Avoid drinking games.
• Do not accept an unattended drink.
• Stay with people you trust.
• Arrange transportation in advance.
• Stop if you begin feeling impaired.

Coffee, cold showers, exercise, and fresh air do not quickly remove alcohol from the body. Only time allows the body to process it.

Do Not Mix Alcohol With Medication Without Checking

Alcohol can interact with prescription medication, over-the-counter products, and herbal supplements.

Possible consequences include:

• Severe drowsiness
• Dizziness
• Falls
• Fainting
• Internal bleeding
• Liver damage
• Abnormal blood pressure
• Memory problems
• Reduced medication effectiveness
• Slowed or difficult breathing
• Overdose

Alcohol may interact with sleep aids, anxiety medication, opioid pain medication, allergy products, cold medicines, antidepressants, seizure medication, diabetes medication, blood thinners, and many other products.

The National Institute on Alcohol Abuse and Alcoholism warns that interactions can occur even when alcohol and medication are not taken at exactly the same time. Ask a pharmacist or healthcare professional whether alcohol is safe with every medication you use. National Institute on Alcohol Abuse and Alcoholism

If you do not know whether a medication interacts with alcohol, avoid drinking until you can check.

Cannabis Can Affect People Differently

Cannabis products may contain tetrahydrocannabinol, known as THC, cannabidiol, known as CBD, or both. THC produces intoxication. CBD does not usually cause the same “high,” but it can still cause side effects and interact with medication.

Possible effects of cannabis include:

• Relaxation
• Sleepiness
• Altered perception
• Slower reaction time
• Reduced coordination
• Impaired attention or memory
• Anxiety
• Panic
• Paranoia
• Increased heart rate
• Confusion
• Nausea or vomiting
• Hallucinations or delusions

A person’s reaction can vary based on the product’s strength, amount used, previous experience, health, medication, and method of use.

High-THC products may produce stronger and less predictable effects. A product that felt manageable to another person may be overwhelming for you.

Be Especially Careful With Cannabis Edibles

Edible cannabis products may take much longer to produce noticeable effects than inhaled cannabis. The effects may also last longer than expected.

The CDC reports that cannabis edibles can take up to two hours to produce intoxicating effects. Taking more before the original amount has taken effect can lead to severe anxiety, confusion, panic, vomiting, hallucinations, or accidental injury. Centers for Disease Control and Prevention

If you use a legal cannabis edible:

• Read the label carefully.
• Check the amount of THC per serving and per package.
• Do not assume the entire package is one serving.
• Begin with the smallest clearly labeled amount appropriate under local guidance.
• Allow sufficient time for the full effect before considering more.
• Do not combine it with alcohol or other drugs.
• Keep the original packaging.
• Store it away from children, visitors, and pets.
• Do not place it with ordinary snacks or candy.

Homemade or unregulated products may have unpredictable amounts of THC.

Call Poison Control at 1-800-222-1222 if someone may have consumed too much cannabis. Call 911 for severe symptoms, loss of consciousness, difficulty breathing, seizures, or immediate danger.

Avoid Mixing Substances

Combining substances can create stronger or less predictable effects than using either one alone.

Particularly dangerous combinations include:

• Alcohol and opioids
• Opioids and benzodiazepines
• Alcohol and benzodiazepines
• Alcohol and sleep medication
• Multiple opioids
• Multiple sedating medications
• Stimulants and other stimulants
• Alcohol and cannabis
• Prescription medication and unknown street drugs

Opioids, benzodiazepines, alcohol, and certain sleep medicines can all slow the central nervous system. Combining them can suppress breathing and cause coma or death.

The FDA warns that combining opioids with benzodiazepines, alcohol, or other central-nervous-system depressants can cause extreme sleepiness, slowed or difficult breathing, coma, and death. U.S. Food and Drug Administration

Cannabis and alcohol together may cause more impairment than either one alone. Centers for Disease Control and Prevention

Do not assume substances are safe to combine because they were used at different times. Their effects may overlap for hours.

Take Prescription Medication Only as Directed

Prescription medications can cause harm when taken incorrectly, even when they were legally prescribed.

To reduce risk:

• Take the prescribed amount at the correct time.
• Do not take an extra dose unless instructed.
• Do not crush, split, or dissolve a pill unless the label or pharmacist says it is safe.
• Do not share medication.
• Use one pharmacy when practical so interactions can be identified.
• Tell healthcare professionals about alcohol, cannabis, supplements, and other drugs you use.
• Read warning labels.
• Store medication securely.
• Dispose of unused controlled medication through an approved take-back program.
• Ask before stopping a medication suddenly.

Some medications can cause dangerous withdrawal if stopped abruptly. Talk with a healthcare professional before changing how you take benzodiazepines, opioids, seizure medications, certain antidepressants, or other regularly used drugs.

Never Drive While Impaired

Do not drive, bike in traffic, operate machinery, swim alone, use a stove, climb a ladder, or perform other risky tasks while impaired.

Cannabis can slow reaction time, impair coordination, affect decision-making, and distort perception. Combining cannabis with alcohol may increase impairment. Centers for Disease Control and Prevention

Feeling “fine” is not proof that you can drive safely. People may underestimate their own impairment.

Before using a substance:

• Choose a designated driver who will remain sober.
• Arrange a taxi or rideshare.
• Use public transportation.
• Plan to stay overnight.
• Give your keys to someone you trust.
• Avoid bringing a vehicle if you know you will use a substance.

Never ride with an impaired driver. Do not allow an intoxicated person to drive if you can safely prevent it.

Impairment Affects Consent and Decision-Making

Alcohol and other substances can affect judgment, communication, memory, and the ability to give consent.

Do not initiate sexual activity with someone who is asleep, unconscious, severely intoxicated, confused, or unable to understand what is happening.

A person who is unable to communicate clearly or make a voluntary decision cannot provide meaningful consent. Previous consent does not apply automatically, and silence is not permission.

Look after friends without making decisions about their bodies for them. Help them reach a safe place, obtain medical attention, or contact someone they trust.

Reduce Risks When Using an Unregulated Drug

No method makes an illegal or unregulated drug completely safe. The strength and contents may be unknown, and contamination can occur.

If someone is going to use despite these risks:

• Do not use alone.
• Make sure someone nearby can recognize an overdose.
• Keep naloxone available when opioid exposure is possible.
• Make sure others know where naloxone is and how to use it.
• Avoid combining substances.
• Avoid using after a period of abstinence, when tolerance may be lower.
• Use drug-checking resources where they are legally available.
• Do not trust a pill based on its color, shape, or markings.
• Keep a phone available.
• Know the local Good Samaritan and naloxone laws.
• Call 911 immediately when an overdose is suspected.

Fentanyl may be present in counterfeit pills or other drugs without the person’s knowledge. Naloxone will not harm someone who is not experiencing an opioid overdose, so give it when opioid exposure is possible and the person has overdose signs.

Keep Naloxone Available

Naloxone is a medication that can temporarily reverse an opioid overdose. It may be available from pharmacies, health departments, community programs, or by prescription, depending on local rules.

Consider keeping naloxone if you or someone around you:

• Uses prescription opioids
• Uses heroin or fentanyl
• Uses pills not obtained from a pharmacy
• Has an opioid use disorder
• Takes opioids with other sedating medication
• Recently stopped using opioids
• Has previously overdosed
• Lives or spends time around someone at risk

Check the expiration date and storage instructions. Teach household members how to recognize an overdose and use the product.

Naloxone’s effects can wear off before the opioid does. Always call 911 after giving it, even if the person wakes up.

Recognize an Opioid Overdose

Possible signs include:

• The person cannot be awakened
• Slow, shallow, irregular, or stopped breathing
• Choking, gurgling, or snoring sounds
• Blue, gray, or very pale lips or fingernails
• A limp body
• Pinpoint pupils
• Slow or absent pulse
• Cold or clammy skin

If an opioid overdose is possible:

1. Call 911.
2. Give naloxone.
3. Begin rescue breathing or CPR according to your training and the dispatcher’s instructions.
4. Give another naloxone dose after the product’s recommended interval if the person does not respond and another dose is available.
5. Place the person on their side if they are breathing but unconscious.
6. Stay until emergency responders arrive.

Do not:

• Leave the person alone
• Put them in a shower or bath
• Make them walk
• Give coffee
• Try to make them vomit
• Assume they will “sleep it off”

Recognize Alcohol Poisoning

Alcohol poisoning can be fatal.

Call 911 if someone who has been drinking:

• Cannot be awakened
• Is confused or unresponsive
• Is vomiting repeatedly
• Has a seizure
• Is breathing slowly or irregularly
• Has blue, gray, pale, or clammy skin
• Cannot sit or stand safely
• Has injured their head
• May have combined alcohol with medication or drugs

Stay with the person. If they are breathing but unconscious, place them on their side to reduce the risk of choking. Monitor their breathing.

Do not leave them alone, place them in a cold shower, give them coffee, or force them to walk.

A person’s alcohol level may continue rising after they stop drinking, particularly if alcohol remains in the stomach.

Recognize a Dangerous Reaction to Cannabis

Cannabis alone is less likely to cause a fatal overdose than opioids, but a severe reaction can still require medical care.

Possible signs include:

• Extreme panic or paranoia
• Severe confusion
• Hallucinations
• Delusions
• Very fast heart rate
• Chest pain
• Repeated vomiting
• Loss of coordination
• Dangerous behavior
• A seizure
• Loss of consciousness

Move the person to a calm, quiet location. Stay with them and offer reassurance without arguing about what they are experiencing.

Call Poison Control at 1-800-222-1222 for guidance. Call 911 for chest pain, severe difficulty breathing, seizures, unconsciousness, extreme agitation, dangerous behavior, or any life-threatening concern.

Store Substances Securely

Alcohol, cannabis, medication, nicotine products, and other substances should be stored where children, visitors, pets, and vulnerable adults cannot access them.

Use:

• Locked storage
• Child-resistant original packaging
• Clear labels
• Separate storage from ordinary food and candy
• Locked medication boxes when necessary
• An accurate medication list

Cannabis edibles may resemble candy, baked goods, or drinks. Never leave them in an unlabeled bag or common food container.

Do not store medication in a place where heat, moisture, or sunlight may damage it. Follow label instructions.

Dispose of unused medication through a pharmacy, police department, or authorized take-back program when possible.

Helpful Resources: Browse Safe Storage for products, equipment, services, or supplies related to this section.

Substance Use Can Change With Age or Health

A substance may affect you differently than it did in the past.

Changes in age, weight, liver or kidney function, sleep, nutrition, medication, and medical conditions can increase impairment.

Older adults may be especially vulnerable to:

• Falls
• Confusion
• Medication interactions
• Memory problems
• Dehydration
• Overdose
• Driving impairment

NIAAA notes that age-related changes can cause alcohol to remain in the body longer and that older adults are more likely to take medications that interact with it. National Institute on Alcohol Abuse and Alcoholism

Talk honestly with your doctor or pharmacist about substance use. Their job is to help you avoid dangerous interactions, not embarrass you.

Signs That Substance Use May Be Becoming a Problem

Consider getting help if you:

• Use more than you intended.
• Have tried unsuccessfully to cut back.
• Spend increasing time obtaining, using, or recovering from a substance.
• Need more to feel the same effect.
• Experience withdrawal.
• Miss responsibilities.
• Continue despite health, legal, financial, or relationship problems.
• Use in dangerous situations.
• Hide or lie about your use.
• Experience blackouts or memory gaps.
• Have repeated falls, crashes, or injuries.
• Use substances to get through most days.
• Feel unable to relax, sleep, socialize, or cope without them.
• Take medication in ways other than prescribed.
• Have experienced an overdose.

A substance-use disorder is a health condition. It is not a character flaw or evidence that someone lacks willpower.

Do Not Stop Certain Substances Suddenly Without Help

Stopping alcohol, benzodiazepines, or certain other drugs suddenly after regular heavy use can cause dangerous withdrawal.

Emergency withdrawal symptoms may include:

• Seizures
• Hallucinations
• Severe confusion
• Extreme agitation
• Fever
• Heavy sweating
• A very fast heartbeat
• Severe shaking
• Loss of consciousness

Call 911 for severe withdrawal symptoms.

If you use alcohol, benzodiazepines, or another substance regularly and want to stop, talk with a healthcare professional. Medical supervision may be necessary.

How to Help Someone You Are Concerned About

Choose a private time when the person is not severely intoxicated.

Use specific, nonjudgmental observations:

• “I’m worried because you passed out twice this month.”
• “I noticed you’ve been mixing alcohol with your pain medication.”
• “You said you wanted to cut back, but it seems difficult.”
• “I care about you, and I’d like to help you find support.”

Avoid:

• Shaming
• Calling the person weak or irresponsible
• Arguing while they are intoxicated
• Making threats you will not carry out
• Covering up dangerous behavior
• Giving money that may support unsafe use
• Trying to manage a dangerous withdrawal at home

You cannot force another adult to recover, but you can set boundaries, refuse to participate in unsafe behavior, offer treatment information, and call emergency services when someone is in danger.

Getting Help

Treatment may include:

• A primary care appointment
• Counseling
• Medication
• Outpatient treatment
• Residential treatment
• Medically supervised withdrawal
• Peer recovery support
• Mutual-help groups
• Harm-reduction services
• Recovery coaching

Different people need different combinations of support. A person does not need to reach a particular “bottom” before asking for help.

For treatment referrals in the United States:

• Visit FindTreatment.gov.
• Call SAMHSA’s National Helpline at 1-800-662-HELP (4357).
• Text your ZIP code to 435748.

SAMHSA’s National Helpline provides free, confidential treatment information and referrals 24 hours a day. Substance Abuse and Mental Health Services Administration

For a substance-use or emotional crisis, call or text 988. Call 911 for an overdose, unconsciousness, severe withdrawal, or another immediate emergency.

A Substance-Safety Checklist

Before using alcohol, cannabis, or any potentially impairing substance, ask:

• Do I know exactly what this is?
• Do I know how much I am taking?
• Could it interact with my medication?
• Am I combining it with another substance?
• Do I need to drive, supervise someone, cook, swim, or use equipment?
• Am I pregnant or managing a condition that makes use unsafe?
• Is the product securely stored?
• Does someone know where I am?
• Is naloxone available if opioid exposure is possible?
• Do I know when to call Poison Control or 911?
• Am I using more often or in larger amounts than I intended?

Reducing substance-related harm begins with honest information. Avoid mixing substances, do not drive while impaired, take medication only as directed, keep naloxone available when opioids may be present, and get help early when use becomes difficult to control. Asking for support is a practical health decision—not something to be ashamed of.

Suggested Guides

• What to Do When Someone May Have Overdosed
• What to Do When Someone Is Unconscious
• Recognizing & Responding to a Diabetic Emergency
• Understanding Prescriptions & Medication Labels
• Using Over-the-Counter Medications Safely
• Recognizing a Mental Health Crisis & Getting Help

Important Health & Safety Notice

The information in this guide is provided for general educational purposes only. Independence Answers is not a medical provider, and this content is not a substitute for professional medical advice, diagnosis, treatment, or supervision. Always follow the instructions of your doctor, pharmacist, or other qualified healthcare professional, especially if you have a medical condition, take medication, or are unsure whether an action is safe for you.

Do not ignore or delay seeking professional care because of something you read here. If you believe someone may be experiencing a serious or life-threatening emergency, call 911 or your local emergency number immediately.