The practice of combining alcohol and inhaled substances, often referred to as “crossfading,” is common, but the order of consumption significantly impacts the experience and safety profile. The physiological interplay between the two substances changes dramatically based on which one enters the bloodstream first. This sequence-dependent effect involves altered rates of absorption and shifts in the perception of impairment, leading to different mechanisms of risk. Understanding this difference is important because it can mean the difference between a manageable evening and severe, acute intoxication.
When Alcohol Comes First
Consuming alcohol before smoking or inhaling a substance, most commonly cannabis, significantly increases the risk of acute adverse effects. Alcohol acts as a “primer” that enhances the body’s absorption of the inhaled substance’s active components, such as tetrahydrocannabinol (THC). Alcohol consumption causes vasodilation (widening of blood vessels), facilitating a quicker and more substantial entry of THC into the bloodstream. Studies show that individuals who drink first exhibit significantly higher blood concentrations of THC compared to those who use cannabis alone. This rapid surge can lead to a sudden onset of severe intoxication, often including intense dizziness, heavy sweating, and profound nausea, commonly described as “greening out.”
When Smoking Comes First
The sequence of consuming an inhaled substance before drinking alcohol presents a different, though still considerable, set of risks. When the effects of the inhaled substance, particularly THC, are established first, they can dull the user’s perception of alcohol intoxication. This change in subjective feeling can lead to a dangerous misjudgment of one’s level of impairment. Users may feel less drunk than they actually are and consume larger amounts of alcohol than they would typically handle, resulting in delayed but severe alcohol impairment and potential alcohol poisoning. The inhaled substance may also temporarily suppress the gag reflex, which is dangerous if the user has consumed a toxic amount of alcohol.
General Safety Guidelines for Combining Substances
Individuals who choose to combine alcohol and inhaled substances should prioritize harm reduction strategies to mitigate the inherent risks, regardless of the consumption order.
- Begin by consuming very small amounts of both substances to gauge the combined effect, as individual tolerance is highly variable.
- Set a firm limit on the number of alcoholic drinks and the quantity of the inhaled substance before consumption begins.
- Maintain adequate hydration, and consume food beforehand to help slow the absorption of alcohol.
- Ensure that consumption occurs in a safe, familiar, and controlled environment with trusted individuals who can monitor for signs of distress.
- Avoid operating any machinery, including driving, as combining these substances significantly impairs cognitive function and reaction time.