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Steroids and Alcohol: Is It Safe to Drink While Taking Steroids?
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Key Points
- Using steroids and drinking alcohol at the same time can have serious risks, especially if you are taking high doses of steroids, have been using them for a long period, or are drinking heavily.
- Corticosteroids such as prednisone and prednisolone are a different type of steroid than anabolic steroids, but there is still potential for adverse reactions when combining them with alcohol.
- When drinking alcohol on steroids, you could experience an increased risk of stomach ulcers, gastrointestinal bleeding, mood swings, hypertension, and blood glucose fluctuations.
- Consuming alcohol may worsen underlying conditions being treated with steroids, such as inflammatory diseases and immune-related health issues.
- People with histories of liver damage, alcohol use disorder, signs of depression or anxiety, or previous ulcers should seek their physician's guidance before drinking.
- If you find yourself unable to stop drinking after beginning steroids, seeking out a licensed professional will provide you with assistance to address your problem drinking in order to preserve both your physical and emotional health.
Many people each year receive short-term steroid prescriptions for issues like inflammation, chronic medical conditions, or concerns about their immune systems. Others misuse anabolic steroids for muscle growth and athletic performance enhancement.
Regardless of why you are taking steroids, it is common to wonder whether you can safely drink alcohol.
There isn’t a single universally applicable “rule” about safe combinations of drinking and steroids. Instead, the degree of risk is based on what type of steroid was prescribed, your dosage levels, how long you plan to use the steroid, your overall health history, and how much alcohol you consume. This article will walk you through how each substance affects the body, side effects you can expect, risk factors that increase adverse reactions, and what to do if your drinking or steroid use is becoming something difficult to manage.
What Kind of Steroids Are We Talking About?
There can be confusion around the term “steroids.” The fact is that steroids are not all created equal.
Glucocorticoids, also called corticosteroids, are prescription drugs designed to reduce inflammation and suppress the immune system, and are often used to treat conditions such as rheumatoid arthritis, breathing difficulties associated with asthma, lupus, multiple sclerosis, psoriasis, eczema, and certain cancers.[1] Examples of commonly prescribed corticosteroids include prednisone and prednisolone.
Corticosteroids are very different from anabolic steroids, which are synthetic versions of testosterone developed to treat certain cases of delayed puberty, low testosterone, and disease-related muscle loss, but are also misused to enhance muscle mass and improve physical appearance or athletic performance.[2]
Because the risks differ slightly, this classification is important. Corticosteroids are typically used medically for the reduction of inflammation. Use of anabolic steroids for cosmetic, muscle-building, or athletic-performance reasons poses distinct risks concerning the heart, liver, hormones, and mental health.
Can You Drink Alcohol While Taking Steroids?
Some doctors might tell patients that a limited amount of alcohol is okay while taking a short course of prednisone or prednisolone. Other physicians will advise against any alcoholic beverages whatsoever.
Personalized risk factors determine why.
Alcohol can affect medication in three ways: through alterations in medication metabolism, through changes in alcohol absorption into the bloodstream, and by changing how medications work in the body.[3]
You should be especially cautious if you are taking a large quantity of steroids, taking steroids over prolonged periods, consuming excessive amounts of alcohol, or taking additional medications. It is also important to avoid drinking if your doctor has advised you not to, regardless of information you may find online and even if you feel well doing it.
The Dangers of Mixing Alcohol and Steroids
The potential consequences of combining alcohol and steroids vary from person to person; however, many are more risky for people experiencing some type of pre-existing medical condition, those with alcohol use disorder, or people who have consumed alcohol repeatedly.
Common side effects are listed below:
Stomach Ulcers and Gastrointestinal Problems
The gastrointestinal system can become irritated by steroid use. The Food and Drug Administration (FDA) states that corticosteroids such as prednisone should be used with caution when treating people with either active or latent peptic ulcer disease, or certain types of gastrointestinal disease.[3]
Alcohol can also irritate the stomach lining and increase risk of gastrointestinal inflammation and bleeding. The combination of heavy, ongoing drinking and steroid use increases the irritation of the stomach lining even further. People who have had surgery to remove portions of their stomach (partial gastrectomy), have inflammatory bowel diseases like Crohn’s disease, experience recurring episodes of gastritis or peptic ulcers, consume excessive amounts of alcohol, or are simultaneously using non-steroidal anti-inflammatory drugs (NSAIDs) may experience increased gastric distress.
Symptoms include extreme abdominal pain, passage of black or bloody stools, vomiting blood, and dizziness or fainting, and require urgent medical care.
Mood Swings and Mental Health Effects
Prednisone labeling includes warnings about the psychological effects associated with this drug, which can include changes in sleep patterns, mood swings, mood disorders, changes in personality, depression, and psychosis.[5]
Chronic and excessive alcohol consumption can also result in mood disturbances, impaired judgment, disrupted sleep patterns, and altered emotional regulation. Drinking on steroids may worsen symptoms related to anxiety, depression, bipolar disorder, post-traumatic stress disorder (PTSD), schizophrenia, personality disorders, and obsessive-compulsive disorder (OCD).
Emergency mental health services should be contacted immediately if symptoms like agitation, severe depression, impulsive behavior, paranoid thoughts, or suicidal ideation develop.
Blood Pressure, Blood Sugar, and Weight Gain
Fluid retention caused by corticosteroids can increase blood pressure levels and lead to an increased desire to eat and weight gain, as well as disrupt normal glucose metabolism, resulting in elevated blood sugar levels.[6] Chronic and excessive alcohol consumption can complicate both of these processes. Those with diabetes, hypertension, heart disease risk factors, and metabolic syndrome should exercise greater caution when consuming alcohol while taking corticosteroids.
It does not necessarily mean that anyone who consumes one alcoholic beverage while taking steroids will react adversely. However, it is important to understand that there is a difference in the amount of risk involved with each person. People who have been prescribed prolonged steroid therapy or large dosages of steroids should be especially cautious about the consumption of alcohol and consult their healthcare providers.
Liver and Heart Risks With Anabolic Steroids
Anabolic steroids present unique risks. The National Institute on Drug Abuse (NIDA) reports that anabolic steroids can lead to severe and sometimes irreversible damage, including premature heart attack and stroke, liver tumors, kidney failure, and psychiatric disturbances.[7]
Alcohol also affects the liver and cardiovascular system, and excessive alcohol consumption may increase the risk for developing liver disease, high blood pressure, cardiomyopathy, arrhythmia, and myocardial infarction.[8] For people misusing anabolic steroids, drinking could create additional liver and heart strain.
Does Alcohol Affect Steroids?
While alcohol may not consistently cancel out the effects of steroids, it can create an obstacle to your larger treatment plan. If you are being treated with corticosteroids for inflammation, immune system symptoms, lupus, rheumatoid arthritis, Crohn’s disease, or multiple sclerosis, then drinking may negatively impact your sleep quality, inflammation, stomach discomfort, and well-being.
Drinking can also prevent you from adhering to your doctor’s recommendations. You may forget doses, take your medicine at the wrong times, or miss potential side effects that would otherwise prompt action.
Who Should Avoid Alcohol While on Steroids?
You should either limit your drinking or seek medical information as soon as possible if you have any of the following:
- Liver disease such as hepatitis B or C, cirrhosis, or abnormal liver enzyme levels
- History of stomach ulcers or gastrointestinal bleeding
- Long-term use of prednisone, prednisolone, or another corticosteroid
- High doses of medication or multiple medications
- Risk factors for high blood pressure, diabetes, osteoporosis, or cardiovascular disease
- Mental illness or a recent mood instability
- Problems controlling your alcohol consumption
- Anabolic steroid use without a doctor’s approval
Don’t abruptly discontinue taking the prescribed steroids unless directed by your primary care physician. Stopping prednisone can leave the body without adequate amounts of its own steroid hormones and produce withdrawal-like symptoms, so medical assistance is required when stopping this medication.[9]
When Alcohol Use Becomes a Bigger Concern
Wondering if you’ll be alright after one drink during a short course of steroids is one question.
But if you feel like you are unable to stop drinking regardless of the potential health consequences, negative impacts from prescribed medication, relationship problems, or medical advice, then that is something altogether different, and it deserves to be addressed.
The Freedom Center in Brookeville, Maryland, specializes in treating various forms of addiction, including alcohol and any co-occurring mental health issue that could be driving its use.
If you are struggling with drinking while on steroids or managing your drinking habit alongside other health issues, there are resources available. Reach out to the Freedom Center today. Our admissions team is standing by to answer your questions, verify your insurance, and help you determine what your next step could look like.
If you or a loved one is ready to get help but finances are holding you back, give us a call. We can work with your health insurance provider.
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Frequently Asked Questions About Steroids and Alcohol
It depends on the type of steroid used, dosage level, duration, and number of drinks consumed per week. Always consult with your prescribing physician before consuming alcoholic beverages, especially if you are prescribed prednisone, prednisolone, or anabolic steroids.
Sources
[1] MedlinePlus. (n.d.). Steroids. National Library of Medicine. https://medlineplus.gov/steroids.html
[2] [7] National Institute on Drug Abuse. (n.d.). Anabolic steroids and other appearance and performance enhancing drugs (APEDs). National Institutes of Health. https://nida.nih.gov/research-topics/anabolic-steroids
[3] National Institute on Alcohol Abuse and Alcoholism. (2024). Alcohol-medication interactions: Potentially dangerous mixes. https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/alcohol-medication-interactions-potentially-dangerous-mixes
[4] [5] [6] U.S. Food and Drug Administration. (2024). RAYOS (prednisone) delayed-release tablets prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/202020s013lbl.pdf
[8] National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol and the human body. https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics-z/alcohol-facts-and-statistics/alcohol-and-human-body
[9] MedlinePlus. (n.d.). Prednisone. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a601102.html
