Crossfading, also called getting “twisted,” means using cannabis and alcohol at the same time, and the combination produces more impairment than either one alone. Lab research shows that drinking before smoking can raise blood THC levels, and survey data link simultaneous use to roughly double the odds of drunk driving and other harms. If you mix them, keep both doses low and never drive.
When this site first wrote about getting twisted in 2011, the slang was new and the research was thin. Both have changed. “Crossfaded” is now the more common term, and researchers have studied how alcohol changes THC levels, how the two combine behind the wheel and what happens to people who regularly use them together. Here is what the evidence says.
Evidence at a Glance
| Claim | Evidence level | Source |
|---|---|---|
| Using cannabis and alcohol together increases impairment | Strong | CDC |
| Alcohol taken first raises blood THC levels after inhaling cannabis | Moderate (two controlled lab studies) | Lukas 2001; Hartman 2015 |
| Driving impairment from the two adds together | Moderate (driving simulator study) | Hartman 2015 |
| Simultaneous use is linked to about double the odds of drunk driving and social harms | Moderate (large national survey, association only) | Subbaraman and Kerr 2015 |
| Simultaneous users tend to drink more often and in larger amounts | Moderate (survey) | Subbaraman and Kerr 2015 |
| Drinking order rules like “grass before beer” | No scientific support | Folk advice |
What Does Crossfaded Mean?
Crossfaded, twisted and “getting cross” all describe being under the influence of cannabis and alcohol at once. Researchers use the term simultaneous alcohol and marijuana use, or SAM use. It differs from concurrent use, which means using both but on separate occasions.
The distinction matters. In a study of more than 8,600 U.S. adults from the National Alcohol Survey, simultaneous use was almost twice as common as concurrent use among people who used both. In other words, people who use both tend to use them together.
What Happens in Your Body When You Mix Weed and Alcohol
Alcohol is a depressant that slows reaction time, judgment and coordination. THC affects attention, memory, coordination and time perception. Both act on the brain at the same time, so their effects stack.
There is also evidence that alcohol changes how much THC reaches the blood:
- In a 2001 lab study, men who drank alcohol before smoking cannabis noticed its effects sooner, reported more euphoria and had higher plasma THC levels than when they drank a placebo. The authors suggested alcohol may increase THC absorption (Drug and Alcohol Dependence).
- A 2015 study gave 32 occasional cannabis users a low dose of alcohol, enough for a breath alcohol level around 0.065%, before they inhaled vaporized cannabis. With alcohol, peak blood THC was significantly higher than without it. At the higher cannabis dose, the median peak rose from 42.2 to 67.5 micrograms per liter (Clinical Chemistry).
These were small lab studies, so the size of the effect in everyday use is uncertain. But they help explain why many people find that a drink followed by a joint hits harder than they expected.
Common Effects of Being Crossfaded
Effects vary with dose, tolerance and the order and speed of use. Commonly reported effects include:
- Stronger intoxication than expected from the same amounts used separately
- Dizziness and the “spins”
- Nausea and vomiting
- Slowed reactions and poor coordination
- Anxiety, a racing heart or paranoia, especially with high-THC products
- Heavy drowsiness
- Gaps in memory of the night
The unpleasant episode many people call “greening out” (feeling pale, sweaty, nauseated and dizzy after too much cannabis) is often described after drinking, though no controlled study has measured how often it happens.
Does the Order Matter? Weed Before Beer or Beer Before Weed
Party rhymes about the right order are not based on research. The closest evidence comes from the two lab studies above, in which alcohol taken before cannabis raised THC levels. That suggests drinking first and then smoking may produce a stronger cannabis effect than expected, so a smaller amount of cannabis is wise in that situation.
Cannabis taken first does not make alcohol safe. Both substances impair you no matter which comes first.
Risks and Side Effects
Driving
This is the biggest danger. The CDC says that using multiple substances such as cannabis and alcohol at the same time can increase impairment, and that the safest option is not to drive after using any alcohol or drugs. In a driving simulator study, cannabis and alcohol each increased lane weaving, and their effects added together. A blood THC level of 5 micrograms per liter combined with a 0.05 breath alcohol level produced weaving similar to a 0.08 alcohol level alone (Drug and Alcohol Dependence). In Washington, 5 nanograms of active THC per milliliter of blood is the legal limit for drivers 21 and over, separate from the 0.08 alcohol limit. See our Washington marijuana laws guide.
Heavier drinking and harms
In the National Alcohol Survey analysis, people who used the two simultaneously drank more often and in larger amounts than alcohol-only drinkers. Compared with alcohol only, simultaneous use was linked to roughly double the odds of drunk driving, social consequences and harms to self (Alcoholism: Clinical and Experimental Research). This is an association from survey data, so it does not prove the combination causes the harm, but a daily-diary study of young adults also found that days with simultaneous use carried more negative consequences than alcohol-only days (Drug and Alcohol Review).
Alcohol poisoning
Heavy drinking can cause alcohol overdose. The National Institute on Alcohol Abuse and Alcoholism lists danger signs including confusion, trouble staying conscious, vomiting, seizures, slow or irregular breathing, clammy skin and bluish or pale skin. Call 911 right away if you see them, and do not leave the person alone to “sleep it off.”
Dependence
Regularly combining the two can make both habits harder to manage. NIDA estimates that 22% to 30% of people who use cannabis have cannabis use disorder. Our article on whether marijuana is addictive covers the warning signs.
If You Do Mix Them: Lower-Risk Habits
- Plan your ride before the first drink. No driving, biking or operating anything.
- Go lower on both. Use less cannabis than you would sober, especially after drinking.
- Be extra careful with edibles. Effects typically start 30 to 90 minutes after eating and peak hours later, according to a pharmacology review, so it is easy to keep drinking while a dose is still rising. Our cannabis dosage guide explains timing.
- Pace yourself and drink water. Eat a meal beforehand.
- Stay with people you trust and in a place where you can rest safely.
- Buy labeled, tested cannabis so you know the THC content. Find licensed stores in our Washington and Oregon directories.
Talk to Your Doctor
Ask a doctor or pharmacist before combining cannabis and alcohol if you take medications, especially sedatives, sleep aids, opioids, anti-anxiety drugs or antidepressants, since all of these can add to drowsiness and impairment. People who are pregnant, have heart conditions, liver disease or a history of substance use problems should get personal advice. If you find you cannot use one without the other, a doctor can help, and the SAMHSA National Helpline (1-800-662-4357) offers free, confidential treatment referrals.
Crossfading FAQ
What does it mean to be crossfaded?
Being crossfaded means being under the influence of cannabis and alcohol at the same time. It is also called getting twisted. Researchers call it simultaneous alcohol and marijuana use.
Is it safe to mix weed and alcohol?
It is riskier than using either alone. The CDC says combining them increases impairment, and survey research links simultaneous use to higher odds of drunk driving and other harms. Never drive after mixing them.
Does alcohol make you higher?
It can. Two lab studies found that drinking before inhaling cannabis raised blood THC levels, and one found people felt effects sooner and reported more euphoria.
Is it better to smoke or drink first?
Neither order is safe. Research suggests drinking first can raise THC levels, so if you have been drinking, use much less cannabis than usual.
Why do I get the spins when crossfaded?
Both substances affect balance and coordination, and their effects stack. Stop using both, sit or lie down safely, sip water and stay with someone.
How long does being crossfaded last?
It depends on doses. Inhaled cannabis effects usually fade within a few hours, while alcohol clears at a fairly steady rate. Do not drive until both have fully worn off, which often means waiting until the next day.
For adults 21+ in legal states. General information, not medical advice. Talk to a doctor before using cannabis for a health condition.
