Does mixing alcoholic drinks really make you more drunk?

Question

There is plenty of anecdotal evidence ("beer after wine and you'll feel fine, wine after beer will make you feel queer") that mixing alcoholic drink types leads to a stronger effect, but I can't find any true studies.

In fact the only studies I found are looking at mixing energy drinks and alcohol (mixing with energy drinks increases motivation for more alcohol (in college students) [1]), and discussed mixing caffeinated beverages with alcoholic ones [2].

Are there any studies specifically looking at mixing alcoholic drinks? They would have to compare people drinking the same amount of alcohol, but some people mixing, others drinking the same thing. Maybe even a cross-over study design? Same people do both, one after the other? The only way to get an unclouded answer!

I am also interested in the follow-up why question: Why does mixing some drinks make you more drunk? Presumably it is something in wine (for example) that interacts badly with something in beer at the chemical level (the metabolites maybe)?

1. Marczinski CA, et al, (2012). Mixing an Energy Drink with an Alcoholic Beverage Increases Motivation for More Alcohol in College Students. Alcohol Clin Exp Res, epub. doi: 10.1111/j.1530-0277.2012.01868.x
2. Touyz LZ, (2011). Mixing drinks and concocting troubles. Curr Oncology, 18(6):262-3. PubMed; FullText.

Answer 1

There are some very general answers to your question.

1. Definitely, there is a lot of magical thinking. We as humans are very prone to anecdotical evidence and extrapolations from incomplete data, even more so when we are drunk.

   As an interesting "proof" is the fact that the German counterpart of the saying "beer after wine and you'll feel fine, wine after beer will make you feel queer" is "Wein nach Bier, gönn' ich Dir, Bier nach Wein, lass es sein" -- which means the exactly opposite of the English saying (beer after wine is bad, wine after beer is fine).

2. Many kinds of alcohol contain unwelcome additional substances, for example fusel alcohols. Definitely, "mixing" broadens the range of these additions.

3. Mixing can lead to a misperception about the actual amount of alcohol that was taken in. Many people who would not drink a vodka and drive have no problem driving after a half a liter of beer (which contains same amount of alcohol two shots of vodka).

Answer 2

Mixing of alcohol and energy drinks can be detrimental to ones health as both alcohol and the caffeine in energy drinks are both stimulants which can cause adverse effects on the heart especially if one has a natural sensitivity to caffeine. One also has to be careful as both caffeine and alcohol are diuretics which when combined can cause even greater risk of dehydration. And some studies suggest that taurine, which while naturally occurring (and even quite necessary in the developmental stages of humans) may cause adverse affects on kidneys and combine that with two diuretics all tied together...it could cause serious potential for health risks. At least in some individuals. [ 1 ] [ 2 ]

I conducted a non-scientific experiment one night when friends were discussing the merits of 'alcohol before liquor' and vice versa where I decided to mix a pint of beer and three shots of Bacardi 151 in stein and consumed it as I would a straight beer. Personally I felt no ill effects but I also had a hell of a tolerance for alcohol. I agree that mixing alcohols can 'confuse' someone regarding just how much alcohol they have consumed and should be watched carefully. Although vigilance is often not one of the virtues displayed by people who consume such drinks.

1. Kristen Kirkpatrick M.S., R.D., L.D. - http://www.doctoroz.com/blog/kristin-kirkpatrick-ms-rd-ld/energy-drinks-demystified

2. Time Magazine Online - http://time.com/3677044/alcohol-energy-drinks/