Sickle cell disease: Alcohol, cigarettes and other recreational drugs

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Learn about the general short- and longer-term effects of alcohol, cigarettes and recreational drugs and find out how these substances impact people with sickle cell disease.

Key points

  • Alcohol, cigarettes and recreational drugs can all make the symptoms of sickle cell disease worse, interact with your pain medications and damage your organs.
  • Alcohol slows down the functioning of the brain, which can make you lose coordination, slur your speech and take longer to respond to things. It also causes your longer-term effects.
  • Cigarettes and other sources of tobacco, such as e-cigarettes, can cause higher blood pressure, faster breathing and a faster heartbeat. They can also lead to addiction and, eventually, cancer.
  • Recreational drugs are dangerous and can affect every aspect of a person's life.
  • Please talk to someone on your health-care team if you have feelings of sadness or worry about your sickle cell disease and you are coping with these feelings by drinking alcohol or taking recreational drugs, or if you are considering self-harm.

Some teens might feel more pressure from friends to drink, smoke or take recreational drugs (drugs not prescribed by a health-care provider and obtained illegally). As a person with sickle cell disease, you need to know the extra health problems that you can experience because of:


When someone drinks alcohol, it is absorbed into their bloodstream and carried throughout their body. Alcohol can have both depressant and stimulant effects.

  • As a depressant, alcohol slows down the functioning of your brain and the messages sent by nerves along the spinal cord. This can make you lose coordination, slur your speech and take longer to respond to things.
  • As a stimulant, alcohol raises your heart rate and blood pressure, which can make it harder for you to get a good night’s sleep. Alcohol can also make you very friendly and talkative, sad or angry and aggressive.

Longer-term effects of alcohol

  • Over time, alcohol can interact with your medications. This can lead to serious health problems such as liver damage. It is important to talk with your health-care provider about the risks of taking alcohol when you are taking medications.
  • Drinking regularly can reduce your ability to concentrate, leading to problems at school and work.
  • Alcohol use can impair your judgment, leading to risky behaviour such as having unprotected sex, drinking and driving, injuring yourself when drunk or breaking the law. According to Canada’s National Crime Prevention Centre, young people who drink are more likely to get into fights and commit crimes than those who do not.
  • The legal age to drink is 19 in most Canadian provinces and 21 years in most US states. Drinking when underage can get you into trouble with the law.
  • Drinking alcohol regularly can lead to addiction, especially if you drink alcohol to numb sickle cell pain sensations, to cope with your feelings about your sickle cell disease or to pass the time when you are alone. If you find that your symptoms or ongoing sadness or worry are leading you to drink alcohol or think about harming yourself, please talk to someone on your health-care team.
  • Drinking large amounts of alcohol in a short time can lead to alcohol poisoning. This is exactly what it sounds like—the body becomes poisoned by a large volume of alcohol because it cannot process it quickly enough. Vomiting (throwing up) is usually the first symptom of alcohol poisoning. Alcohol poisoning can also cause extreme sleepiness, unconsciousness, trouble breathing, low blood sugar levels, seizures and even death. If you think someone may have alcohol poisoning, get medical help immediately.

Impact of alcohol on sickle cell disease

Alcohol is a diuretic (it causes you to urinate more often). With sickle cell disease, this can cause you to lose too much fluid from your body and become dehydrated, which can trigger a pain crisis. Alcohol can also be dangerous when you are taking pain medications, especially opioids.

Cigarettes and other sources of tobacco

Closeup on a teen's hand holding a lit cigarette

Cigarettes have a number of ingredients: tar, carbon monoxide, ammonia, hydrogen cyanide, arsenic and, of course, nicotine. Not one of these ingredients is good for your body!

When you breathe in cigarette smoke, it passes from your lungs into your bloodstream. Once in the bloodstream, it causes the body to release a hormone called epinephrine. This leads to higher blood pressure, faster breathing and a faster heartbeat.

When nicotine reaches the brain, it causes the release of a feel-good hormone called dopamine at much higher levels than usual. The release of this hormone is what causes someone to feel happy and relaxed when they smoke, and what makes cigarettes so addictive, even if someone knows how harmful they are.

Some people use e-cigarettes because they believe they are a safe alternative to smoking, but they are not. E-cigarettes are just another way of putting nicotine (a highly addictive drug) into your body.

Longer-term effects of cigarettes

Smoking is harmful to everyone because of the cancer-causing agents in cigarettes.

Impact of cigarettes on sickle cell disease

For people with sickle cell disease, smoking is even more harmful because nicotine causes the blood vessels to constrict (become smaller). This can cause increased pain crises.

Nicotine also reduces the amount of oxygen that gets to the lungs. Many people with sickle cell disease are anemic, and smoking only further reduces the supply of oxygen to the body.

People with sickle cell disease commonly experience temporary and long-term lung problems. When you smoke, you have a greater chance of having a number of life-threatening conditions, including:

  • acute chest syndrome (includes fever and breathing problems)
  • pneumonia (infection of the lung)
  • pulmonary hypertension (increased pressure in the lungs)
  • stroke

Recreational drugs

Recreational drugs (those not prescribed by a health-care provider) include:

  • marijuana (also known as pot, weed, joint, THC, cannabidiol)
  • cocaine (also known as coke, snow, flake, blow)
  • amphetamines (for example, ecstasy, X, E, uppers, XTC, speed, meth, ice, crank, m-cat)
  • heroin (also known as H, horse, smack)
  • anabolic steroids

Why people take recreational drugs

Some people believe drugs will help them to think better, be more active or become better athletes. Others take them because they want to fit in and be more popular with their peers. Still more are simply curious and assume that trying them once won't hurt.

Many people use drugs because they are depressed and think drugs will help them escape their problems. This can be a risky way of thinking, especially if you are considering recreational drugs to help you handle your sickle cell disease.

It is normal for anyone with a chronic illness such as sickle cell disease to feel sad and worried at times. If you find that feelings of sadness or worry are not going away or are leading to thoughts of taking drugs or harming yourself, please talk to someone on your health-care team.

Dangers of recreational drugs

Recreational drugs don't solve problems. In fact, they only hide feelings and problems for a short time. They may actually make things worse once they wear off.

Some recreational drugs have a depressant effect, while others are powerful stimulants. Regardless of their intended effects, all recreational drugs are dangerous. Using drugs can ruin every aspect of a person's life.

  • They can interact with your medications and possibly cause severe damage to organs such as your brain, liver and kidneys.
  • They may cause confusion, anxiety, learning difficulties or memory loss.
  • They can lead to risky behaviour, such as having unprotected sex or engaging in “high driving” (driving while impaired by drugs).
  • Repeated use can lead to tolerance and addiction. This means a person uses the drug for a psychological high, and their body becomes used to the effects of the drug.
  • You may never be sure if the drug you are taking is laced or “cut” with something else. Some drugs can be laced with other, cheaper substances to bulk them up (and make them more profitable). It is difficult to know what is in them and what effect these other substances can have on you alongside the drug.
  • Many drugs are illegal. Being caught with some of these drugs, even for personal use, will get you in trouble with the law.
  • A drug overdose can cause serious mental or physical damage or even death.

Impact of recreational drugs on sickle cell disease

All recreational drugs can cause health problems in a person with sickle cell disease. For instance, many have side effects that can worsen the symptoms of the disease.

  • Cocaine can narrow blood vessels even more than nicotine does.
  • As an opioid, heroin and fentanyl are even stronger than morphine. They can lead to overdoses when used alone and especially when combined with prescription opioids.
  • Amphetamines can stress the heart, which may already be working extra hard to pump the thinner sickle cell blood (due to lack of red blood cells).

Last updated: November 6th 2023