Alcohol and Medicine: When Drugs Interact

Is it okay if I drink with these pills?

We've all seen the warnings; the labels on prescription bottles telling us not to mix the pills with alcohol. The warnings tell us that alcohol may blunt or enhance or nullify the effect of the prescribed drugs.

But what's so bad about mixing alcohol with common medications? What, really, can go wrong? "Nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination," according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). "It can also put you at risk for internal bleeding, heart problems, and difficulties breathing. In addition to these dangers, alcohol can make a medication less effective or even useless, or it may make the medication harmful or toxic to your body."

The NIAAA reminds consumers that certain medicines, such as cough syrup and laxatives, may contain up to 10 per cent alcohol to begin with. Moreover, older people are at particular risk, since the body breaks down alcohol more slowly with age. Woman are also at high risk for drug/alcohol interactions, since blood--alcohol levels are typically higher in women than in men after consuming the same amount of alcohol.

Finally, the NIAAA advises, "Timing is important. Alcohol and medicines can interact harmfully even if they are not taken at the same time."

Herewith, a partial listing of drug/alcohol reactions to watch out for, taken from the NIAAA's publication, "Harmful Interactions: Mixing Alcohol with Medicines."

Possible reactions with alcohol:

--Angina: Isordil, Nitroglycerin. Rapid heartbeat, dizziness, fainting.

--Anxiety and Epilepsy: Librium, Valium, Xanax, etc. Increased risk of overdose, difficulty breathing, impaired motor control, memory problems.

--Blood clots: Coumadin (Warfarin). Internal bleeding, strokes, heart attacks.

--Depression: Prozac, Zoloft, Lexapro, Wellbutrin, etc. Drowsiness, dizziness, increased risk of overdose.

--Diabetes: Glucophage, Orinase, etc. Abnormally low blood sugar, flushing reaction, nausea, vomiting.

--Arthritis: Celebrex, Naprosyn, Voltaren. Ulcers, stomach bleeding, liver problems.

--High blood pressure: Catapres, Cardura, Lopressor, etc. Dizziness, fainting, arrhythmia.

--High cholesterol: Crestor, Lipitor, Pravachol, etc. Liver damage.

--Infections: Acrodantin, Flagyl, Grisactin, Nizoral, Nydrazid, Seromycin, Tindamax: Rapid heartbeat, stomach pain, vomiting, flushing.

--Severe pain: Demerol, Percocet, Vicodin, etc. Drowsiness, dizziness, increased risk of overdose, difficulty breathing, impaired motor control.

--Sleep problems: Ambien, Lunesta, Sominex, etc. Dizziness, difficulty breathing, impaired motor control, memory problems.

--Enlarged prostate: Cardura, Flomax, etc. Dizziness, fainting.

And don't forget the herbals: Alcohol with Kava Kava may cause liver damage; alcohol with St. John's Wort risks dizziness and overdose. Chamomile, valerian and lavender will increase drowsiness when mixed with alcohol.

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Nothing Beats Booze

Annual survey ranks alcohol as #1 problem.

Drugs may make headlines, but alcohol is the elephant sitting in the corner of the room, according to Community Anti-Drug Coalitions of America (CADCA), a non-profit organization that conducts an annual survey of community anti-drug service groups. CADCA, sponsored in part by the U.S. Department of Health and Human Services, found that 68 percent of community anti-drug coalitions ranked alcohol as “the number one problem facing their community.”

The group said that marijuana was in second place, listed by 60 percent of communities as one of the major problems in their areas. Tobacco was a close third.

“It’s no surprise that our members are seeing big problems with youth alcohol use in their communities,” said Arthur T. Dean, CADCA chairman and CEO. 700 community anti-drug coalitions took part in the 2007 survey. Community anti-drug coalitions rely on strategies including media outreach, advertisements, educational events and community forums.

Asked to name the major partners helping them tackle community drug problems, 88 percent of survey respondents listed “law enforcement.” That was slightly ahead of the number of respondents listing “parents” (86 percent).

While the results cannot be considered a surprise, it is disheartening to discover that an earlier CADCA survey found that the “alcohol stigma” is alive and well: 63 percent of Americans still believe alcoholism is a moral weakness. Only 34 percent of respondents labelled it a disease. The earlier survey also reported that two out of every five Americans reported that they have encouraged a loved one to seek help for an alcohol problem.

Moreover, a group of Britain’s most prominent drug researchers published a report in the Lancet last year calling for the U.K. to scrap its current drug classification scheme in favor of one that “more honestly reflects the harm caused by alcohol and tobacco,” according to an article in the U.K Guardian by science correspondent James Randerson.

The study team “asked 29 consultant psychiatrists who specialise in addiction to rate [20 drugs of abuse] in nine categories. Three of these related to physical harm, three to the likelihood of addiction and three to social harms such as healthcare costs,” writes Randerson. In the final rankings, heroin and cocaine were ranked as the most dangerous. Alcohol placed 5th, well ahead of marijuana (11th), LSD (14th), and Ecstasy (18th).

Predictably, howls of outrage and shock were heard from dozens of U.K. politicians and anti-drug crusaders after the report was published.

Photo Credit: LiveJournal

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