Warnings of drug interactions with alcohol use are commonly associated with prescription and non-prescription sleeping medications, as well as over-the-counter cold and allergy medications, alerting the public that excessive drowsiness can occur. Alcohol, however, can cause serious interactions with many types of drugs, including those that treat heart conditions, high blood pressure, diabetes, infection and blood anticoagulants.
About 2,800 prescription drugs are on the market in the U.S., with physicians writing 14 billion prescriptions annually. According to the National Institute of Alcohol Abuse and Alcoholism (NIAAA) the elderly represent only 12 percent of the population but consume 25-30 percent of all prescription medications. Alcohol use is also common among the elderly, with 10 percent of seniors living in the community and 40 percent of those in nursing homes fitting the criteria for alcohol abuse.
Results from a new study authored by Rosalind A. Breslow, an epidemiologist at the NIAAA, show the effects of alcohol on a wide range of prescription medications that can cause harm. Headaches, loss of coordination, internal bleeding, heart problems and difficulties in breathing are but a few.
Breslow and colleagues studied data from the 1999-2010 National Health and Nutrition Examination Survey, in which 26,657 adults provided personal data on alcohol consumption and prescription drug use. “Almost 42 percent of drinkers in the U.S. population used one or more alcohol-interactive prescription medications,” Breslow said. “Among seniors, aged 65 and older, the proportion was even higher, almost 78 percent.”
Alcohol can impact the effectiveness of a drug by altering its availability. Several different types of interactions can occur, including alcohol competing with the drug for the same set of metabolizing enzymes, affecting the metabolism of certain drugs for several weeks, magnifying the inhibitory effects of sedatives and activating enzymes via chronic alcohol consumption, transforming some drugs into toxic chemicals.
The effects of the drug and alcohol interaction vary depending on the drug and whether the alcohol consumed was due to an acute event or a chronic condition. For example, with antibiotics, acute alcohol consumption decreases the availability of isoniazid in the bloodstream, where chronic alcohol use decreases the availability of rifampin. In both cases, the effectiveness of the antibiotic is compromised.
According to Aaron White, a neuroscientist who co-authored the new study, the consequences of mixing medications with alcohol can have varying effects, ranging from mild to deadly. According to White:
“Alcohol can increase blood pressure, which could be counterproductive if one is taking medications to control blood pressure. Mixing diuretic medications with alcohol, which is also a diuretic, could contribute to dehydration. Mixing alcohol and other sedatives, like sleeping pills or narcotic pain medications, can cause sleepiness, problems with coordination, and potentially suppress brain stem areas tasked with controlling vital reflexes like breathing, heart rate, and gagging to clear the airway. Alcohol increases insulin levels and lowers blood glucose, so combining alcohol with anti-diabetic agents that regulate glucose levels could cause an undesirable drop in blood sugar. And, over time, alcohol can contribute to insulin insensitively.”
It is estimated that interactions to alcohol and prescription medication may be responsible for at least 25 percent of all emergency room admission, not to mention the less serious interactions that go unreported. This study provides important information on the mechanisms of drug and alcohol interactions that will increase overall public awareness.
Sovereign Health Group is a California-based addiction, mental health and dual diagnosis treatment provider, offering several locations in our home state in addition to centers in Utah, Arizona and Florida. For more information on our substance abuse and mental health programs, please call (866) 819-0427.
Written by Eileen Spatz, Sovereign Health Group writer