Meds and Alcohol: A Very Risky Combination

Mix alcohol with certain prescription medications and the result can be any one of a range of dangerous reactions, from dizziness to death. Now new research shows that the number of Americans taking this potentially fatal combo is surprisingly high: nearly 42%, according to findings from lead researcher Rosalind Breslow, PhD, of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), whose study was published in the February 2015 issue of Alcoholism: Clinical and Experimental Research.

We’ve all seen the labels on prescriptions with cautions about the dangers of mixing some meds with alcohol, but not enough of us are paying attention, it seems. And among adults 65 and older, a staggering 78% are mixing alcohol with prescription meds, Dr. Breslow and her colleagues found. The researchers looked at the results of the National Health and Nutrition Examination Survey of 26,657 adults aged 20 years and older, focusing on recent alcohol consumption and prescription medication use.

A Particularly Risky Drug

Common types of drugs that Breslow considered were those prescribed for cardiovascular problems, metabolic problems (such as diabetes) and prescriptions given for pain or to help with anxiety. One particular type of drug – benzodiazepines, which are prescribed for anxiety as well as sleep problems – has the potential to be addictive, and its use rises sharply with age. In fact, 9% percent of people ages 65 to 80 take these drugs, which include Valium, Xanax, Ativan and Librium, among others, according to a study published in the February 2015 issue of JAMA Psychiatry.

Short-term use is considered safe, but taking benzodiazepines on their own daily over weeks, months or even longer can result in impaired memory and cognition which can lead to car accidents and falls, an increased risk of Alzheimer’s – and addiction.

Without the supervision of a medical doctor, those who drink alcohol and also take benzodiazepines are courting disaster. “Alcohol and anti-anxiety medications interact at a specific type of neurotransmitter receptor in the brain — the GABA receptor — to cause sleepiness, impair balance and coordination and disrupt memory,” explains Aaron White, PhD, of the NIAAA, who co-authored the research with Breslow. “When combined in high enough doses, areas in the brain stem in charge of vital reflexes can be suppressed, leading to death.” And the older the patient, the higher the risks.

Don’t try to outwit the potentially negative effects of benzos by waiting a few hours to drink, thinking the medication’s effects will have worn off. “In general, the more often you drink, the higher the likelihood you’ll have an overlap,” meaning the alcohol and the medication will interact in your body, says Dr. White. “That’s really the key: Are both ‘on board’ at the same time? But it’s actually a bit more complicated, because some medications linger in the body longer than others.”

Signs that you’re in the midst of a dangerous interaction include dizziness, trouble breathing and a rapid heartbeat. But there may be other side effects happening, too, that you can’t see or feel, like liver damage and dangerously high blood pressure. “It’s important for people to understand the risk of alcohol-medication interactions in order to prevent them from happening,” says Breslow. “We suggest that patients and their families ask their doctor or pharmacist whether they should avoid alcohol while taking the medications they’re prescribed.”

It’s worth adding that substance addicts and alcoholics will sometimes intentionally mix certain drugs and drinks to enhance the effects of alcohol. “Avoidance of pain is the objective for many users at the beginning,” points out White, “and becomes a major focus once addiction develops. As such, there are likely two reasons someone addicted to alcohol or other drugs would combine [alcohol and medication]. One is to get a higher high. The other is that two or more drugs together might ease the pain of life more than one drug alone.”

For a more complete list of medications and how they interact with alcohol, visit the National Institute on Alcohol Abuse and Alcoholism.

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