I’m a former nurse and recovering alcoholic, and I’ve been concerned by the lack of health education given to the general public about the dangers of mixing alcohol with certain medications. The common practice is to place warnings on medications that they should not be combined with alcohol. Although some doctors will provide warnings and some education, they often don’t because education takes up a lot of time in a busy healthcare environment. Plus, many doctors underestimate the ability of patients to retain education. Lastly, discussing this may prompt people to stop taking their vital medications so it becomes a risk/benefit issue.
This is especially problematic with mental health and pain relief medications. My father died eight years ago from liver failure due to alcoholism. He also struggled with a horrible depression that went on for most of his life. My father didn’t get a little down; he lost all ability to function when he was depressed. And, of course, the more depressed he got, the more he drank. He also took several medications for his depression. He mixed them with alcohol and pain relief medications which sped up his liver failure. Also, he took medications for metabolic health issues that also shouldn’t be mixed with alcohol.
Public education is sorely lacking about the interactions between alcohol and medications used for common physical and mental health issues. There are a lot of serious health risks associated with these interactions, and if you take any of these medications and drink regularly, you may want to consider cutting back or quitting alcohol altogether.
Mental health medications
Almost all medications for mental illness, whether it’s depression or psychosis, should not be taken with a lot of alcohol. For one, some of these medications are hard on the organs, so combining them with alcohol can increase damage to some bodily organs.
Another painkiller that is not an opioid, and should also not be mixed with alcohol is Tylenol or acetaminophen. Both alcohol and Tylenol are hard on the liver and can increase liver damage when taken together. Usually, these adverse effects happen over a long period of use of both alcohol and Tylenol.
Benzodiazepines
Benzodiazepines are medications like Xanax and Ativan that are usually taken to calm anxiety. Both alcohol and benzodiazepines cause a similar action in the nervous system. Therefore, when mixed, can increase the effect of both substances, causing an increase in side effects and toxicity like drowsiness, respiratory depression, blackouts, and dangerous withdrawal.
Cough and cold medication
Whether it’s over the counter or prescribed by a doctor, cough and cold medications can be hazardous when mixed with alcohol. The reasons are pretty similar to what happens with painkillers. When taken together, these medications can cause an increase in overdoses and severe toxicity to the brain and organs. The real danger of these medications is that the ingredients are often not understood by the general public. Cough and cold medications often contain sedatives, painkillers, antihistamines, and cough suppressants, all of which increase toxicity when mixed with alcohol.
Diabetes and cholesterol medications
Diabetes medications like Insulin and Metformin are hard on the liver — unfortunately, so is alcohol. When these medications are taken with alcohol, it can increase the potential for liver disease, especially when combined over a long period. Often, doctors will say it’s ok to have a drink or two, here and there. However, when alcohol consumption goes past a drink or two, the probability of liver problems increases. I’ll discuss more about liver issues, alcohol, and other medication interactions towards the end of the article.
Combining cholesterol-lowering medications and alcohol is also a risk. Medications like Rosuvastatin and Atorvastatin are hard on the liver, so when combined with alcohol, can increase liver problems. It’s also worth mentioning that both of these conditions (diabetes and high cholesterol) can also increase problems with the liver and are associated with liver damage. But when you add in the medication interaction, it can be deadly.
Antibiotics and antifungals
Antibiotics are used fairly frequently by many people. Unfortunately, again these medications are very hard on the liver and so when combined with alcohol can increase the risk of liver damage.
Also, antifungal medications can increase acetaldehyde accumulation in the body when mixed with alcohol. This creates a very uncomfortable reaction causing flushing, nausea, and vomiting. These symptoms are unpleasant but can also be dangerous. Too much acetaldehyde can also induce blood vessel dilation, low blood pressure, and rapid heartbeat which can be dangerous for people with coronary artery or vascular issues.
Conclusion and other important facts
These are the most common and important medications that should not be mixed with alcohol. The combinations either cause serious drowsiness and a high potential for overdose or increase damage to the organs, especially the liver. Some of these issues happen immediately, while others happen over years of combining alcohol and medications. The critical issue is to know more about which medicines are problematic and why. The more that people understand this, the better decisions they can make. This is the goal of public health education, and I’m committed to providing this for the general population.
Unfortunately, once people develop alcohol tolerance, they feel these mixtures are safe. Thus, they may end up consuming more medications or drugs, thinking it’s ok. Even adding cough medicine on top of alcohol and mental health medications can cause extreme side effects and overdose. And it’s quite easy to take over-the-counter medications like this and not think about how they mix with alcohol or other medications. There have been reports of accidental deaths when combining cough and cold medications with other recreational and prescription drugs. But then add alcohol to the mix and the interaction intensifies.
As I mentioned above, one of the biggest concerns around alcohol and medication interactions is liver toxicity. This is because one of the first things the liver prioritizes when doing its job is toxic substances. The liver will divert all energy towards this and will fall behind on its other jobs. The liver has a hard enough time trying to metabolize alcohol. When you add medications to the mix, it increases the workload for the liver.
A few things happen when the liver has to work hard to metabolize both alcohol and medications. One, levels of either alcohol or medications may reach toxic levels in the blood, depending on the medication. This is because the liver may be overwhelmed by trying to work on both substances. The liver reduces its workload on other bodily priorities like digestion, nutrient absorption, and creating substances the body needs for blood and enzyme production.
This information is not discussed enough by health professionals or in the general public. Hopefully, this article helps expand public knowledge and education and can lead to better decision-making and overall health safety.
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