7 Medications You Shouldn’t Mix with Alcohol

Alcohol has become a big part of American culture, and while the risks associated with moderate drinking are low, heavy consumption or the mixing of alcohol with other substances, such as prescription pills, can be dangerous and life-threatening. Seven types of medications you shouldn’t mix with alcohol include allergy, anxiety, ADHD, cough, depression, nausea, and pain medications.

Mixing alcohol with prescription drugs can also create dependencies and lead to drug abuse. If you do not know or are unsure about the effect of mixing alcohol with a currently prescribed medication it is best to avoid alcohol entirely until after speaking with your pharmacist or health care provider.

Mixing Prescription Pills and Alcohol

Over sixteen million Americans age twelve and older abuse prescription drugs each year. Combine that number with the number of Americans who report binge drinking and it makes sense that a large number of people will mix prescription drugs with alcohol each year. Research suggests that as many as 42 percent of adults who drink also use medications known to interact with alcohol. Combining prescription and over-the-counter drugs with alcohol can have unpredictable and unwanted consequences.

Dangers of Mixing Prescription Pills and Alcohol

Many common drugs have potential interactions with alcohol, with consequences ranging from reduced medicinal efficacy to serious potential harm or danger. For example, antibiotics, which most people reading this have likely been prescribed at some point, can have reduced efficacy when combined with alcohol. Furthermore, as both are processed by the liver, consuming alcohol while also taking antibiotics could cause liver damage. While these effects are dangerous for everyone, the elderly or those with compromised livers are especially at risk when mixing prescription drugs and alcohol. 

Drugs that are especially likely to be abused can also have potentially life-threatening interactions. Opioids, for example, combined with alcohol can cause severe respiratory system malfunction that can lead to death, in addition to the damage it causes to the liver. Some cold medicines already contain alcohol and can lead to dangerous levels of alcohol consumption if combined with regular drinking. Antihistamines can have reduced efficacy and can potentially cause liver damage when mixed with alcohol. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has a table showing the harmful effects of commonly used prescription and over-the-counter drugs when used with alcohol. Consider the following table from the National Institute on Alcohol Abuse and Alcoholism regarding the harmful effects of commonly used prescriptions and over-the-counter drugs when paired with alcohol.

Commonly Used Medicines (Both Prescription and Over-the-Counter) That Interact With Alcohol

Source: NIAAA

Prescription Pills

Prescription drug use is incredibly common in the United States, with just under half (48.6 percent) of all persons using at least one prescription drug in the past thirty days. Just under a quarter (24 percent) of all people used three or more drugs in the past thirty days, and about half of those people (12.8 percent) used five or more. As these statistics make clear, prescription drug use is quite common, with many people experiencing a tremendous boost in quality of life thanks to pharmaceutical developments. However, this increase goes hand in hand with an increase in prescription drug abuse. 

Certain classes of drugs have been found to be most commonly abused:

Opioids

Opioids are a class of drugs used to reduce pain. Commonly used opioids include:

• Oxycodone (OxyContin)
• Hydrocodone (Vicodin)
• Morphine
• Methadone
• Heroin
• Fentanyl

Central Nervous System (CNS) Depressants

CNS depressants are medicines that slow brain activity, making them useful for treating anxiety, panic, acute stress reactions, and sleep disorders. Commonly used CNS depressants include:

• Diazepam (Valium)
• Alprazolam (Xanax)
• Triazolam (Halcion)
• Zolpidem (Ambien)

Stimulants

Stimulants speed up the body’s systems and can reverse the effects of fatigue on both mental and physical tasks. Commonly used stimulants include:

• Amphetamines (Adderall)
• Methylphenidate (Ritalin)
• Methamphetamine
• Cocaine

While these drugs can have positive, life-changing effects when used properly, misuse or abuse of these drugs can lead to worsening of the original condition, hospitalization, or worse. Drug abuse can, on its own, be harmful to individuals and their communities. Even a helpful or neutral substance can lead to tragedy if misused or abused, and alcohol is no exception. Misuse and/or abuse of a drug occurs when someone:

• takes medicine in a way or dose other than prescribed,
• takes someone else's medicine,
• takes medicine for the effect it causes — to get high

Alcohol

Alcohol use is incredibly common, with almost seven out of eight (85.6 percent) people, ages eighteen and older, reporting alcohol use at some point in their life. Unfortunately, binge drinking, defined as four drinks (five for men) within two hours, is also prevalent, with just over a quarter (25.8 percent) of people over eighteen reporting binge drinking behavior in the past month. This level of cultural prevalence means that many people twelve and older, almost fifteen million, suffer from Alcohol Use Disorder (AUD). 

AUD is defined as a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. In the worst cases, alcohol abuse can have tragic repercussions, with over ninety-five thousand deaths in the United States attributed to alcohol-related causes. The damage is not just related to the immediate health effects of drinking, as alcohol abuse can lead to traffic fatalities and has strong links to domestic abuse behavior, meaning even non-drinkers can suffer from the effects of alcohol abuse. 

Legality

Health effects are not the only potential consequences of mixing prescription drugs and alcohol, as the United States has many harsh drug laws. While efforts are underway to reexamine our drug laws with a more rehabilitation-focused lens, the current laws on the books, including the Comprehensive Drug Abuse Prevention and Control Act of 1970, the Anti-Drug Abuse Act of 1986, and the Anti-Drug Abuse Act of 1988, include severe penalties, ranging from fines to significant prison sentences, for drug abuse. 

Additionally, states may create their own laws and penalties for drug possession and abuse, varying widely from state to state. In certain situations, mandatory minimum sentencing guidelines require judges to send offenders to prison. 

Treatment for Prescription Drugs and Alcohol

There are many ways to address substance use disorders (SUD), ranging from quitting “cold turkey” to in-patient rehabilitation programs. Stopping all drug use immediately, often referred to as “quitting cold turkey,” is extremely difficult for most and can even be potentially harmful, causing symptoms of withdrawal that can be quite brutal. If your body has developed a dependency on a certain drug, then removing that substance from the body suddenly can be dangerous and not typically recommended. 

In many cases, medically assisted detoxification, often referred to as “weening off”, is the first stage of treatment. It is important to note, however, that this is only the first step and that staying off drugs is just as important, if not more than, stopping use in the first place.

The most commonly used forms of treatment to help patients continue to refrain from drug use are counseling and other forms of behavioral therapies. Addiction is complex, and the right treatment can vary from patient to patient, so various treatments and a healthy dose of patience may be necessary to find the right solution for any particular individual. Offering grace and practicing patience is crucial regardless of whether one is a healthcare provider, a patient, or a loved one of a patient. SUD is often a lifelong affliction, so treatment is often a marathon, not a sprint.

Frequently Asked Questions (FAQs) About Mixing Prescription Pills and Alcohol

Below, we answer some frequently asked questions about mixing prescription pills and alcohol. 

Can I drink alcohol if I think my medication is ok to mix?

It is always best to double, even triple, check. Reading the prescription’s warning label, looking online at the NIAA or MedlinePlus charts, and/or calling your pharmacist could be potentially life-saving acts. There are hundreds of thousands of prescription and over-the-counter drugs, so it is always best to be safe. 

Who is most vulnerable to mixing prescription pills and alcohol?

Aside from those with substance abuse disorders, those aged 65 and older are also at high risk for harmful alcohol medication interactions. Older people are more likely to take a medication that interacts with alcohol. Additionally, because aging slows the body’s ability to break down alcohol, alcohol remains longer in a person’s system. 

How can I tell if someone is abusing prescription drugs and alcohol?

Advanced Recovery Systems states that recognizing the signs of addiction can be a concrete first step toward getting someone the help they need. There are behavioral, physical, and psychological aspects of addiction that can be recognized. 

Bottom Line

Understanding the dangers of alcohol and prescription drug abuse, particularly when mixed, can help prevent future incidents of abuse or unintentional interaction, which can help prevent tragedy. Educating yourself and others can be the first step in prevention, which is the best form of treatment. Protect yourself by avoiding alcohol if you take medication and do not know its effect. To learn more about a medicine and whether it will interact with alcohol, talk to your pharmacist or other health care provider.

Substance abuse is a complex condition that can affect not only the individual but those around them. Behavioral therapy has been proven to be extremely helpful in treating those suffering from addiction. Mira offers access to mental health professionals so that its members can receive mental health treatment and addiction services. Sign up today to get connected with affordable, high-quality mental health professionals.