Americans at risk for alcohol-drug interactions

Healthcare providers need to help patients understand how alcohol can interact with their medications, according to a study from the National Institutes of Health and published in the February 2015 issue of Alcoholism: Clinical and Experimental Research.

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Rosalind Breslow, PhD, who led the study, and colleagues analyzed data from more than 26,000 adults aged 20 years and older who participated in the National Health and Nutrition Examination Survey (1999-2010). Participants are asked about alcohol use in the past year and prescription drug use in the past month.

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The research is among the first to estimate the proportion of adult drinkers in the United States who may be mixing alcohol-interactive medications with alcohol. The resulting health effects can range from mild (nausea, headaches, loss of coordination) to severe (internal bleeding, heart problems, difficulty breathing).

Breslow and researchers found that almost 42% of drinkers in the US population used prescription medications that interact with alcohol. Among seniors, the percentage was even higher: 78%. Not only are they more likely to be taking medications in general, but certain alcohol-interactive medications, such as diazepam (Valium), are metabolized more slowly as one ages, creating a larger window for potential interactions.

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The main therapeutic classes of alcohol-interactive medications used were cardiovascular agents (eg, blood pressure drugs), central nervous system agents (eg, sleeping pills, pain medications, muscle relaxers), metabolic agents (eg, medications for diabetes and cholesterol), and psychotherapeutic agents (eg, antidepressants and antipsychotics).

“It’s really important to note that the data don’t tell us exactly how many people actually drank and took their medications within a similar time frame,” said Breslow. “So our results show the proportion of the population at potential [rather than actual] risk.”

The combination of alcohol and prescription medications that interact with alcohol can result in harmful side effects such as falls, traffic accidents, and overdoses and in some cases literally can be deadly, she said.  

Based on recent estimates, about 71% of US adults drink alcohol.

For more on alcohol-medication interactions, see the National Institute on Alcohol Abuse and Alcoholism fact sheet.