While everyone, in the back of their minds, “knows” it’s not smart to mix your drinks and medications, do you really know the dangers and potentially lethal consequences of combining alcoholic drinks and prescription painkillers?

It is all too easy to minimize the risks of combining medications with a glass of beer or wine, let alone a potent cocktail, which can contain several types of alcohol of unknown strengths. Sadly, history is littered with too many tragic examples of famous people who fatally combined prescription painkillers and alcohol.

Increasing the Risks

It is estimated that up to 60% of patients using prescription painkillers also drink, with up to 5% having up to three drinks at any one time. Given these statistics, it is important to understand the effects of both painkillers and alcohol and what the increased risks are when they are combined so that you can make more informed choices.

Alcohol can intensify the side-effects of some medications and it can also interfere with how the medication is designed to work in your body. Both of these effects can be dangerous to your health due to a number of factors.

Both alcohol and painkillers are depressants as they work on the central nervous system. That means that they both slow your breathing down. Combined, they can slow your breathing down to dangerous levels, suppressing your cough reflex, and cause you to choke and die. They are also sedatives which can cause dizziness and drowsiness, increasing the risk of accidents and falls.

The combination of alcohol and some prescription painkillers, particularly those containing acetaminophen, can cause long-term liver damage and failure.

Men and women tend to metabolize alcohol at different rates, with women taking longer to metabolize a drink than men. This is why, in general, women who consume alcohol are more likely to be diagnosed with damage to their kidneys and other organs than men. Age also plays a major role in how quickly and effectively your body metabolizes alcohol. The longer alcohol remains in your body, the more it can interfere with medications.

One of the most concerning side-effects of mixing your medications with alcohol relate to an increased risk of upper gastrointestinal (GI) bleeding. Symptoms of GI problems include stomach ache, indigestion, nausea, diarrhea, black, tarry stools, a persistently upset stomach, vomiting blood, and vomit with a consistency of coffee grounds. If you experience any of these symptoms while taking painkillers, see your doctor immediately, as intestinal or gastric perforation is a life-threatening event.

Prescription painkillers can become highly addictive. Between 3% and 5% of patients become addicted to their painkillers, while others may become physically dependent on their pain medication, experiencing severe withdrawal symptoms when their pills run out, or finding that they need a higher dosage to get the same pain relief.

Less common side effects of taking prescription painkillers include increase blood pressure and headaches and potentially an increase in asthma symptoms. High doses or long-term usage of painkilling medications can lead to strokes, heart attacks or kidney failure. Again, with all of these symptoms, the consumption of alcohol is likely to aggravate and increase these effects.

Avoiding the Worst of the Side-effects

Assess your own health track record to determine whether drinking while taking prescription painkillers will present problems. If you have had issues in the past with drowsiness, gastric complaints, reduced mental clarity or dizziness while taking painkillers, best to forgo the alcohol.

Taking painkillers with a glass of milk or food can reduce stomach-related side-effects.

Opiod-based Prescription Painkillers

Opiod-based painkillers are stronger painkillers, usually available only on prescription. They are often combined with paracetamol. Opiod painkillers can cause low blood pressure (hypotension) and drowsiness. Alcohol can increase these side-effects, so avoid drinking altogether while taking opiod painkillers if you experience such effects.

Types of Opiod-based Prescription Painkillers

Common types of prescription painkillers include codeine, dihydrocodeine, tramadol, morphine, pethidine.

DO NOT Take Painkillers, Drink and then Drive!

Particularly, avoid drinking alcohol when you need to drive as the combination of opiod painkillers and alcohol will make you drowsy, making it more difficult to concentrate and stay alert while on the wheel. If you have had a drink while taking painkillers, be safe and responsible and get someone else to drive you home.

Over-the-counter Medications and Alcohol

While it can be OK to consume a small amount of alcohol while taking over-the-counter medications such as aspirin, ibuprofen and paracetamol, moderation is still strongly recommended. You particularly want to avoid driving when you have taken a painkiller and had a drink, as the combination can reduce your concentration and make you drowsy, and impact on your ability to drive safely.