Pain Medication & Alcohol – A Dangerous Mixology

pills and alcoholIt is always wise to be careful about drinking alcohol when taking any medication.  All medications can interact with other substances you ingest. For example, meds can interact with vitamin supplements, and even certain foods that you eat.

It is no surprise then that one should be careful with mixing alcohol and medications (including pain medications). In this article, I will discuss some of the most common medications and how they interact with alcohol in the body.

Opioids & Pain Meds

The most common concern about alcohol is with opioid/narcotic pain medications.  These drugs include:

  • Percocet
  • Vicodin
  • Oxycodone
  • Oxycontin
  • Morphine
  • Codeine
  • Fentanyl

All narcotics can affect your cognitive ability and judgment, and alcohol can have the same effect.  The combination of the two is not always additive, and the alcohol can greatly diminish both of the above.  Thus your judgment could become very poor, and the toxicity increased such that either drug can essentially cause death.  If one is on a stable dose of narcotic, people can usually function without impairment.  An occasional alcoholic drink should be safe. You may feel more impaired then usual, but you should not be toxic.

Neuropathic Meds

Many pain patients also use neuropathic medications like gabapentin, or other seizure type drugs, and antidepressants.  These drugs also can affect cognition, and mixing with alcohol can worsen this ability.  Alcohol is metabolized and broken down in the body by the liver, and the same process is also used by many of these medications.  Therefore, alcohol and these medications can also interact in unpredictable ways.  Again, if you have been on these medications long-term, then an occasional drink is likely safe, but heavy drinking is not a good idea.

Ibuprofen, Tylenol, & other Over the Counter Meds

Over the counter pain medications such as ibuprofen and acetaminophen/Tylenol are generally very safe if taken as directed.  Unfortunately, people often take a little more than directed in the hopes that they will work better.  Mixing alcohol with these drugs can be very dangerous.  Anti-inflammatories like ibuprofen can cause stomach irritation. Mixing them with alcohol can cause severe ulcers and stomach bleeding.  Acetaminophen alone can easily be toxic to the liver. Mixing this with alcohol has led to fatal liver failure.

The answer to drinking alcohol with pain medications is not simple.  If one takes their medications only as directed, and has been stable on them, then having an occasional alcoholic beverage, not daily and not more than one, should be safe.  Your judgment, memory, and cognition could be affected even with one drink, and you may not be safe to drive, but it should not be toxic to the body.