How do these substances interact?
Let’s be honest… when we’re prescribed medication and given a stack of paper with never-ending cautionary instructions, do we read all of it (if any)? Probably not. A lot of people who take medication also drink alcohol whether it be consumed in small or large amounts casually or regularly. Many medications interact with alcohol when mixed, and this isn’t exclusive to prescription drugs, it also includes over the counter medications that we don’t think twice about taking. The interaction is a two-way street, meaning that a medication can change the side effects of alcohol, or alcohol can change the way medication works in the body!
With some medications, alcohol can change how that medication is absorbed in the digestive system and make it less effective (1). With others, alcohol can increase the amount of a medication that enters the bloodstream and create a toxic (potentially lethal) effect (1). This means that existing side effects of a particular medication could be enhanced, or new side effects could pop up (1)! For example, if sleepiness or slowed breathing are side effects of a medication, mixing it with alcohol would be toxic and/or life-threatening (1). Keep in mind that not all medications will specify if they can be mixed with alcohol, so it’s always best to ask your pharmacist or a doctor. There is an infinite number of medications that interact with alcohol, but let’s talk about some of the ones that are more common.
Birth Control Pill
Let’s start with hormonal oral contraceptives (AKA birth control pills). Thankfully, alcohol doesn’t directly change the function or effectiveness of the pill, but the pill can alter the way alcohol is distributed in the body (2)! When mixed, alcohol could be eliminated from the bloodstream at a slower rate than when consumed alone because the pill contains hormones that can change the body’s water distribution (2). This leads to an increased blood alcohol concentration, intoxication level, which, among other potential side effects, increases the risk of nausea (2). If you take your birth control pill and vomit from drinking alcohol a couple of hours later, the pill might not be fully absorbed, and your chances of getting pregnant are higher (2).
SSRIs and Antidepressants
This varies depending on the specific type of medication, but generally, mixing alcohol with antidepressants can worsen existing depression symptoms and/or medication side effects (1). SSRIs (selective serotonin reuptake inhibitors) are a commonly prescribed type of antidepressant medication, and although they’re safer to consume with alcohol than other types of antidepressants, mixing these two substances should be done with caution (2, 3). The side effects of SSRIs (i.e. impaired reflex, difficulty focusing, intense fatigue/sedation, etc.) are heightened when alcohol is thrown into the mix, even if you’ve never felt these side effects before (3)! Serotonin is needed in the body, but too much of it can cause symptoms of serotonin syndrome such as muscle spasms, increased blood pressure, restlessness, sweating, and so on (4). The initial warm and fuzzy feeling you get when you have a drink is your serotonin level spiking, and in combination with SSRIs, you might be at risk of serotonin syndrome (4). It’s super important to note that stopping your prescription to drink alcohol is not something you should do because this can cause other negative side effects or potentially worsen your diagnosed condition (4)!
Benzodiazepines
Benzodiazepines are prescription medications that are usually used to treat anxiety disorders, but they can also be used to treat insomnia (5). The combination of mixing alcohol and benzodiazepines is not safe because both substances are depressants -- meaning that they function to repress your nervous system and level of consciousness (6). This combination will slow your breathing, make you drowsy, and increase dizziness (5). There is a risk of overdose, which can look like impaired breathing, speech, strength, heart rate, and/or loss of consciousness (5). Because of the severe interaction between alcohol and benzodiazepines, it’s recommended that the two substances are not mixed (5, 6).
Talk to a physician or pharmacist
Birth control pills, SSRIs, and benzodiazepines are just a few of many medications that interact with alcohol. The list of medications goes on and on, and the way you experience negative interactions will depend on other medications and underlying health conditions. Basically, you should always talk to a physician or pharmacist about your medication in relation to alcohol, even if you only drink small amounts in moderation. If you need assistance connecting with a health professional so you can ask questions about your medication (whether it’s over the counter or prescription), please reach out to us by emailing outreach@southhousehalifax.ca!
Disclaimer: Please note that this article is for informational purposes only and should not be used to substitute medical or treatment advice. Always seek out the advice of a physician or licensed health provider regarding your health and/or substance use.
Sources
Weathermon, R., & Crabb, D. (1999). Alcohol and medication interactions. Alcohol Research and Health, 23(1), 40-54.
Holland, K. (2018). Can you drink alcohol while taking birth control? https://www.healthline.com/health/womens-health/birth-control-and-alcohol
The Recovery Village. (2020). Alcohol and SSRIs. https://www.therecoveryvillage.com/alcohol-abuse/faq/alcohol-and-ssri/
Mayo Clinic. (2019). Serotonin syndrome. https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
Centre for Addition and Mental Health. (2012). Anti-anxiety medications (benzodiazepines). https://www.camh.ca
American Addiction Centers. (2020). Dangers of combining benzos and alcohol. https://americanaddictioncenters.org/benzodiazepine/and-alcohol