121.jpg bar Title: Drugs & Alcohol: Simple Facts About Alcohol-Drug Combinations
Author: Christina Dye
Publisher: Do It Now Foundation
Publication Date: February 2011
Catalog Number: 121

..The Simple Facts

There are hundreds of studies, crammed with millions of words, examining the subject of alcohol-drug interactions
from every conceivable angle. Still, if you had to summarize them all, you could do it with a single word: Don't.

Because the simple fact is that alcohol is a drug and, like every other drug, has potential for risks, both large and small.

And when it's used with other drugs, the risk index for booze jumps right off the chart. Just consider:

  • Government reports rank alcohol-drug combinations as the leading cause of drug-related deaths in the United States, and have for decades.
  • Complications caused by drinking-and-drug interactions sent 497,987 Americans to hospital emergency rooms in 2009 alone for poisoning-overdose treatment.

Those are pretty simple facts. Want another?

Then try this one: A majority of all the poisonings and overdoses that take place every year are accidents, plain and simple.

They involve normal, everyday people using normal, everyday medicines-folks who just didn't realize that Drink A (a Tequila Mockingbird, say, from the local Mai Tai Hut) interacts with Drug B (Flagyl®, for example) to produce Effect C (cramps, vomiting) until after it did.

That's why we've put together this pamphlet. Because the hardest fact to swallow is this: Most drug-and-alcohol mishaps could be avoided if the people involved only knew what might happen before it did happen.

The fact that they often don't only makes the rest of what we'll be talking about in this pamphlet that much more critical.

Sound simple enough? Good.

Stick around. It keeps getting simpler.

..Simple Fact #1: Drinking and downers don't mix.

Simple Fact #1 flows from Funny Fact #1 (as funny as these facts ever get, anyway) of this pamphlet, which is that one and one doesn't always equal two.

Oh, it does on a calculator, but that's because calculators can't calculate all the possible outcomes of all the dumb things that people do.

And one of the dumbest things that people ever do centers around one of the most critical times that one and one doesn't equal two: When somebody adds the effects of booze to other depressant drugs.

That's because alcohol is a depressant, just like tranquilizers and sleeping pills. And like other downers, it slows bodily functions, including breathing and heart rate. And when people drink enough (or combine too much alcohol with too many downers), things slow down so much that they stop altogether.

Why? Because alcohol and downers compete for the same system of liver enzymes that break down drugs and flush them from the body.

That means when two or more downers are in play at the same time, the liver can't handle the load. Result: Drug molecules are reabsorbed and recirculated throughout the body.

That's when problems really kick in.

The scientific name for this process is synergism. It means that the effects of drugs taken together can be very different than the effects they produce solo.

The difference can be like night and day. In fact, it can even determine whether a person makes it through the night to ever see another day.

..Simple Fact #2: Smoking doesn't mix with anything.

Sniff the air inside almost any bar and you'll immediately bump into one of the most common alcohol-drug combinations: booze and cigarettes.

And according to recent studies, it may also be one of our most dangerous.

Because researchers now believe that drinking increases absorption of cancer-causing tobacco by-products in the body. Recent studies have shown a greater risk of cancers of the mouth, neck, and throat among drinkers who also smoke. And alcoholics who smoke heavily suffer higher levels of these cancers than heavy smokers who don't drink.

Risks linked to smoking and drinking don't stop with cigarettes, either. Today, scientists warn that an increased risk of cancer may also be linked to marijuana and alcohol, since pot contains many of the same cancer-causing chemicals as tobacco.

Long-term risks aside, though, alcohol and pot pose a multitude of immediate problems, with effects that can turn a night out on the town into a night of just being plain out of it.

For one thing, each can reduce coordination and concentration and slow reaction time, all critical skills if you're performing complex tasks -- driving, for example.

In addition, both booze and pot can impair visual "tracking" ability, making it harder for a smoker or drinker to follow a moving object or perceive changes and movement in peripheral vision.

Those are just some of the factors that make piling a pot high on top of a booze buzz potentially risky.

And the risk is needlessly compounded when a stoned drinker does something really dumb -- like sliding behind the wheel of a car.

..Simple Fact #3: Medicine doesn't make it as a mixer.

A hundred years ago, alcohol was the number one all-purpose cure-all in the country, the "secret" ingredient in any number of patent medicines and prescription potions.

Today, alcohol isn't considered a cure or treatment for anything, or used at all medicinally, except as an ingredient in some cough and flu preparations.

Because the fact is that alcohol can alter the way medicines work and often blocks or decreases their therapeutic action.

Antibiotics (a group that includes such common drugs as penicillin and tetracycline) tend to lose their effectiveness when mixed with alcohol.

Other medications (including such drugs as metronidazole, or Flagyl®) can interact violently with alcohol, producing a set of unexpected (and unwelcome) side effects, such as cramps, vomiting, and headaches.

And those kinds of effects can be (or fast become) a bigger problem than the original.

Want to avoid problems altogether? Just do the math -- and remember to subtract, rather than add.

..Simple Fact #4: Up isn't always the opposite of down.

The best recipe for sobering up is hot coffee and a cold shower, right?

In a word, no. In fact, dosing a drunk with caffeine, the main stimulant in coffee, is little more than a time-honored waste of time.

After throwing down a few cups of Brazil's Best, a drinker may be wide awake -- but every bit as drunk as before. 

One study even suggests that following up a liquor-ish late-night with an early-morning cup of joe may slow response time even more than booze alone.

Stronger stimulants, such as cocaine or amphetamines, don't straighten out a drinker, either. (They can even make things worse: Check out the "Simple Fictions" listed in the box below for more.)

Even worse, they can trick users into believing that they're speeding toward sobriety.

Why? Because stimulants temporarily mask the depressant effects of liquor, giving drinkers a false sense of security without improving coordination or concentration, or driving skills, for that matter.

Alcohol/stimulant combinations cause other problems, too, including increased blood pressure, tension, and jitters.

These effects may not always be serious in themselves, but they can contribute to a number of potential problems that nobody wants or needs.

..Simple Fact #5: It's easier to prevent problems than fix them.

The truth is that there's no real trick to avoiding problems with drugs and alcohol.

In fact, staying out of trouble is basically a simple matter of applying common sense about what you put in your body and when.

It's an old adage, but it's as true now as ever: An ounce of prevention can prevent a ton of pain.

To reduce your risk of problems with the drugs that you take (or may be taking in the future), always remember:

  • Tell your doctor about any drugs you're taking.
  • Follow instructions carefully. Be sure you understand how and when to take any drug and that you're aware of potential side effects.
  • If you drink, find out if it's safe to drink while taking a prescription drug. If you're not sure, assume that it's not okay-and don't do it.

Because the final simple fact about alcohol/drug combinations is that staying alive and staying healthy starts with staying smart.

Accidents can happen. But they don't happen as often to people who are smart enough to avoid them.

And that's the simplest fact of all.

..Sidebar1 | Rumors & Reality

Rumor: Beer and wine cause fewer "serious" problems than hard liquor.

Reality: All alcoholic beverages contain about the same amount of alcohol. Beer and wine contain more water, but have the same potential for problems.

Rumor: Cocaine and alcohol cancel each other out, enabling party people to stay straight longer.

Reality: They might think they're straight, but they're not. In fact, the body converts the breakdown products of cocaine and alcohol into a different chemical, cocaethylene, which is twice as deadly as cocaine is all by itself.

Rumor: If you take aspirin before drinking, you can avoid a hangover.

Reality: Aspirin increases the stomach's absorption of alcohol, particularly when taken an hour or so before drinking. If anything, it increases the odds of a hangover.

..Sidebar 2 | Bomb Squad: Booze Lights Their Fuse

Drug Class Trade Name(s) Effects with Alcohol
Anti-Alcohol Antabuse® Severe reactions to even small amounts: headache, nausea, convulsions, coma, death.
Penicillin, Cyantin®
Reduces the drugs' therapeutic effectiveness.
Elavil®, Prozac®, Tofranil®,
Increased central nervous system (CNS) depression and blood pressure changes. Combination use of alcohol with MAO inhibitors can trigger massive increase in blood pressure, resulting in brain hemorrhage and death.
Allerest®, Dristan®
Drowsiness and CNS depression. Impairs driving ability.
Anacin®, Excedrin®
Can intensify alcohol's effects. Irritates stomach lining. May cause gastrointestinal pain, bleeding.
Valium®, Ativan®, Xanax®
Dangerous CNS depression, loss of coordination, coma. High risk of overdose and death.
heroin, codeine, Darvon®
Serious CNS depression. Possible respiratory arrest and death.
amphetamine, cocaine
Masks the depressant action of alcohol. May increase both blood pressure and physiological tension. Increases risk of overdose.

This is one in a series of publications on drugs, behavior, and health by Do It Now Foundation.
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