Disturbing Trends in Alcohol and Drug Abuse

Transcription

1 Disturbing Trends in Alcohol and Drug Abuse I. Municipal Court Concerns a. Alcohol Offenses i. Chapter 106 ABC 1. Minor in Possession 2. Minor in Consumption 3. DUI ii. Public Intoxication b. Alcohol Related Offenses c. What Can We Do? II. Disturbing Trends 1 a. Mixing Drugs with Alcohol i. Mixing alcohol and medicines can be harmful. Alcohol, like some medicines, can make you sleepy, drowsy, or lightheaded. Drinking alcohol while taking medicines can intensify these effects. You may have trouble concentrating or performing mechanical skills. Small amounts of alcohol can make it dangerous to drive, and when you mix alcohol with certain medicines you put yourself at even greater risk. Combining alcohol with some medicines can lead to falls and serious injuries, especially among older people. 1. Some medications including many popular painkillers and cough, cold, and allergy remedies contain more than one ingredient that can react with alcohol. Read the label on the medication bottle to find out exactly what ingredients a medicine contains. Ask your pharmacist if you have any questions about how TMCEC Regional Judges Seminar - Mark Goodner Notes

2 Disturbing Trends in Alcohol and Drug Abuse alcohol might interact with a drug you are taking. 2. Some medicines contain alcohol. Certain medicines contain up to 10 percent alcohol. Cough syrup and laxatives may have some of the highest alcohol concentrations. 3. Older people are at particularly high risk for harmful alcohol medication interactions. Aging slows the body s ability to break down alcohol, so alcohol remains in a person s system longer. Older people also are more likely to take a medication that interacts with alcohol in fact, they often need to take more than one of these medications. 4. Mixing alcohol and medicines puts you at risk for dangerous reactions. Protect yourself by avoiding alcohol if you are taking a medication and don t know its effect. To learn more about a medicine and whether it will interact with alcohol, talk to your pharmacist or other health care provider. ii. E-cigs and Vaportinis 1. Alcohol is inhaled rather than swallowed. 2. Selling points (from the website) a. smooth and flavorful b. absorbed directly into the bloodstream TMCEC Regional Judges Seminar - Mark Goodner Notes

3 Disturbing Trends in Alcohol and Drug Abuse c. does not go through the digestive tract i. no calories, no carbs, no impurities ii. the effects of consuming alcohol are immediately felt, making it easier to responsibly imbibe d. Vaportinis give more control, shortly after exhaling all of the effects of the alcohol consumed are felt. In contrast, it takes 20 to 30 minutes to feel the full effects of spirits that are swallowed. e. The Vaportini is legal to sell in all states for any establishment with a ìconsumption on Premiseî license. The alcohol consumed through a Vaportini will be detected by a blood alcohol test. 3. Dangers a. The recommended amount of spirits is 1 ounce. One inhales through the straw and holds their breathe for a moment and then exhales. b. Unlike drinking alcohol, where the liquid is metabolized through one s liver, inhaling alcoholic vapors sends ethanol straight to TMCEC Regional Judges Seminar - Mark Goodner Notes

4 Disturbing Trends in Alcohol and Drug Abuse the lungs, the blood stream and ultimately, the brain. c. Leads to rapid intoxication d. Particularly risky for kids because they may not know when to stop inhaling. e. When people drink, the normal sensation when they get more and more drunk is to vomit. It's your body's way of expelling alcohol is to vomit," he wrote. "However your brain can't expel alcohol, so it's extremely dangerous." iii. Pharming Parties 1. Get-togethers where prescription drugs are exchanged and randomly ingested, in order to become intoxicated. a. Fact or Fiction? iv. Alcohol Energy Drinks 1. Caffeinated alcoholic beverages are premixed beverages that contain not only alcohol but also include caffeine and other stimulants. 2. As much caffeine as a large cup of coffee, along with additives like guarana and ginseng that can speed up the central nervous system. 3. High alcohol content, sometimes as high as 12% as compared with 5% for a typical can of beer. TMCEC Regional Judges Seminar - Mark Goodner Notes

5 Disturbing Trends in Alcohol and Drug Abuse Wide-awake drunkenness, where caffeine masks the feeling of drunkenness but does not decrease actual alcohol-related impairment. As a result, you feel less drunk than you really are, which can lead to consumption of even more alcohol or engaging in risky activities like drunk driving. 5. In 2010 the Food and Drug Administration warned companies that the caffeine added to some of their alcoholic beverages makes the products unsafe. 6. Double The Risk: Wake Forest University School of Medicine researchers found that students who mixed alcohol and energy drinks had double the risk of being hurt or injured, requiring medical attention, driving with an intoxicated driver, being taken advantage of sexually, or taking advantage of another sexually. b. They Put it WHERE? i. Alcohol Enemas 1. Introducing alcohol into the rectum and colon via the anus. This method of alcohol consumption is dangerous because it leads to faster intoxication since the alcohol is absorbed directly into the bloodstream and neutralizes the body's ability to reject the toxin by vomiting. TMCEC Regional Judges Seminar - Mark Goodner Notes

6 Disturbing Trends in Alcohol and Drug Abuse III. ii. Tampons 1. Vodka-soaked tampons inserted vaginally to get drunk faster and without having booze on your breath. It's known as "slimming." 2. Snopes.com concluded it was false, but a November 2011 report by KPHO Phoenix included interviews with a police officer and doctor who said they had witnessed cases of it. iii. Eyeballing 1. Those who do it claim that it induces feelings of drunkenness at break-neck speeds, providing an instant high. c. Substances Not Intended for Ingestion i. Hairspray ii. Mouthwash iii. Antifreeze Resources a. b. c. Notes 6 TMCEC Regional Judges Seminar - Mark Goodner

7 Alcohol Facts and Statistics Alcohol Use in the United States: Prevalence of Drinking: In 2012, 87.6 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 71 percent reported that they drank in the past year; 56.3 percent reported that they drank in the past month. 1 Prevalence of Binge Drinking and Heavy Drinking: In 2012, 24.6 percent of people ages 18 or older reported that they engaged in binge drinking in the past month; 7.1 percent reported that they engaged in heavy drinking in the past month. 2 Alcohol Use Disorders (AUDs) in the United States: Adults (ages 18+): Approximately 17 million adults ages 18 and older (7.2 percent of this age group) had an AUD in This includes 11.2 million men (9.9 percent of men in this age group) and 5.7 million women (4.6 percent of women in this age group). 3 About 1.4 million adults received treatment for an AUD at a specialized facility in 2012 (8.4 percent of adults in need). This included 416,000 women (7.3 percent of women in need) and 1.0 million men (8.9 percent of men in need). 4 Youth (ages 12 17): In 2012, an estimated 855,000 adolescents ages (3.4 percent of this age group) had an AUD. This number includes 444,000 females (3.6 percent) and 411,000 males (3.2 percent). 5 An estimated 76,000 adolescents received treatment for an AUD at a specialized facility in 2012 (8.9 percent of adolescents in need). This included 28,000 females (6.3 percent of adolescent females in need) and 48,000 males (11.7 percent of adolescent males in need). 6 Alcohol-Related Deaths: Nearly 88,000 7 people (approximately 62,000 men and 26,000 women 8 ) die from alcoholrelated causes annually, making it the third leading preventable cause of death in the United States. 7 In 2012, alcohol-impaired-driving fatalities accounted for 10,322 deaths (31 percent of overall driving fatalities). 9 NIH... Turning Discovery Into Health National Institute on Alcohol Abuse and Alcoholism

8 Economic Burden: In 2006, alcohol misuse problems cost the United States $223.5 billion. 10 Almost three-quarters of the total cost of alcohol misuse is related to binge drinking. 10 Global Burden: In 2012, 3.3 million deaths, or 5.9 percent of all global deaths (7.6 percent for men and 4 percent for women), were attributable to alcohol consumption. 11 Alcohol contributes to over 200 diseases and injury-related health conditions, most notably alcohol dependence, liver cirrhosis, cancers, and injuries. 12 In 2012, alcohol accounted for 5.1 percent of disability adjusted life years (DALYs) worldwide. 11 Globally, alcohol misuse is the fifth leading risk factor for premature death and disability; among people between the ages of 15 and 49, it is the first. 13 Family Consequences: More than 10 percent of U.S. children live with a parent with alcohol problems, according to a 2012 study. 14 Underage Drinking: Prevalence of Underage Alcohol Use: Prevalence of Drinking: 2 out of 5 15-year-olds report that they have had at least 1 drink in their lives. 15 In 2012, about 9.3 million people ages (24.3 percent of this age group) reported drinking alcohol in the past month (24.7 percent of males and 24 percent of females). 16 Prevalence of Binge Drinking: Approximately 5.9 million people (about 15 percent) ages were binge drinkers (16.5 percent of males and 14 percent of females). 16 Definitions Alcohol Use Disorder (AUD): AUDs are medical conditions that doctors diagnose when a patient s drinking causes distress or harm. The fourth edition of the Diagnostic and Statistical Manual (DSM IV), published by the American Psychiatric Association, described two distinct disorders alcohol abuse and alcohol dependence with specific criteria for each. The fifth edition, DSM 5, integrates the two DSM IV disorders, alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder, or AUD, with mild, moderate, and severe subclassifications. Binge Drinking: NIAAA defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dl. This typically occurs after 4 drinks for women and 5 drinks for men in about 2 hours. 33 The Substance Abuse and Mental Health Services Administration (SAMHSA), which conducts the annual National Survey on Drug Use and Health (NSDUH), defines binge drinking as drinking 5 or more alcoholic drinks on the same occasion on at least 1 day in the past 30 days. 34 Heavy Drinking: SAMHSA defines heavy drinking as drinking 5 or more drinks on the same occasion on each of 5 or more days in the past 30 days. NIAAA s Definition of Drinking at Low Risk for Developing an AUD: For women, low-risk drinking is defined as no more than 3 drinks on any single day and no more than 7 drinks per week. For men, it is defined as no more than 4 drinks on any single day and no more than 14 drinks per week. NIAAA research shows that only about 2 in 100 people who drink within these limits have an AUD. Substance Use Treatment at a Specialty Facility: Treatment received at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center to reduce alcohol use, or to address medical problems associated with alcohol use. Alcohol-Impaired-Driving Fatality: A fatality in a crash involving a driver or motorcycle rider (operator) with a BAC of 0.08 g/dl or greater. Disability Adjusted Life Years (DALYs): A measure of years of life lost or lived in less than full health. Underage Drinking: Alcohol use by anyone under the age of 21. In the United States, the legal drinking age is 21. NIH... Turning Discovery Into Health National Institute on Alcohol Abuse and Alcoholism

9 Prevalence of Heavy Drinking: Approximately 1.7 million people (about 4.3 percent) ages were heavy drinkers (5.2 percent of males and 3.4 percent of females). 16 Consequences of Underage Alcohol Use: Research indicates that alcohol use during the teenage years could interfere with normal adolescent brain development and increase the risk of developing an AUD. In addition, underage drinking contributes to a range of acute consequences, including injuries, sexual assaults, and even deaths. 17 Alcohol and College Students: Prevalence of Alcohol Use: Prevalence of Drinking: In 2012, 60.3 percent of college students ages drank alcohol in the past month compared with 51.9 percent of same-age peers not in college. 18 Prevalence of Binge Drinking: 40.1 percent of college students ages engaged in binge drinking (5 or more drinks on an occasion) in the past month compared with 35 percent of same-age peers not in college. 19 Prevalence of Heavy Drinking: 14.4 percent of college students ages engaged in heavy drinking (5 or more drinks on an occasion on 5 or more occasions per month) in the past month compared with 10.7 percent of same-age peers not in college. 20 Consequences Researchers estimate that each year: 1,825 college students between the ages of 18 and 24 die from alcohol-related unintentional injuries, including motor-vehicle crashes ,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking ,000 students between the ages of 18 and 24 report experiencing alcohol-related sexual assault or date rape. 21 Roughly 20 percent of college students meet the criteria for an AUD. 22 About 1 in 4 college students report academic consequences from drinking, including missing class, falling behind in class, doing poorly on exams or papers, and receiving lower grades overall. 23 Alcohol and Pregnancy: The prevalence of Fetal Alcohol Syndrome (FAS) in the United States was estimated by the Institute of Medicine in 1996 to be between 0.5 and 3.0 cases per 1, More recent reports from specific U.S. sites found the prevalence of FAS to be 2 to 7 cases per 1,000, 24 and the prevalence of Fetal Alcohol Spectrum Disorders (FASD) to be as high as 20 to 50 cases per 1, Alcohol and the Human Body: Among all cirrhosis deaths in 2009, 48.2 percent were alcohol related. The proportion of alcohol-related cirrhosis was highest (70.6 percent) among decedents ages NIH... Turning Discovery Into Health National Institute on Alcohol Abuse and Alcoholism

10 In 2009, alcohol-related liver disease was the primary cause of almost 1 in 3 liver transplants in the United States. 27 Alcohol has been identified as a risk factor for the following types of cancer: mouth, esophagus, pharynx, larynx, liver, and breast. 28 Health Benefits of Moderate Alcohol Consumption: Moderate alcohol consumption, according to the Dietary Guidelines for Americans, is up to 1 drink per day for women and up to 2 drinks per day for men. 29 Moderate alcohol consumption may have beneficial effects on health. These include decreased risk for heart disease and mortality due to heart disease, decreased risk of ischemic stroke (in which the arteries to the brain become narrowed or blocked, resulting in reduced blood flow), and decreased risk of diabetes. 30 In most Western countries where chronic diseases such as coronary heart disease (CHD), cancer, stroke, and diabetes are the primary causes of death, results from large epidemiological studies consistently show that alcohol reduces mortality, especially among middle-aged and older men and women an association which is likely due to the protective effects of moderate alcohol consumption on CHD, diabetes, and ischemic stroke. 31 It is estimated that 26,000 deaths were averted in 2005 because of reductions in heart disease, stroke, and diabetes from the benefits attributed to moderate alcohol consumption. 32 Expanding our understanding of the relationship between moderate alcohol consumption and potential health benefits remains a challenge, and although there are positive effects, alcohol may not benefit everyone who drinks moderately. For more information, please visit: 1 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect2petabs43to htm#tab2.71b 2 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect2petabs43to htm#tab2.46b 3 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect5petabs1to htm#tab5.8a 4 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect5petabs1to htm#tab5.32a 5 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect5petabs1to htm#tab5.5a 6 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect5petabs1to htm#tab5.29a 7 Centers for Disease Control and Prevention. Alcohol use and health. Available at: 8 Centers for Disease Control and Prevention. Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Available at: Default/Report.aspx?T=AAM&P=f6d7eda7-036e b17ffad620e&R=d7a9b303-48e bf47-070a4827e1fd&M=AD96A9C1-285A-44D2-B76D- BA2AE037FC56&F=&D= 9 National Highway Traffic Safety Administration Motor vehicle crashes: Overview. Available at: 10 Centers for Disease Control and Prevention. Excessive drinking costs U.S. $223.5 Billion. Available at: 11 World Health Organization. Global status report on alcohol and health, p. XIV ed. Available at: msb_gsr_2014_1.pdf?ua=1 12 World Health Organization. Global status report on alcohol and health, p. XIII ed. Available at: msb_gsr_2014_1.pdf?ua=1 13 Lim, S.S.; Vos, T.; Flaxman, A.D.; et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, : A systematic analysis for the Global Burden of Disease Study Lancet 380(9859): , PMID: science/article/pii/s Substance Abuse and Mental Health Services Administration (SAMHSA). Data spotlight: Over 7 million children live with a parent with alcohol problems Available at: 15 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect2petabs1to htm#tab2.15b NIH... Turning Discovery Into Health National Institute on Alcohol Abuse and Alcoholism

11 16 Substance Abuse and Mental Health Services Administration (SAMHSA). Results from the 2012 National Survey on Drug Use and Health: Summary of national findings. NSDUH Series H-46., HHS Publication No. (SMA) Rockville, MD: Substance Abuse and Mental Health Services Administration, Available at: samhsa.gov/data/nsduh/2012summnatfinddettables/index.aspx?from=carousel&position=1&date= National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol Alert, No. 67 Underage Drinking, Available at: 18 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect6petabs55to htm#tab6.88b 19 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect6petabs55to htm#tab6.89b 20 Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH). Available at: data/nsduh/2012summnatfinddettables/dettabs/nsduh-dettabssect6petabs55to htm#tab6.90b 21 Hingson, R.W.; Zha, W.; and Weitzman, E.R. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18 24, Journal of Studies on Alcohol and Drugs (Suppl. 16):12 20, PMID: Blanco, C.; Okuda, M.; Wright, C. et al. Mental health of college students and their non-college-attending peers: Results from the National Epidemiologic Study on Alcohol and Related Conditions. Archives of General Psychiatry 65(12): , PMID: Wechsler, H.; Dowdall, G.W.; Maenner, G.; et al. Changes in binge drinking and related problems among American college students between 1993 and 1997: Results of the Harvard School of Public Health College Alcohol Study. Journal of American College Health 47(2):57 68, PMID: pdf/ / Stratton, K., Howe, C., Battaglia, F., eds Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: Institute of Medicine National Academy Press, May, P.A.; Gossage, J.P.; Kalberg, W.O.; et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Developmental Disabilities Research Reviews 15(3): , PMID: Yoon, Y.H., and Yi, H.Y. Surveillance Report #93: Liver Cirrhosis Mortality in the United States, Bethesda, MD: NIAAA, Available at: gov/publications/surveillance93/cirr09.htm 27 Singal, A.K.; Guturu, P.; and Hmoud, B.; et al. Evolving frequency and outcomes of liver transplantation based on etiology of liver disease. Transplantation 95(5): , PMID: (Please note: The almost 1 in 3 figure aggregates the total number of transplants necessitated by alcoholic cirrhosis, alcoholic liver disease plus hepatitis C virus infection, and 40 percent of transplants necessitated by hepatocellular carcinoma.) 28 National Cancer Institute. Cancer Trends Progress Report, Update. Available at: 91&coid=906&mid 29 U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, th Edition, p. 31. Available at: 30 U.S. Department of Agriculture. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, pp. 355, 359. Available at: 31 U.S. Department of Agriculture. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, pp Available at: 32 Danaei, G.; Ding, E.L.; Mozaffarian, D.; et al. The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Medicine 6(4):1 23, PMID: National Institute on Alcohol Abuse and Alcoholism (NIAAA). NIAAA Council Approves Definition of Binge Drinking. NIAAA Newsletter Number 3, Winter Available at: 34 Substance Abuse and Mental Health Services Administration (SAMHSA). Binge Drinking: Terminology and Patterns of Use. Available at: access-resources/binge-drinking-terminology-and-patterns-use NIH... Turning Discovery Into Health National Institute on Alcohol Abuse and Alcoholism July 2014

12 Harmful Interactions mixing alcohol with medicines

13 Harmful interactions May cause DROWSINESS. ALCOHOL may intensify this effect. USE CARE when operating a car or dangerous machinery. You ve probably seen this warning on medicines you ve taken. The danger is real. Mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems, and difficulties in breathing. In addition to these dangers, alcohol can make a medication less effective or even useless, or it may make the medication harmful or toxic to your body. Some medicines that you might can result. The list gives the brand never have suspected can react with name by which each medicine is alcohol, including many medications commonly known (for example, which can be purchased over-the- Benadryl ) and its generic name or counter that is, without a prescription. active ingredient (in Benadryl, this Even some herbal remedies can is diphenhydramine). The list have harmful effects when combined presented here does not include all with alcohol. the medicines that may interact This pamphlet lists medications harmfully with alcohol. Most imthat can cause harm when taken with portant, the list does not include all alcohol and describes the effects that the ingredients in every medication. 1

14 s typically are safe and effective when used appropriately. Your pharmacist or other health care provider can help you determine which medications interact harmfully with alcohol. D I D Y O U K N O W Mixing alcohol and medicines can be harmful. Alcohol, like some medicines, can make you sleepy, drowsy, or lightheaded. Drinking alcohol while taking medicines can intensify these effects. You may have trouble concentrating or performing mechanical skills. Small amounts of alcohol can make it dangerous to drive, and when you mix alcohol with certain medicines you put yourself at even greater risk. Combining alcohol with some medicines can lead to falls and serious injuries, especially among older people. MEDICINES MAY HAVE MANY INGREDIENTS Some medications including many popular painkillers and cough, cold, and allergy remedies contain more than one ingredient that can react with alcohol. Read the label on the medication bottle to find out exactly what ingredients a medicine contains. Ask your pharmacist if you have any questions about how alcohol might interact with a drug you are taking. SOME MEDICINES CONTAIN ALCOHOL Certain medicines contain up to 10 percent alcohol. Cough syrup and laxatives may have some of the highest alcohol concentrations. ALCOHOL AFFECTS WOMEN DIFFERENTLY Women, in general, have a higher risk for problems than men. When a woman drinks, the alcohol in her bloodstream typically reaches a higher level than a man s even if both are drinking the same amount. This is because women s bodies generally have less water than men s bodies. Because alcohol mixes with body water, a given amount of alcohol is more concentrated in a woman s body than in a man s. As a result, women are more susceptible to alcohol-related damage to organs such as the liver. 2

15 OLDER PEOPLE FACE GREATER RISK Older people are at particularly high risk for harmful alcohol medication interactions. Aging slows the body s ability to break down alcohol, so alcohol remains in a person s system longer. Older people also are more likely to take a medication that interacts with alcohol in fact, they often need to take more than one of these medications. TIMING IS IMPORTANT Alcohol and medicines can interact harmfully even if they are not taken at the same time. R E M E M B E R... Mixing alcohol and medicines puts you at risk for dangerous reactions. Protect yourself by avoiding alcohol if you are taking a medication and don t know its effect. To learn more about a medicine and whether it will interact with alcohol, talk to your pharmacist or other health care provider. Commonly Used Medicines (Both Prescription and Over-the-Counter) That Interact With Alcohol Symptoms/ Disorders (Brand name) (Generic name) Some possible reactions with alcohol Allergies/ Alavert Loratadine Drowsiness, colds/flu Atarax Hydroxyzine dizziness; Benadryl Diphenhydramine increased risk Clarinex Desloratadine for overdose Claritin, Loratadine Claritin-D Dimetapp Brompheniramine Cold & Allergy Sudafed Chlorpheniramine Sinus & Allergy Triaminic Chlorpheniramine Cold & Allergy Tylenol Chlorpheniramine Allergy Sinus Tylenol Chlorpheniramine Cold & Flu Zyrtec Cetirizine Angina Isordil Isosorbide Rapid heartbeat, (chest pain), Nitroglycerin sudden changes coronary in blood pressure, heart disease dizziness, fainting 3

16 Symptoms/ Disorders (Brand name) Commonly Used Medicines (Both Prescription and (Generic name) Some possible reactions with alcohol Anxiety Ativan Lorazepam Drowsiness, dizziness; and BuSpar Buspirone increased risk for epilepsy Klonopin Clonazepam overdose; slowed or Librium Chlordiazepoxide difficulty breathing; Paxil Paroxetine impaired motor control; Valium Diazepam unusual behavior; Xanax Alprazolam memory problems Herbal preparations (Kava Kava) Liver damage, drowsiness Arthritis Celebrex Celecoxib Ulcers, stomach Naprosyn Naproxen bleeding, liver Voltaren Diclofenac damage Attention and concentration (Attention deficit/ hyperactivity disorder) Adderall Concerta, Ritalin Dexedrine Focalin Strattera Vyvanse Amphetamine/ dextro-amphetamine Methylphenidate Dextroamphetamine Dexmethylphenidate Atomoxetine Lisdexamfetamine Dizziness, drowsiness, impaired concentration (methylphenidate, dexmethylphenidate); possible increased risk for heart problems (amphetamine, dextroamphetamine, lisdexamfetamine); liver damage (atomoxetine) Blood clots Coumadin Warfarin Occasional drinking may lead to internal bleeding; heavier drinking also may cause bleeding or may have the opposite effect, resulting in possible blood clots, strokes, or heart attacks Cough Delsym, Dextromethorpan Drowsiness, dizziness; Robitussin Cough increased risk Robitussin A C Guaifenesin + codeine for overdose 4

17 Over-the-Counter) That Interact With Alcohol Symptoms/ Disorders (Brand name) (Generic name) Depression Abilify Aripriprazone Anafranil Clomipramine Celexa Citalopram Clozaril Clozapine Cymbalta Duloxetine Desyrel Trazodone Effexor Venlafaxine Elavil Amitriptyline Geodon Ziprasidone Invega Paliperidone Lexapro Escitalopram Luvox Fluvoxamine Nardil Phenelzine Norpramin Desipramine Parnate Tranylcypromine Paxil Paroxetine Pristiq Desevenlafaxine Prozac Fluoxetine Remeron Mirtazapine Risperdal Risperidone Seroquel Quetiapine Serzone Nefazodone Symbyax Fluoxetine/Olanzapine Wellbutrin Bupropion Zoloft Sertraline Zyprexa Olanzapine Herbal preparations (St. John s Wort) Diabetes Diabinese Chlorpropamide Glucotrol Glipizide Glucophage Metformin Glynase, Glyburide DiaBeta, Micronase Orinase Tolbutamide Tolinase Tolazamide Enlarged Cardura Doxazosin prostate Flomax Tamsulosin Hytrin Terazosin Minipress Prazosin Some possible reactions with alcohol Drowsiness, dizziness; increased risk for overdose; increased feelings of depression or hopelessness (all medications); impaired motor control (quetiapine, mirtazapine); increased alcohol effect (bupropion); liver damage (duloxetine) Monoamine oxidase inhibitors (MAOIs), such as tranylcypromine and phenelzine, when combined with alcohol, may result in serious heartrelated side effects. Risk for dangerously high blood pressure is increased when MAOIs are mixed with tyramine, a byproduct found in beer and red wine Abnormally low blood sugar levels, flushing reaction (nausea, vomiting, headache, rapid heartbeat, sudden changes in blood pressure); symptoms of nausea and weakness may occur (metformin) Dizziness, light headedness, fainting 5

18 Symptoms/ Disorders (Brand name) Heartburn, Axid Nizatidine indigestion, Reglan Metoclopramide sour stomach Tagamet Cimetidine Zantac Ranitidine High blood Accupril Quinapril pressure Calan Verapamil Capozide Hydrochlorothiazide Cardura Doxazosin Catapres Clonidine Cozaar Losartan Hytrin Terazosin Lopressor HCT Hydrochlorothiazide Lotensin Benzapril Minipress Prazosin Norvasc Amlodipine mesylate Prinivil, Lisinopril Zestril Vaseretic Enalapril Commonly Used Medicines (Both Prescription and (Generic name) Some possible reactions with alcohol Rapid heartbeat; increased alcohol effect; sudden changes in blood pressure (metoclopramide) Dizziness, fainting, drowsiness; heart problems such as changes in the heart s regular heartbeat (arrhythmia) 6 High Advicor Lovastatin + Niacin cholesterol Altocor Lovastatin Crestor Rosuvastatin Lipitor Atorvastatin Mevacor Lovastatin Niaspan Niacin Pravachol Pravastatin Pravigard Pravastatin + Aspirin Vytorin Ezetimibe + Simvastatin Zocor Simvastatin Infections Acrodantin Nitrofurantoin Flagyl Metronidazole Grisactin Griseofulvin Nizoral Ketoconazole Nydrazid Isoniazid Seromycin Cycloserine Tindamax Tinidazole Zithromax Azithromycin Liver damage (all medications); increased flushing and itching (niacin), increased stomach bleeding (pravastatin + aspirin) Fast heartbeat, sudden changes in blood pressure; stomach pain, upset stomach, vomiting, headache, or flushing or redness of the face; liver damage (isoniazid, ketoconazole)

19 Over-the-Counter) That Interact With Alcohol Symptoms/ Disorders (Brand name) (Generic name) Mood Depakene, Valproic acid stabilizers Depakote Eskalith, Lithium Eskalith CR, Lithobid Muscle pain Flexeril Cyclobenzaprine Soma Carisoprodol Nausea, Antivert Meclizine motion Dramamine Dimenhydrinate sickness Phenergan Promethazine Pain Advil Ibuprofen (such as Aleve Naproxen muscle ache, Excedrin Aspirin, minor arthritis Acetaminophen pain), fever, Motrin Ibuprofen inflammation Tylenol Acetaminophen Seizures Dilantin Phenytoin Horizant, Gabapentin Neurontin Keppra Levetiracetam Klonopin Clonazepam Lamictal Lyrica Tegretol Topamax Trileptal Phenobarbital Lamotrigine Pregabalin Carbamazepine Topiramate Oxcarbazepine Barbiturates Some possible reactions with alcohol Drowsiness, dizziness; tremors; increased risk for side effects, such as restlessness, impaired motor control; loss of appetite; stomach upset; irregular bowel movement; joint or muscle pain; depression; liver damage (valproic acid) Drowsiness, dizziness; increased risk of seizures; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems Drowsiness, dizziness; increased risk for overdose Stomach upset, bleeding and ulcers; liver damage (acetaminophen); rapid heartbeat Drowsiness, dizziness; increased risk of seizures (levetiracetam, phenytoin); unusual behavior and changes in mental health (such as thoughts of suicide) (topiramate) 7

20 Commonly Used Medicines (Both Prescription and Over-the-Counter) That Interact With Alcohol Symptoms/ Disorders (Brand name) (Generic name) Severe pain Darvocet N Propoxyphene from injury, Demerol Merepidine postsurgical Fiorinal Butalbital + codeine care, oral with codeine surgery, Percocet Oxycodone migraines Vicodin Hydrocodone Some possible reactions with alcohol Drowsiness, dizziness; increased risk for overdose; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems Sleep Ambien Zolpidem problems Lunesta Eszopiclone Prosom Estazolam Restoril Temazepam Sominex Diphenhydramine Unisom Doxylamine Herbal preparations (chamomile, valerian, lavender) Drowsiness, sleepiness, dizziness; slowed or difficulty breathing; impaired motor control; unusual behavior; memory problems Increased drowsiness 8

21 Additional resources MedlinePlus A service of the U.S. National Library of Medicine and the National Institutes of Health. druginformation.html Provides information on prescription and over-the-counter medications. National Institute on Alcohol Abuse and Alcoholism Phone number: Makes available free informational materials on alcohol use, alcohol abuse, and alcoholism. U.S. Food and Drug Administration Center for Drug Evaluation and Research Phone numbers: Main FDA for general inquiries: INFO FDA ( ) Drug Information: To submit a report about Adverse Drug Reaction: Medwatch: FDA 1088 Provides information on prescription and over-the-counter medications, consumer drug information, and reports and publications. 9

22 NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM NIH... Turning Discovery Into Health NIH Publication No Published 2003 Revised 2014