People often wonder if it is okay to take painkillers (analgesics) while consuming alcohol. The answer to this question depends on the classification which a particular drug belongs to. That said, combining alcohol and pain relief pills is generally not advised since alcohol affects the entire body, and serious adverse reactions can occur.

Painkillers and Alcohol
Common OTC painkillers include ibuprofen, acetaminophen, naproxen and aspirin.

Ibuprofen, sold as Motrin or Advil, poses little or no harmful effects when combined with alcohol, given that it is taken as advised by the manufacturer. However, the drug can cause stomach irritations or upper gastrointestinal bleeding on its own, so short-term use is advised.

Acetaminophen, commonly known as Tylenol, increases an individual’s kidney disease risk by over 100 percent when combined with a very small amount of alcohol. Acetaminophen use, with or without alcohol, has been cited as the number one cause of liver failure in the United States.

Naproxen sodium, also called Aleve, is generally considered to be safe for use when consuming alcohol. However, like ibuprofen, naproxen sodium carries a risk of stomach bleeding and should be used in moderation.

Aspirin, sold under various brand names, can also cause stomach bleeding. Additionally, a study done by the Bronx Veterans Affairs Medical Center in 1990 showed that taking two tablets of aspirin one hour before drinking caused blood alcohol levels to spike 30 percent higher than levels found from drinking alone. This happens because aspirin interferes with the action of an enzyme called alcohol dehydrogenase that is found in the stomach lining. This enzyme breaks down a portion of each drink as it is consumed before it enters the bloodstream, causing the spike.

According to Dr. Charles S. Lieber, one of the co-authors of the study, “This is a significant interaction, and people should be aware of it. If they know from past experience that a small amount of alcohol doesn’t interfere with their ability to drive or operate machinery, they may be in danger if they have taken aspirin as well.”

While mixing alcohol with non-prescription drugs can potentially cause harm, there are even more hazardous results when someone combines prescription painkillers with alcohol.

Prescription painkillers are most commonly opioid drugs. Prescription opioids include hydrocodone, oxycodone and meperidine. Prescription opioids have a chemical composition that is similar to heroin, making their effects very similar as well. By affecting circuitry in the brain, they elicit euphoric feelings and enhance the pleasure/reward centers. People who were prescribed opioids as a means of pain management may find themselves craving the drugs over time. This can lead to addiction and dependency, and negatively impacting the health of the individual. If alcohol use is present as well, those effects can be greatly exacerbated.

Additionally, there is an interplay between the body’s respiratory and central nervous systems when alcohol and painkillers are used at the same time. This interaction can cause serious breathing impairment. Additionally, liver damage, which is already a concern for people who drink alcohol, is complicated due to the acetaminophen found in some of these drugs.

Finally, aside from these effects, other body parts such as the heart, brain and pancreas can be seriously damaged by combining alcohol with any type of painkiller. Due to the risks associated with this combination, mixing the use of alcohol and painkillers of any kind is strongly discouraged.

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