Arming yourself with strategies and tips can help you or a loved one take small steps towards big results.
Is it OK to drink while on medication?
If you’re taking medication, always consult with your doctor or pharmacist if you think you might want to drink any alcohol.
You should always consult your doctor or pharmacist about whether it is safe to drink alcohol if you are on medication. This page provides general information, but it isn’t a substitute for professional medical advice – so it’s essential to check. Alcohol interacts with some medications. Depending on what you’re taking and your health condition, drinking can make medication less effective, or lead to dangerous health consequences. There are also medications that don’t have harmful interactions with alcohol – but it’s important to check before consuming alcohol, to ensure you’re not putting yourself at risk. And whether you’re taking any medication or not, it’s important to stick to the UK Chief Medical Officers’ low risk drinking guidelines. This means no more than 14 units a week, whether you’re male or female, spread over three or more days, with several drink-free days every week – and no bingeing.
How alcohol affects some medicines
A few specific antibiotics affect how the body processes alcohol. This can lead to very unpleasant and sometimes dangerous consequences after a small amount of alcohol, including severe vomiting and raised temperature. So always check with your doctor or pharmacist before you start your course of antibiotics if it is OK to have even one drink or not. Your body breaks down and absorbs different medications in different ways. Drinking alcohol at the same time your body is processing medicine can affect the speed it’s broken down inside you – in some cases increasing the effect of the medicine and decreasing it in others. It’s also known that older adults are particularly vulnerable to adverse effects from consuming alcohol alongside their medication. 1
Anyone taking long-term medication should be careful about drinking alcohol, as the two can interact and reduce the effectiveness of the treatment, or lead to serious side-effects. That’s why you should always read the leaflet for any medication you’re taking, and consult your doctor or pharmacist for further advice. 2
Alcohol and antibiotics 3
You should never drink alcohol while taking certain types of antibiotics. This is because some antibiotics interfere with the breakdown of alcohol in the body, leading to serious side effects including nausea, vomiting, flushing of the skin, accelerated heart rate, dizziness, drowsiness. Two examples of antibiotics that are never safe to combine with alcohol are metronidazole and tinidazole, but there are others too. That’s why it’s vital to read the leaflet and check with your pharmacist or doctor, if necessary, before consuming any alcohol when you’re taking antibiotics. You might also be advised to avoid alcohol for up to 72 hours after finishing the course. Several other antibiotics also interact with alcohol in a way that stops them from working properly. It’s important not drink alcohol if you are prescribed these, too, so the medicine is able to work as intended. The NHS website advises that it’s best to avoid alcohol if you’re feeling unwell. However, for many commonly prescribed antibiotics, it also states that drinking within the UK low risk drinking guidelines is unlikely to cause additional problems. Visit the NHS website for more information about how different types of antibiotics can interact with alcohol.
Over the counter painkillers
Drinking within the UK low risk drinking guidelines while taking a standard dose of most over-the-counter painkillers such as paracetamol and ibuprofen is unlikely to cause any problems. But you should always read the leaflet that comes with the medication and get further advice from your pharmacist or doctor if you need it. For example, some over-the-counter painkillers are stronger than others, and certain cold and flu remedies also contain sedatives which can be dangerous when mixed with alcohol.
Prescription painkillers
Alcohol must be avoided while on a course of prescription-only painkillers, such as tramadol, gabapentin and codeine and other morphine-like drugs. Consuming alcohol alongside these medications can be dangerous – leading to severe drowsiness and other side effects, such as nausea. 4 Visit the NHS website for more information about how different types of painkillers can interact with alcohol.
A man thought it was a good idea to take a ‘sip’ of his friend’s assisted suicide cocktail
At the North American Clinical Congress on Toxicology annual conference in Montreal over the weekend, a case study was presented involving a 37-year-old man from Denver who survived after swallowing a “sip” of a cocktail of assisted suicide drugs during an end-of-life celebration for a friend dying of pancreatic cancer.
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“The patient’s friend was prescribed a Medical Aid in Dying (MAID) preparation as part of a physician-assisted suicide program,” read a slide from the case study tweeted out Sunday.
“After the patient’s friend consumed part of the preparation and described it as bitter, this patient ingested an unknown-sized ‘sip’ of the preparation,” which included lethal doses of drugs to cause the person ending their life to lose consciousness and stop the heart.
According to those attending the discussion on the management of medical emergencies, the 37-year-old man, who had a history of anxiety, attention deficit disorder and chronic pain, made a full recovery over a few days, from what was reported at the toxicology conference.
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The American Academy of Clinical Toxicology, the conference host, did not respond to a request for more information about the case or the presenter before deadline.
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But it had uncanny similarities with a case published last year involving a 35-year-old Colorado man who survived after taking a sip of a MAID cocktail. His older friend had invited loved ones to be present while he consumed the MAID preparation, according to the report.
“After his first swallow, he remarked, ‘Man that burns!’ The younger man, said, ‘Let me see,’ and then also took a swallow,” the report said.
“The attending paramedic directs rescuers to begin ventilating the younger man while requesting evidence of advance directives for the older man,” the report continued.
“Care was not rendered to the death with dignity patient” because he had a valid medical form stating he wanted no lifesaving measures performed on him.
The younger man was treated for “massive polypharmacy ingestion.”
“As patients who have an ingestion of MAID medication intend to die, resuscitation of such individuals is very rare,” the authors wrote. The man was ventilated and regained consciousness “with full neurologic recovery” after a two-day stay in intensive care.
“Accidental ingestion (of a MAID cocktail) should be rare and to our knowledge has never been reported,” the team wrote. “As was the case in this call, the individual drug components that comprise the MAID medication are intentionally at high doses to ensure death.”
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Many expressed shock at the concentrations of drugs used in the assisted suicide cocktail described at the weekend toxicology conference.
“My chin is on the floor looking at that list,” one nurse tweeted. “I’m stunned that anyone could survive that ‘sip.’”
“Was the attending physician out back having a spliff and a beer,” another tweeted. “Or are these self-supervised events? Not even a pamphlet telling them not to share their lethal dope with their mates?”
“If this is true, it’s highly irresponsible of the medical professional in attendance to allow a random guest to touch the drugs,” another person said. “Seems very suspicious to me!”
Colorado, like several other U.S. states, allows MAID by the oral route only, through a prescription the qualified terminally ill patient fills and administers themselves or with family, to end his or her own life.
A doctor may be present but must not be involved in the delivery of the medication.
In Canada, oral MAID is rarely used. Intravenous MAID, death by doctor-administered lethal injection, is the primary mode of assisted dying provision in Canada. Of 10,064 MAID deaths reported in 2021, fewer than seven involved the oral route.
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The oral protocol, which isn’t legal in Quebec, is not popular for several reasons. Among them are higher rates of complications, longer, drawn-out deaths and a higher failure rate.
High-dose barbiturates are the drugs most often used, compounded into a sweet liquid formulation that needs to be swallowed within a certain number of minutes so that it reaches peak levels.
If people have trouble swallowing because of gut problems caused by disease, if they regurgitate, it can mean incomplete doses that fail to kill.
Death can be prolonged. Most provinces require that a doctor or nurse practitioner be present with an IV back-up kit in case death doesn’t occur “within an agreed upon time.”
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