Frequently asked questions about alcohol and pain medications

People with chronic pain should learn the facts about alcohol and how it can interact with pain medication, even if they only drink occasionally.

Here are some things that are important to know:

  1. Combining alcohol with some pain medications can cause serious and unexpected health problems, and sometimes can even lead to death.  They both have the potential to decrease your body’s ability to protect itself and together they can be dangerous.
  2. People who cope with chronic pain may be highly stressed, suffer from depression, or have problems with sleeping.   Alcohol doesn’t help these problems, although many people think it will, and use alcohol for these reasons. Using alcohol can actually make them worse.
  3. Alcohol use is very common in the United States, as is chronic pain. One out of 3 Americans is suffering from pain at any given time.  According to the government’s National Institutes of Health, only 35% of adults over age 18 do not drink at all, while 65% do.  Thirty-seven percent (37%) of adults reported drinking at low risk levels and 28% reported drinking at heavy or at-risk levels.  The National Institutes of Health defines heavy drinking as at least one episode of more than 5 drinks for a man, or 4 drinks for a woman, within the past 30 days.

How much alcohol is in an alcoholic drink?

You may already know that the concentration of alcohol in different drinks can vary a lot. Since not all drinks are the same, it’s important to know the difference.  A standard drink is any drink that contains about 14 grams of pure alcohol.  So what is considered one drink?

  • 12 ounces of beer (5% alcohol)
  • 8 – 9 ounces of malt liquor (7% alcohol)
  • 5 ounces of wine (12% alcohol)
  • 1.5 ounces of hard liquor, alone or in a mixed drink (40% alcohol)

Mixed drinks may have more, or less, of this amount of alcohol in them, and can be difficult to measure. 

What happens when alcohol enters the body? 

About 20 percent of the alcohol that is consumed is absorbed in the stomach, and about 80 percent is absorbed in the small intestine.

Several things can influence how fast alcohol is absorbed, including:

  • The concentration of alcohol
    • The greater the concentration, the faster it’s absorbed
  • Whether the stomach is full or empty
    • Food slows down absorption of alcohol
  • Type of drink
    • Carbonated beverages speed up absorption. Champagne and anything with a mixer, such as club soda or tonic water, will be absorbed faster. Having a soft drink after drinking alcohol will also increase absorption.
  • Rate of drinking
    • The faster a person drinks, the faster the absorption.
  • Mood
    • Stress and tension can cause the stomach to “dump” its contents faster so that alcohol gets absorbed more rapidly.

 

Once it is absorbed, alcohol enters the blood and is carried through the body where it dissolves in the water in the body’s tissues. The only tissue that alcohol cannot dissolve in is fat. Since women typically have more body fat than men, who have more muscle, they do not get rid of as much alcohol. This is why women are usually more affected than men by the same amount of alcohol.

What are the effects of alcohol?

Alcohol is considered  to be a depressant. So why do people feel stimulated by alcohol?  Their speech may be more free and animated, and they act more emotional and less inhibited. These effects can be misleading because alcohol affects the cerebrum, the part of the brain that controls reasoning and emotion.  The brain is actually being depressed and is not functioning normally in controlling a person’s judgment. Alcohol actually slows down brain activity.

As a person drinks more, alcohol effects can progress to a dangerous level.

  • From euphoria (feeling happy and self-confident), to confusion.
    • As the brain slows down, people become more sleepy, forgetful, uncoordinated, with a delay in their reaction time.
    • Alcohol poisoning is characterized by confusion, vomiting, seizures, slow irregular breathing, blue or pale tinged skin, and unconsciousness.
  • Stupor
    • While any level of intoxication is a safety risk, the final phases are especially dangerous because at this point the body is swamped with alcohol and it starts to shut down. During this stage, a person is barely able to move or respond to stimuli.
  • Coma
    • Coma is a state of being unconscious, with slowed breathing, a decreased heart rate, and lower than normal body temperature.
  • Death
    • Alcohol can depress important body functions to such a degree, that it can be lethal. For example, breathing can slow down to dangerous levels, or your “gag reflex” that protects your airway may be depressed.

How long does alcohol stay in the body and how does it leave the body?

While the effect varies from person to person, depending on weight and other factors, on average about one and a half hours after consuming an alcoholic drink, the alcohol may have left your system.

Alcohol leaves the body in three ways:

  • The kidneys eliminate about five percent of alcohol in urine
  • The lungs exhale about five percent
  • The liver chemically breaks down the remaining alcohol with an enzyme

Summary

The bottom line is if you have chronic pain and take medication, either over the counter or prescription medication; ask your health care provider if it is safe for you to use alcohol. Alcohol and pain medications might be competing with each other to leave the body, and slow the process down, making the effects last even longer or more exaggerated. That can be bad news.