Take a look at this scenario: You are out with friends, the work week has finally come to an end. Then the obstinate headache makes itself behind your eyes. You take an over-the-counter painkiller in the medicine cabinet, either an NSAID, such as ibuprofen or naproxen, or maybe a prescription painkiller you carry in your bag. And as you continue to relax with your friends, you choke down a glass of wine or a beer. You reason, “It won’t harm to have one drink, will it?
Of course, it looks like a harmless situation, but one that preconditions a wordless, quiet, dangerous chemical process within your body. That one drink, when used with a painkiller, can make it a moment of relaxation or a life changing situation. The fact of the matter is that the internal chemistry that happens when you combine these substances is more dangerous than most people are aware of.
This article will dissect the biological and chemical interactions that make this combination so dangerous and why it may result into poor breathing, serious liver and kidney damage, and even death.
The Central Nervous System: A Sedative Overload
The main risk of alcohol and painkillers interactions is that they have a joint impact on the central nervous system (CNS), which is a part of your brain and spinal cord. Imagine your CNS as the control tower of the body, and it is in charge of all the functions, conscious thought to automatic functions such as breathing and heart rate. Alcohol and most pain medications, particularly, opioids and sedative-hypnotics, are strong CNS depressants. They slow neural activity causing one to feel relaxed, drowsy and pain relief.
These substances combine to produce more than their depressant effect when used together; their effect is multiplied to produce a state of deep sedation. The reason behind this is that in most cases they act on the neurotransmitter systems. Alcohol amplifies the actions of GABA (gamma-aminobutyric acid) that is an inhibitory neurotransmitter that functions as a brake to the activities of the brain. Instead, the opioids attach to certain opioid receptors in the brain and body, preventing pain signals, and also reducing important functions. A combination of these two substances slows your brain down with the sheer force of overwhelming power.
Respiratory depression is the most life-threatening outcome of this CNS depression. Your breathing rate is regulated by the medulla oblongata which is in the brainstem. Inundated with alcohol and painkillers, this critical part of the brain can get so suppressed that it forgets to command your lungs to breathe. Your breathing may slow down to a dangerous degree and in worst scenario the breathing may stop altogether.
It is the primary cause of fatality in fatal overdoses and it is a silent killer because a person who has fainted can simply look like he/she is asleep. This combination is a lethal hazard, and this is despite the fact that, at least one of the substances would be deemed safe at just a safe dose.
The Liver’s Battle: A Toxic Overload
Other than the brain, there is also the liver, an essential organ, which is subjected to extreme stress, because of this combination. The liver is the body detoxification station thus metabolizing and excreting toxic substances in the blood; all the droplets of alcohol and all the milligrams of medication you take. Introducing the two substances simultaneously forces the liver into the state of metabolic crisis, which it is not always able to win. The exact risk is contingent upon which kind of painkiller is used, but the consequences may be serious and permanent liver damage.
The Dangers of Acetaminophen
The potentially most dangerous threat is one of the most popular analgesics (suffer relievers) called acetaminophen, or paracetamol. A widely used component in hundreds of over-the-counter and prescription drugs, such as Tylenol and cold and flu remedies, is acetaminophen. In healthy conditions, acetaminophen is metabolised well and easily in the liver, it is transformed into the harmless compounds that are safely eliminated out of the body. Nevertheless, the drug is turned into a very poisonous product amidst a tiny portion referred to as NAPQI (N-acetyl-p-benzoquinone imine). A natural defense mechanism against NAPQI: a compound known as glutathione, neutralizes the toxin, which the liver has a built-in defense mechanism against.
The issue comes about when the alcohol is involved. The liver gives metabolism of alcohol the first priority as it knows it is a poison that must be neutralized as soon as possible. Such redirection of resources results in the overactivity of the cytochrome P450 enzyme system, the one that breaks down acetaminophen, and leads to higher production of the toxic NAPQI. At the same time the excessive use of alcohol empties the liver of its stock of glutathione its main defense against the toxin. In the case of low glutathione stores and high NAPQI synthesis, the toxicant is free to react with liver tissues resulting in mass cell death and acute liver disease. This may occur quickly and usually no visible effect is detected until the damage becomes permanent.
The Risk with NSAIDs
Non-Steroid Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve) are another typical type of pain medication that is a different but equally severe risk to the liver and other organs. Although they do not cause hepatotoxicity directly the same way as acetaminophen does, NSAIDs and alcohol are hepatic metabolites, thus exerting a heavy burden on the liver. This is especially harmful to people who have underlying liver disease as the stress taken together can accelerate the disease.
A Double Assault: Gastrointestinal Bleeding and Kidney Strain
The risks of combining painkillers and alcohol are not only due to the central nervous system and liver to other important organ systems.
The Gut-Wrenching Reality
NSAIDs are characterized by the fact that they may cause irritation of the stomach lining and the risk of ulceration and inner bleeding, particularly in the long-term course. Alcohol is a gastrointestinal irritant that has also been well documented. Combination effects When these two substances are introduced, they act multiplicatively on the stomach and intestinal lining. Together the attack may seriously impair the protective lining of the stomach as a result of which the mucous membrane becomes inflamed and, in the worst case, causes a deadly hemorrhage. The symptoms may include stomach pain, nausea, and vomiting up to the blood and passing black, tarry stools that are signs of a severe medical emergency.
A Burden on the Kidneys
Kidneys are also important in removing plasma wastes in the blood such as the metabolites of alcohol and analgesics. Both NSAIDs and alcohol may cause strain to the kidneys particularly when the body is dehydrated. Combined, this may compromise the effectiveness of the kidneys to work effectively, which may cause acute kidney injury or increase the deterioration of kidney functioning in patients with pre-existing kidney disease. It is a very silent threat, as kidney damage is usually not noticed until such a point when it is critical.
The Stealthy Killer: Unintentional Overdose
In addition to the physical harm direct, the use of alcohol and painkillers together makes the inadvertent overdose a risky environment. The intoxicating and de-inhibiting action of alcohol may cause distorting judgment and memory lapses. An individual could also take a painkiller, drink and fail to remember that he or she had already taken the drug, and he or she may end up taking another dose. The alcohol impairs the senses and it becomes more difficult to realize the signs of an overdose till it is too late. Because the two substances are increasing the effects of the other, a dose which is usually harmless may turn deadly when combined with even a moderate dosage of alcohol. This makes the possibility of the fatal overdose very real and very unforeseen even when an individual is not predisposed to substance abuse.
A Look at Different Painkiller Types
The intensity of danger is greatly determined by the kind of analgesic medication that you are utilizing. It is important to realize that not every painkiller is created equal, and the interaction between them and alcohol may vary widely in terms of its severity.
Opioid Painkillers: The Highest Risk
It is the most dangerous combination by far. Opioids are overpowering central nervous system depressants. They work very well in the management of moderate and intense pain and are quite sedative. Together with alcohol, there is a high risk of fatality respiratory depression. Breathing may slow and even halting within the body. This is the reason why the healthcare providers come up with such stern warnings regarding the use of alcohol together with such drugs as OxyContin, Vicodin, or Percocet.
NSAIDs: A Risk to Your Gut
NSAIDS (such as Advil and Aleve) are regarded as less dangerous than opioids, however, the combination of these drugs with alcohol is quite dangerous. As stated above, severe gastrointestinal bleeding is the most important concern. Moreover, the alcohol and NSAIDs are excreted by the kidneys. This combination may overburden these organs, which may cause the damage of the kidney, especially in people with prior kidney disorders or those who are dehydrated. This is an unholy combination to be avoided under all costs since it is associated with the risk of stomach ulcers and internal bleeding.
Acetaminophen: A Silent Threat to the Liver
The threat is not acute CNS depression but chronic non-reversible liver damage. Hundreds of over the counter and prescription drugs contain acetaminophen and one can easily surpass the safe dose per day without knowing it. The threat of a toxic hepatic response becomes acute when the person is under the influence of alcohol. In contrast to most of other adverse effects, hepatotoxicity caused by acetaminophen may be silent and only its consequences occur once the damage is severe and occasionally irreversible. It is an especially cunning and dangerous mix.
The Bottom Line: When in Doubt, Don’t
It is simple and direct: alcohol and painkillers do not work well together in a safe way. Although the exact risks will depend on the kind of medication, the general principle will be the same. Be it a severe CNS depression that halts your breathing, a toxic overload that leads to your liver failing or internal bleeding that may turn into a medical emergency, the outcome is disastrous.
It is good to always look at the label and act as directed by your doctor or pharmacist before you take any medication. Provided that you take prescription painkillers, tell your medical professional about your drinking habits. They are able to give you advice and make you aware of the particular risks concerning your medication. In matters to do with your health, it never hurts to be on the safe side. Take the correct decision and protect yourself and your family.
