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Official Newsletter of Drug Free Workplaces
February 2015 Vol. 16 No. 2
DrugFree@WorkPlace
Published by The Council on Alcohol and Drugs
Tel (404) 223-2486 | Fax (866) 786-9811 | www.LiveDrugFree.org
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Dangerous Drug Interactions
combination are needed."
Adverse drug interactions are one of the leading causes
of death in the United States. Many celebrities have
died as a result of combining illicit street drugs with
prescription drugs and/or alcohol.
Mixing antidepressants and methadone is another
dangerous combination because of the sedative effect
of both drugs. There has been a dramatic increase in
deaths in recent years related to methadone use, and
drug interactions have been implicated in many of
these deaths. Severe adverse events including deaths
have also occurred in patients who co-ingested methadone and alcohol.
While most drug interactions are not life-threatening,
mixing some medicines or drinking alcohol and/or
ingesting street drugs with certain medications can
cause serious consequences. Some drugs, when taken
in combination, exhibit synergism resulting in toxicity.
At the very least, mixing some medications and/or
food and drink interactions with certain meds can
cause them to not work properly.
Mixing Percocet and Xanax, especially if abusing
these prescription drugs by taking more than prescribed, is one example of a dangerous combination.
Both drugs are depressants and can cause shallow
breathing, respiratory arrest, and even death. Drinking
alcohol while taking fast-acting Xanax is also dangerous for the same reason. Drinking alcohol with any
depressant drug is risky because both affect the part of
the brain that regulates heart rate and breathing.
Just because alcohol and prescription drugs are legal
does not mean they are safe, especially when combined. Legal does not always mean safe. While drinking alcohol and taking some prescription medications
can be safe in moderation, drinking while taking other
medicines can intensify the effects of both alcohol and
the drug taken, resulting in serious injury or death.
Alcohol and Depressant/Stimulant Use
Combining painkillers, sedatives, or stimulants with
booze can be a deadly combination. According to a
2010 study of 13 U.S. states, 3,883 deaths were tied to
opioid pain relievers – 22 percent of which involved
alcohol. And another 1,512 deaths were tied to benzodiazepine drugs, more than 21 percent of which involved alcohol. Opioid pain relievers and benzodiazepine drugs – like alcohol – are central nervous system
depressants.
"These findings indicate that alcohol plays a significant role in opioid pain reliever and benzodiazepine
abuse,” the study authors wrote. “Interventions to reduce the abuse of alcohol and these drugs alone and in
For the same reason(s) that no one should ever use
cocaine and methamphetamine at the same time,
prescription stimulant drugs such as Ritalin or Adderal should not be taken with alcohol. Mixing stimulant drugs with alcohol is dangerous because the
combination can create a false sense of sobriety.
Stimulants may convince the user that he or she can
continue to drink beyond physical limitations, resulting in alcohol poisoning and death, or the alcohol
could mask the effects of the drug, resulting in a
stimulant drug overdose.
“Speedballing”
Unless a doctor prescribes both medications and
carefully monitors the patient, stimulants and depressants such as opiates should not be mixed because of
the opposite effects of these drugs. Stimulants speed
up the heart, while opiates slow it down, creating an
increased risk of overdose. It may seem that one drug
would cancel out the effects of the other, but this is
not the case. The body is not capable of adequately
processing these counteracting drugs.
Stimulants require that the body use more oxygen,
but depressants reduce the breathing rate, causing a
lack of oxygen at a time when it is needed most.
Many overdoses have occurred from celebrities and
street drug users engaging in the risky behavior of
“speedballing”; mixing stimulants and opiates. Most
fatal overdoses occur as a result of this type of polydrug abuse.
Antidepressants
Most people who take antidepressants know that they
should not drink alcohol because it can lessen the
effect of the medication. But there are also prescription drugs that should not be combined with antidepressants.
To help us combat substance abuse, go to www.LiveDrugFree.org and click on “Donate!”
DrugFree@WorkPlace | February 2015 Vol. 16 No. 2 | www.LiveDrugFree.org | Tel (404) 223-2486
Antidepressants affect serotonin levels, and when
taken in combination with some pain medicines, a
deadly reaction known as serotonin syndrome can
occur. Serotonin impacts the heart, muscles, and
breathing, and the wrong combination of meds can
result in shivering, restlessness, euphoria, and diarrhea. If not treated quickly, serotonin syndrome
could result in death.
Food and OTC Drug Interactions
It is always best to check with your doctor and pharmacist about combining medications and drinking
and drug interactions, but it is also important to ask
about food and drug interactions. While alcohol and
prescription drugs are among the most common and
dangerous, other types of interactions also can be
life threating, including interactions between herbal
or dietary supplements, over-the-counter (OTC)
medications, and food.
For example, limes and Seville oranges may block
enzymes that break down statins, including dextromethorphan, the active ingredient in cough medicine. This could result in a build-up of dextromethorphan in the blood, increasing side effects. Symptoms could include severe muscle damage, sleepiness, and hallucinations.
Mixing ACE inhibitors like Prinivil, Capoten, Vasotec, and Zestril that are used to lower blood pressure
with bananas, oranges, green leafy vegetables, and
certain salt substitutes could result in irregular heartbeat and heart palpitations. The reason is that ACE
inhibitors can increase the amount of potassium in
the body, and foods and products high in potassium
lead to too much potassium buildup. Some over-thecounter decongestants can also decrease the effectiveness of these blood pressure medications. People
with high blood pressure should not take over-thecounter nasal decongestants without checking with
their doctor or pharmacist.
Kale, spinach, broccoli, cabbage, Brussels sprouts,
and other greens should be eaten in moderation
when taking blood thinners such as Warfarin or
Coumadin. These foods are rich in Vitamin K and
can reduce the drugs’ anticlotting effects. Warfarin
should also not be combined with aspirin as this
significantly increases the risk of bleeding. The risk
is even higher if taken with garlic pills or other
herbal remedies that thin the blood.
Staying Safe
People who take medicine must avoid deadly drug
combinations and take their medications responsibly. Every person reacts differently to each psychoactive drug. It is important for patients to check
their reaction carefully and contact their doctor
immediately if they feel something is wrong.
To be safe, always follow your doctor’s advice,
never abuse prescription drugs or mix medications
without a doctor’s approval, and be aware of and
careful with all food, alcohol, OTC medicines, and
drug interactions. Know exactly what drugs you are
taking and all of their side effects, and if possible
get all of your drugs at the same pharmacy so that
the pharmacist will have a complete record of all
your medications.
You should always ask your pharmacist about the
side effects of a new medication and review what
the medication is used for. It’s also a good idea to
ask general questions regarding how to take meds
(with or without food), if you need refills, when
drugs expire, and what to do if you miss a dose.
Always check your medication before leaving the
pharmacy to make sure it is your name on the bottle and that it is the correct drug your doctor prescribed.
Be sure to tell your doctor and pharmacist about
any over-the-counter, herbal or home remedy medications you are taking, and don’t engage in illegal
drug use or alcohol abuse, especially in combination with prescription meds. Never take medicine
prescribed for someone else, and don’t increase or
decrease the dosage of your medicine without your
doctor’s consent. Ask your doctor for written instructions on taking any new medication, and when
you leave the doctor’s office, make sure you know
the name of the medication and the generic name,
what it is for, how many times a day you should
take it, and how you might react.
Reducing the risk of adverse drug interactions is
often a matter of using common sense and asking
your doctor or pharmacist the right questions.
To help us combat substance abuse, go to www.LiveDrugFree.org and click on “Donate!”