Interactions between alcohol and prescription medications

We thank Berends and Lubman for their excellent article on the delivery of alcohol and drug interventions. The article highlights the importance of primary care strategies to detect risky drinking. We believe this should include primary care professionals assessing the possible concomitant use of alcohol and interacting prescription medications. This is important because patients may not voluntarily disclose their use of alcohol or interacting prescription medications in routine primary care consultations.

Up to 28% of older adults who consume alcohol also use sedative-hypnotics. In a recent study, one in four Australian men aged 70 years and older who used sedative-hypnotics also consumed more than two alcoholic drinks daily. Pharmacodynamic interactions between alcohol and psychotropic medications may result in increased central nervous system depression. Chronic heavy drinking may induce liver enzymes responsible for drug metabolism.
Additionally, alcohol is implicated in up to one-fifth of unintentional fatal prescription medication overdoses. Implementing strategies to promote awareness and detection of interactions between alcohol and prescription medications is likely to fulfil an important primary care need.