ALCOHOL AND MEDICINE USE

The potential for interactions between medicines and alcohol is well recognised. However, it is timely to revisit this issue for two reasons.

• Firstly, the Australian population is ageing. The use of medicines increases with age, and age-related physiological changes increase the risk of interactions between medicines and alcohol.
• Secondly, there is widespread use of complementary and alternative medicines (CAM). CAM are freely available, yet do not require the same level of stringent evaluation as pharmaceutical drugs and are not necessarily dispensed by trained professionals. While their relative safety is under-researched, adverse effects and drug interactions have been reported.

We surveyed Australian adults recruited by telephone using random probability sampling for the Pfizer Australia Health Report. It examined:

• the prevalence and patterns of concurrent use of prescription and over-the-counter medicines, CAM and alcohol; and
• concerns about medicine-alcohol interactions.

A diary was used to facilitate recall of all medicines used in the past 24 hours.

After adjusting for age, gender and drinking status, women and adults 45+ years were significantly more likely to have used conventional medicines and CAM in the past 24 hours.

Australians aged 65+ years were using the greatest number of medicines (median=4). In the last 24 hours,

• 25% of adults had consumed alcohol and taken a conventional medicine,
• 18% had used alcohol and CAM, and
• 14% had used alcohol and both types of medicines.
• Daily drinking was most common among those aged 65+ years, and
• there was a trend towards greater recent use of alcohol and all medicine types among this group.

Daily drinkers had used alcohol and a wide range of commonly used medicines in the last 24 hours including:

• blood pressure (25%),
• pain relieving (13%),
• cholesterol-lowering and indigestion (each 12%) and
• blood-thinning (10%)
• medicines, vitamins and glucosamine (each 15%),
• fish oils (11%) and
• minerals (9%).

Among people who had recently taken alcohol and other medicines, one-half (49.1%) were ‘not at all’ concerned about potential interactions.

Among daily drinkers, there was a trend for the oldest age group (65+ years) to have recently consumed alcohol and all medicine types.

Given age-related physiological changes, these data indicate that older Australians in particular may be at risk of interactions between alcohol and their medicines.

While we do not know the quantity of alcohol consumed, or whether alcohol was used at the same time as medicines, interactions can occur with low blood alcohol content among older people. Despite this, there were few concerns about the effects of mixing alcohol and the medicines people reported using. This illustrates the need for continued efforts to provide education on safe use of medicines.

From ‘Of Substance’ The Australian National Magazine On Alcohol, Tobacco And Other Drugs. vol. 5 no. 2 2007. Subscription forms and back issues of Of Substance (in PDF format) are available at Ofsubstance.org.au. ALCOHOL AND MEDICINE USE, Wendy Swift, Marie Pirotta & Neil Stollznow.

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