Commentary: Doctors Perfectly Positioned to Help Prevent Drug and Alcohol Overdoses, Expert Says

A recent study that found soaring hospitalization rates for combined drug and alcohol overdoses among young adults suggests doctors could play a pivotal role in educating the public about the dangers of combining these substances, says the study’s author.

The study found hospitalization rates for combined alcohol and drug overdoses increased 76 percent among adults ages 18 to 24 from 1999 to 2008. During that same period, hospitalizations for alcohol overdoses alone increased 25 percent, and for drug overdoses, 55 percent. There was a 122 percent increase in hospitalizations for narcotic pain medication poisonings, and alcohol overdoses played a role in one in five such hospitalizations.

“While the increase could be due to better reporting, we think, given corroborating evidence, that this represents an actual increase in the rate of overdoses for drugs, alcohol and the combination of the two,” says study author Aaron White, PhD, Health Scientist Administrator at the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

White says his study does not contradict other studies that have indicated binge drinking by high school students is decreasing and stabilizing among college students. “The most likely explanation is that we’re seeing an increase in the percentage of young people who are going to extremes when they drink,” he notes. “In other words, overall alcohol use could be going down, while the subgroup of extremely risky drinkers is increasing. We need more research to find out.”

He is concerned that too few young people are aware of the dangers of combining drugs, particularly prescription medications, and alcohol. “Drugs such as narcotic pain medications, some anti-anxiety medications and benzodiazepine-like sleep medications are very risky to combine with alcohol due to their depressant effects on brain function,” he points out. Adding them to alcohol can increase the risk of injuries, amnesia and death. White explains that alcohol can cause death by suppressing neurons in the brainstem that control vital reflexes like breathing and gagging. Some prescription drugs, such as narcotic pain medications, suppress these same brain stem areas, making them especially dangerous to combine with alcohol.

“Doctors are in a perfect position to educate patients about the medications they are receiving and how they might interact with alcohol,” White says. “Prescription bottles may warn people not to take the drugs with alcohol, but they don’t explain why it’s dangerous or how dangerous it might be. And alcohol labels don’t warn you not to drink and take drugs together. Most people don’t realize that if they consume alcohol even at moderate levels, they could end up with toxic side effects if they combine it with the wrong medication.”

Every time a teen or young adult visits the doctor, it’s an opportunity to discuss drugs and alcohol, according to White. The NIAAA recently released a new alcohol screening tool called Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide, which walks doctors through the steps to take when patients say they or their friends drink, and helps them assess the level of risk for current and future alcohol problems. The tool focuses on two key questions designed to help pediatricians spot children and adolescents at risk for alcohol-related problems.

“We can’t assume the public is aware of the dangers of combining prescription drugs and alcohol,” White says. “We have to get the facts out to them, and physicians are one optimal way to deliver the message.”