Patients Continue to Use Alcohol and Prescription Drugs Concurrently

Cordant Study Finds Patients Continue to Use Alcohol and Prescription Drugs Concurrently, Despite Label Warnings

As part of Alcohol Awareness Month, Cordant Health Solutions™ (Cordant), a provider of innovative tools for chronic pain, mental health and workers’ compensation providers through its uniquely integrated drug testing programs, today released results from an internal data set on the concomitant use of prescription medications and alcohol showing that nearly two-thirds of its samples confirmed positive for alcohol in 2018 also tested positive for other drugs, including prescription medications for which alcohol is contraindicated.

Cordant’s internal study evaluated 511,645 samples to determine correlations between prescription medication and alcohol use from a variety of industry segments, including chronic pain, medication-assisted and abstinence-based treatment, workers’ compensation, and mental health clinics. From the overall data set, 29.2% of samples confirmed positive for alcohol were also positive for a prescribed medication.

However, breaking the data into healthcare segments reveals differing levels of risk. For example, workers’ compensation patients show a significantly higher likelihood of combining alcohol and prescription drug consumption, with 79.3% of samples testing positive for alcohol also testing positive for prescribed medications.

“Cordant’s analysis also broke down alcohol use in combination with specific types of medication. One of the most dangerous combinations with alcohol is benzodiazepines, which were prescribed for about 5% of the U.S. population in 2013, predominantly to treat anxiety-related disorders,” said Richard Stripp, PhD, chief scientific and technical officer. “Because they employ similar mechanisms in the brain, consuming alcohol and benzodiazepines can have additive consequences, in which the negative effects of one substance are enhanced by the other. This can result in a synergistic depression of the central nervous system that often leads to addiction and a greater risk of overdose and other health-related concerns.”

Cordant’s results showed that more than 1 in 10 samples collected from patients with mental health disorders who confirmed positive for alcohol also tested positive for a benzodiazepine(s), and that figure doubled for samples from chronic pain patients.

“Furthermore, combining opioids and alcohol creates similar elevated overdose risks,” explained Stripp. “Both substances depress the central nervous system and may result in potentially fatal respiratory depression.”

A study published in 2017 by the American Society of Anesthesiologists found that normal prescription doses of oxycodone, when taken concomitantly with one to three drinks, can dangerously suppress breathing.

Cordant’s internal study found that of the 93,000 samples from chronic pain patients, 62.8% of samples confirmed positive for alcohol were also positive for an opioid (morphine, codeine, hydrocodone, hydromorphone, oxycodone, oxymorphone, and/or heroin). Results for workers’ compensation patients were almost identical, with 62.7% of samples that confirmed positive for alcohol also testing positive for opioids.

“Understanding the dangers of alcohol while taking prescription medicines can be a mindset challenge,” said Stripp. “Despite contraindication labels on medications, the perceived risk associated with prescription or over-the-counter drugs is that they carry a lower potential for toxicity and are ‘safer’ than illicit drugs. This is certainly not the case, as many prescription drugs have a high risk of fatal overdose, particularly when taken with alcohol. Also, many individuals believe that spacing medications with alcohol consumption negates the risk. However, medications for chronic conditions are metabolized at different rates and consuming alcohol hours later can still cause deleterious effects.”

In fact, alcohol is known to interact negatively with as many as 150 medications and can inhibit the effectiveness of some medicines, such as antipsychotics. Stimulants can even conceal the effects of alcohol, leaving people incapable of judging their level of intoxication and increasing their risk for alcohol poisoning and risk-taking behavior.

The problem of medications being taken concomitantly with alcohol is unlikely to fade soon. The number of medical prescriptions dispensed in the U.S. increased from 3.99 billion in 2010 to 4.45 billion in 2016.[1] And a 2017 study published in JAMA Psychiatry found that alcohol use in the U.S. rose an average of 11% over a 12-month period, and the increase was greater for some higher-risk groups, such as minorities, women, seniors, and people with lower levels of education and income.[2] Age is a particularly important factor in evaluating alcohol use with medicine because aging slows metabolism in general.

“The results of this study highlight the ongoing need for open and candid conversations about the risks of combining prescribed medications and alcohol,” said Stripp. “This data shows that patients with already vulnerable health situations are too frequently engaging in behavior that can have serious and lasting effects. By breaking down the results, we better understand which patients are potentially at higher risk. Our goal is to help clinicians, patients, and families understand and be able to talk openly and easily about the ways in which alcohol can create adverse health risks.”

Alcohol Awareness Month was established in 1987 by the National Council on Alcoholism and Drug Dependence, with the goal of raising awareness of the dangers related to alcohol consumption. To learn more about this program, go to https://www.facingaddiction.org/resources/alcohol-awareness-month.


[1] https://www.statista.com/statistics/238702/us-total-medical-prescriptions-issued/
[2] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2647079


About Cordant Health Solutions™

Based in Denver, Cordant Health Solutions™ (www.cordantsolutions.com) provides innovative tools for monitoring behavioral health, chronic pain and criminal justice cases. Our unique pharmacy and drug testing programs provide accurate, actionable results to protect prescribers, hold patients accountable and optimize quality of life.

As a leader in quality standards, Cordant is committed to developing solutions for payers, clinicians and organizations involved with substance use disorder, pain management and criminal justice agencies. Cordant is one of the only healthcare companies that offers monitoring and risk assessment tools through its innovative drug testing options and full-service, high-touch pharmacies, which specialize in the complex management and dispensing of controlled substances. Cordant’s testing protocols and digital case-management tools help clients become more efficient and effective in using drug testing programs to monitor patient adherence, reduce risk and improve patient outcomes.