Many people with chronic pain take some form of medication, and also sometimes drink alcohol. In fact, since alcohol can numb physical pain1, it’s quite common for people to drink and also take painkillers. Even people experiencing temporary pain—including hangover symptoms—often down an ibuprofen or two after drinking alcohol.
But is it really safe to mix alcohol and pain medicine? And are some combinations more dangerous than others?
In general, you should ask your doctor first and read the warning labels on any medication you take before combining it with alcohol. And as a good rule of thumb, you should only drink alcohol moderately while taking painkillers. For reference, the Centers for Disease Control (CDC) defines moderation as no more than two drinks a day for men and no more than one drink per day for women2.
But it also matters quite a bit what type of pain medicine you are taking. There are big differences between over-the-counter medicines like Tylenol, and prescription painkillers (including opioids). Below, we’ll discuss some of the most common painkillers, the risks, and whether it’s safe to combine them with alcohol.
Disclaimer: Each person’s body is different, and none of the information in this article should be taken as a substitute for medical advice. If you have questions about combining medications with alcohol, it’s best to consult your primary care physician.
Over-the-Counter Pain Medications and Alcohol
Some of the most common pain medications taken in the United States are over-the-counter remedies such as acetaminophen, ibuprofen, and aspirin. Each of these can be safe to combine with alcohol in small amounts, and people often do so. However, each poses particular risks when mixed with alcohol, especially in large quantities. There are situations in which it is not safe to mix over-the-counter pain medicine and alcohol, and it’s important to exercise caution.
Alcohol and Tylenol
Alcohol and acetaminophen (Tylenol) can be safe when taken together in small amounts3. However, if you drink and take Tylenol on a regular basis, or take more than the regular dose, the combination can have negative health consequences. Both alcohol and acetaminophen are processed through the liver, and can place stress on this vital organ. If you already have liver damage this can be especially dangerous, and it’s best to avoid the mixture.
Alcohol and Ibuprofen
As above, ibuprofen and alcohol can be a safe combination in moderation, but there are significant risks to be aware of. Ibuprofen can cause gut and stomach issues, including ulcers and intestinal bleeding 4. Alcohol can cause gastrointestinal inflammation, worsening the problem. Drinking on ibuprofen can also be hard on your kidneys. It’s best not to combine the two regularly, and if you have underlying conditions, avoid the combination completely.
Alcohol and Aspirin
It can be safe to take aspirin when drinking small amounts of alcohol, but as with other over-the-counter pain medications, it’s best not to do so chronically. This combination can cause nausea and worsen stomach irritation, and excessive amounts of each can sometimes cause severe stomach bleeding 5. Aspirin and alcohol are far from an ideal combination, and it’s best to limit using these two together.
Alcohol and Opioid Painkillers
Aside from over-the-counter remedies, many Americans take prescription medications for more severe or chronic pain. Among the most common of these are opioid medications such as hydrocodone, codeine, oxycodone, tramadol, and fentanyl. While it is possible to combine alcohol with these medications, there is a risk of severe medication interaction, and it’s recommended to avoid drinking on opioids.
Both alcohol and opioids are central nervous system depressants, and can cause drowsiness. While it’s already dangerous to drive a car or operate heavy machinery when consuming alcohol alone, the risk is multiplied when combined with opioids. In larger amounts, the combined depressive effect can lead to difficulty breathing6 or accidental overdose—either of which can be fatal.
While over-the-counter medications with alcohol have their own risks, alcohol and opioids are much more dangerous, and it’s best not to combine them. This is especially true given that both are addictive substances, and statistics show a link between opioid addiction and alcohol abuse.
Should You Drink Alcohol While Taking Painkillers?
In summary, the severity of the interaction varies, but most combinations of alcohol and painkillers pose some risk. Alcohol and over-the-counter medications like Tylenol and Aspirin can cause or worsen stomach, liver, and kidney problems. Meanwhile, alcohol and opioids can lead to fatal overdoses and increased chances of addiction.
If you drink alcohol and also take pain medication on a regular basis, it’s best to consult your doctor about safe limits, and what will be best for your body. You can also access online help to scale your drinking back to a safer level, 100 percent from home. Learn more about newer options for controlling your drinking, without even having to quit completely.