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Combining drugs, alcohol

Published:Wednesday | March 14, 2012 | 12:00 AM

by Dr Dahlia McDaniel

Prescription drugs such as diazepam (better known as Valium), alprazolam and lorazepam are sedatives that control anxiety - anxiolytics. They are used to help relieve symptoms of anxiety disorders, panic disorders, and some phobias.

They are prescribed, too, for persons experiencing bereavement, as an anticonvulsant for those who experience seizures, and for persons who feel anxious about undergoing medical procedures. At higher doses these products induce sleep and act like sedatives.

These anxiolytics are recommended for only short-term relief of anxiety (two to four weeks), because their main challenge is that they are habit-forming when taken for longer periods. So their effects usually grow weaker with time, and the user needs higher and higher doses to achieve the calming effect.

These drugs (diazepam, alprazolam and lorazepam which belong to a group called benzodiazepines) are only available legally by a doctor's prescription; doctors prescribe them minimally to help the patient get through a limited period of severe anxiety.

One rule of thumb which medics use with benzodiazepines is to prescribe the smallest possible dose for the shortest possible time. Dependence on benzodiazepines is especially likely in persons with a history of drug abuse (including alcohol abuse).

How these 'chill pills' work

Benzodiazepines interfere with chemical activity in the brain, reducing communication between nerves. Brain functioning and activity slow down so we fall asleep more easily. When we take these benzodiazepines, we may experience side effects like lightheadedness, drowsiness, confusion (especially in the elderly), loss of memory and weakness.

Alcohol and some other drugs, when taken with benzodiazepines, increase the actions of the alcohol, the other drugs and the benzodiazepines. So those who take benzodiazepines should avoid alcohol, other sedatives, antidepressant drugs and antihistamines. Any combination of these often results in increased sedation, impaired coordination, excessive depression, breathing difficulties, and other adverse effects with the potential to be lethal.

The truth is that most drugs don't mix well in the system with alcohol, which is itself a drug. The combination may cause life-threatening symptoms, prevent the prescribed drug from being effective or cause it to be overactive in the body.

Dr Dahlia McDaniel is a pharmacist with a doctorate in public health;