Pharmacoepidemiology of potential alcohol-prescription drug interactions among primary care patients with alcohol-use disorders

Objective: To report on the proportion of individuals with alcohol-use disorders who take prescription medications that could interact with alcohol and on the proportion who recall advice to avoid alcohol with their medications. Design: Secondary analysis of a randomized controlled trial of telephone counseling. Setting: 18 primary care practices in southcentral and southeastern Wisconsin. Patients: 897 adults with alcohol-use disorders as identified by systematic survey. Intervention: Telephone and mail survey. Main outcome measures: Patient-reported prescription medication use, potential for alcohol-drug interactions according to DrugDex, and patient-reported receipt of advice not to take alcohol with their medications. Results: Of the 869 patients who provided usable information on prescription medication use, 348 (40.0%) were taking medications with alcohol interactions or proscriptions; the most frequently reported were bupropion, selective serotonin reuptake inhibitors, and various acetaminophen-containing compounds. Slightly more than 20% of patients were taking medications with moderate to severe alcohol interactions; over one-third of these 184 patients did not recall advice to avoid alcohol. Conclusion: Practitioners who prescribe or dispense medications may need to enhance their efforts to advise patients about alcohol-drug interactions. Prescribing and dispensing medications that interact with alcohol present opportunities to administer alcohol screens and interventions.