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

Abstract 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.