Interview: Michael Blecker, Clinical Pharmacist in the Emergency Department at the Hospital of the University of Pennsylvania.

Q: How does alcohol interact with medications?
A: It moslty has to do with the metabolism of the two substances, specifically in the liver. What usually happens is the medication inhibits the metabolism of the alcohol and it stays in the system longer because it cannot be absorbed in the kidneys and excreted by the urinary system.

Q: What is the side effects?
A: Since the alcohol is in the blood for longer time, it is also in larger concentration which means that if someone had a few drinks now it would be like he had double the amount and this more common in Asian population.

Q: Which are the most common medications patients in the ED usually combine with alcohol?
A: The most common case we see here in the ED is when patients combine oxycodone, which a narcotic analgesic to treat severe pain and also sedative medication, such as benxodiazepine. There is actually a synergistic process between these class of medications and alcohol. This means that the two substances being consumed together, have similar properties and they bind the same molecule on the targeted cell.

Q: Do patients that come in the ED because the combined the two substances, do it on purpose or accidentally?
A: Younger patients usually do it on purpose, to get "high" but elderly people do it accidentally because they might be on prescribed painkillers, for example, and have some drinks with their meal. This will lead to lose control this is why they are prevented from driving. Also, there is a high risk of fall which can cause further damage or injuries.

Q: Which case is more common that you see in the ED?
A: I would say the second, with the elderly people cause they usually do not think that one or two drinks can cause any problem.