Can patients on opioids drink alcohol?

[DrCabral3074]

Is there a regulatory body such as the DEA or FDA that makes a statement that patients taking opioids should not drink alcohol? We have patients coming in for urine compliance screening with alcohol while being prescribed opioids but I don't know if the DEA, FDA, DHHS takes a formal position on this subject and where to find it.

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[Laryngospasm]

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[dhcofc]

You’re in the wrong forum...

 

[deleted131481]

Not to be an ass, but do you really need an official statement from the DEA or FDA to tell you opioids and alcohol don't mix well?

 

[DrCabral3074]

Not to be an ass, but do you really need an official statement from the DEA or FDA to tell you opioids and alcohol don't mix well?

Just to educate a colleague who is not aligned ideologically.

 

[deleted131481]

Just to educate a colleague who is not aligned ideologically.

I hope this isn't a practice that puts you in a tough spot - just don't let what colleagues do override what you're comfortable with.

To your actual question, I am not aware of any DEA or FDA statement that explicitly states absolutely no alcohol and opioids. I think you can find plenty of guidelines cautioning on the dangers, not to mix, evaluate for substance abuse (including alcohol), etc.

 

[gdub25]

Haha, yeah, plenty of guidelines for sure, like the side of the pill bottle to start. Don’t they all have the warning to not mix with alcohol?

 

[Ducttape]

sounds like you should send these patients to an ACGME certified pain physician...


okay, sorry to sound like an arse, but the guidelines have been neutered because doctors (under the influence of Big Pharma) have lobbied against any such definitive statements. the CDC guidelines, the FSMB guidelines, all state to "use caution" or "consult an addiction specialist" before initiating, etc. none come out and state "do not prescribe". that is the physician judgement.

otoh, the DEA will be more than happy to look in to things if your patient ODs on a combination of alcohol and your prescribed opioids.


I have had Legacy patients that I found were using alcohol consistently. they were initially counselled. screening and monitoring was increased. some ended up with dose reductions, and complete cessation was done in quite a few.

 

[lobelsteve]

sounds like you should send these patients to an ACGME certified pain physician...


okay, sorry to sound like an arse, but the guidelines have been neutered because doctors (under the influence of Big Pharma) have lobbied against any such definitive statements. the CDC guidelines, the FSMB guidelines, all state to "use caution" or "consult an addiction specialist" before initiating, etc. none come out and state "do not prescribe". that is the physician judgement.

otoh, the DEA will be more than happy to look in to things if your patient ODs on a combination of alcohol and your prescribed opioids.


I have had Legacy patients that I found were using alcohol consistently. they were initially counselled. screening and monitoring was increased. some ended up with dose reductions, and complete cessation was done in quite a few.

As in the ceased seeing you to keep the pills and booze flowing....
Problem with pain is people. Some people.

 

[Ducttape]

both

 

[SommeRiver]

I don't feel I can safely give any wiggle room with opiates. No EtOH is what I tell people.

You lose your right to SOME freedoms if I've got you on dope.

There are no shortage of docs who will let you drink on their dope.

My dope is the good zhit bro...The fire!

 

[swamprat]

The big problem is that the tests show etoh metabolite for a few days. We counsel ppl hey dont take ur short acting opioid before during or after u drink if your going to drink. If they are on long acting it kinda defeats the purpose. I honestly wish we just didnt test for it. Same for THC.

 

[Baron Samedi]

Your opioids, your benzos, your marijuana, or your booze -- pick one.

 

[Aether2000]

I am aware of physicians that lost their medical license and DEA registration when knowingly prescribing opioids to patients that were documented in their records to be drinking alcohol. In the past, we would rapidly wean off all opioids those using alcohol (UDS) since the continued use of opioids in those using alcohol can be deadly.