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Non-steroidal anti-inflammatory drugs (NSAIDs) account for up to 10% of all prescribed medications each year, according to the NIH. They are most commonly used to relieve inflammation and pain. At least 95% of individuals over 65 will have a prescription for an NSAID at some point. You can also find them available in various forms as over-the-counter medications such as aspirin, ibuprofen and naproxen, which are versions of Motrin, Advil, Aleve, and their generic store-brand counterparts. While it might be tempting to combine alcohol and NSAIDs for any number of reasons, it is critical that you do not mix them as it can result in serious life-threatening illness, disease, and injury.

What Are Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)?

NSAIDs are available as both prescription and non-prescription drugs. They can be used to moderate pain, reduce inflammation, lower fevers, treat arthritis, and prevent blood clotting. These NSAIDs can help prevent heart disease, treat colds and the flu, minimize menstruation discomfort, reduce inflammation to improve healing, reduce arthritis pain, and much more. A prescription is required in more severe cases, though it’s important to note that NSAIDs are typically not considered a controlled substance or narcotic. Many are considered safe enough to use on babies and infants.

The following are various types of NSAIDS available:

  • Celecoxib
  • Diclofenac
  • Diflunisal
  • Etodolac
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Nabumetone
  • Oxaprozin
  • Piroxicam
  • Salsalate
  • Sulindac
  • Tolmetin

Brand names of NSAIDs prescriptions might include Cambia, Cataflam, Celebrex, Daypro, Disalsate, Feldene, Indocin, Ketoprofen, Toradol, Voltaren, Zipsor, and Zorvolex. It is important to note that brand names for these types of drugs are discontinued regularly and new ones become active.

Common Side Effects of NSAIDs

Whether you use prescription or over-the-counter NSAIDs, you could experience unwanted side effects. Most people will not have any side effects, however, a small group of people are sensitive to NSAIDs; the side effects they experience are usually minor. Keep in mind that NSAIDs have rather few side effects compared to other types of medications.

If you do experience a side effect, it might include one or a few of the following:

  • Constipation
  • Diarrhea
  • Dizziness
  • Drowsiness
  • Headache
  • Lower appetite
  • Nausea
  • Rash
  • Vomiting

In some instances, side effects can become more severe. And it is also important to note that a small percentage of the population could be allergic to NSAIDs.

Interactions of Alcohol and NSAIDs

Generally speaking, NSAIDs are safe as long as you follow the directions on the packaging and the advice of a medical professional. They can even be safe if you consume a moderate amount of alcohol at the same time. The definition of moderate being, one drink for a woman and two drinks for a man, per day. Side effects can increase if you take more than the recommended amount, consume NSAIDs for a long time, or if you combine them with heavy drinking.

You should not knowingly combine alcohol and NSAIDs, particularly if you are more than a moderate drinker. NSAIDs are often meant to be used as a temporary solution rather than a long-term solution and if you abuse NSAIDs it can lead to serious issues. When you combine drinking and NSAIDs, you could experience continued bleeding after surgery or after an injury. You could also experience excessive fluid retention. Some people will experience kidney failure and liver failure while other people will develop ulcers.

Alcohol Poisoning and NSAIDs Overdose

If you drink alcohol excessively, it’s critical to avoid NSAIDs, or the results could be severe. It is important to understand the symptoms of alcohol poisoning and an NSAID overdose.

Symptoms and signs of alcohol poisoning include:

  • Confusion
  • Irregular breathing
  • Low body temperature
  • Pale or blue skin
  • Seizures
  • Unconsciousness
  • Vomiting

While an overdose of NSAIDs by itself is unlikely, it can cause toxicity in the body.

Symptoms and signs of NSAID overdose include:

  • Blurred vision
  • Breathing challenges
  • Chills
  • Diarrhea
  • Difficulty moving
  • Drowsiness
  • Headache, severe
  • Nausea
  • Rash
  • Sweating
  • Vomiting

When you combine alcohol and NSAIDs, particularly if you are an excessive drinker, you will damage your liver and kidneys and prevent your blood from clotting. Keep in mind that if a prescription combines NSAIDs and opioids or other drugs, the results of combining alcohol with such types of medications are often far more severe, far more quickly including slow breathing, coma, and death.

Withdrawal

NSAIDs do not typically cause chemical dependence; therefore, you will not usually experience withdrawal symptoms. However, if you do abuse NSAIDs by taking them for a long time and stop suddenly, you can experience unpleasant side effects.

Some such side effects include:

  • Agitation
  • Anxiety
  • Depression
  • Headaches
  • Increase pain
  • Nausea

These symptoms are slightly different and similar to alcohol withdrawal signs and symptoms, which include anxiety, headaches, insomnia, nausea, shaky hands, sweating, and vomiting.

It is possible that you might take more NSAIDs than you should as your body develops a tolerance to the drugs. Some people develop a dependence on NSAIDs because they simply enjoy the feeling associated with the drugs, both emotional and physical. While the actual drug is not habit-forming, you can develop a dependence for other reasons (psychological) that will require treatment to overcome just like any addiction.

Treatment

Because NSAIDs are not themselves addictive, you will not find programs specifically for NSAID addiction. If you believe you have suffered an NSAID overdose, you should seek out medical attention immediately as this can be toxic. The same is true if you have alcohol poisoning. If you find yourself taking more than the recommended amount of NSAIDs, it is likely you have a more serious underlying issue. It is possible that you need psychological assistance from a mental health professional to help you learn to better manage your emotions and feelings. It is possible you like the way NSAIDs make you feel about yourself, or they may help you exercise more effectively. Or you could have a far more serious medical condition that needs treatment immediately.

If you are abusing alcohol and overusing NSAIDs, you need to seek alcohol addiction treatment from medical professionals. You can choose from inpatient and outpatient programs. And today, most insurance companies cover at least part of recovery programs. If you are taking more painkillers than you know you should and abusing alcohol, you should know that it is possible to stop in a responsible manner. You should first speak with your doctor and, with them, determine the right course of action.

NSAIDs are ideal medications to help manage various daily physical issues such as arthritis, heart disease, and minor to moderate pain. You should not take NSAIDs if you drink more than one drink for women and two drinks for men each day. If you do begin to combine the two, or if you take far more than the recommended dose each day, you should seek treatment to get your life back on track.

Sources:

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772852/

  • https://orthoinfo.aaos.org/en/treatment/what-are-nsaids/