Risk drinking behavior among psychotropic drug users in an aging Finnish population: The FinDrink study

Concurrent use of alcohol interactive medications and alcohol in older adults: a systematic review of prevalence and associated adverse outcomes

“…Consistent with those studies investigating psychotropic medications [14, 22, 25, 26, 28, 32, 34, 36], the following drug classes were classified as AI medications, sedatives/hypnotics [18–21, 24, 27, 30, 31], antidepressants [18–21, 27, 30, 31], opioids/narcotics [18–21, 27, 30, 31], anticonvulsants [19–21, 24, 27, 30, 31] and anti-psychotics [19–21, 27, 29, 30]. After CNS agents, cardiovascular medicines (CVS) were the most common AI medicines [18–21, 24, 27, 29–31], followed by antidiabetic drugs [18, 20, 21, 24, 27, 29–31], warfarin [18–21, 24, 27, 30, 31], gastrointestinal agents [18–21, 24, 30, 31], non-steroidal anti-inflammatory drugs (NSAIDs) [18–21, 29–31], antibiotics/anti-infectives [21, 24, 27, 29–31] and anti-histamines [19–21, 30].…”

“…Ten of the included studies were conducted in Europe [14, 19, 21–23, 25, 27–29, 36], eight in North America [18, 20, 24, 30–32, 34, 35] and two in Australia [26, 33]. (Table 1) All studies were cross-sectional [14, 18–36].…”

“…No reference source reportedBeverage specific quantity-frequency, past 2 weeksDel Rio 2002 [22]Spain, community dwelling adults≥ 16 years≥66 years = 1025≥16 years N  = 639648% menNRCross sectional (survey with interview)Benzodiazepine use, past 2 weeksBeverage specific quantity-frequency past 2 weeks: Low (men: ≤ 21 units/week, women: ≤ 14 units/week), moderate (men: 22–50 units/week, women: 15–35 units/week) & high consumption (men: >50 units/week & women: >35 units/week)1 unit = 10 g of alcoholDu 2008 [14]Germany, community dwelling older adults N  = 160545.2% menNRRange: 60–79 yearsCross sectional (survey & interview; prescriptions or original containers)Any psychotropic medication use in past 7 days: ATC nervous system drugs coded N00. (Excluded drugs coded N02B aspirin & paracetamol, except for N02BA71) Opiate codeines used as antitussives were merged with N02A & opiates for GI conditions (A07D) were not recordedBeverage specific quantity-frequency, past 12 months: Problem use (risky drinking): daily consumption ≥10 g for women & ≥ 20 g for menForster 1993 [24]US, community dwelling older adults N =66739.9% men74.1 (±6.6 years)NRCross sectional (survey & interview; medication containers)Prescription or OTC medications currently or past month: AI drugs defined by study clinical team: OTC painkillers, anti-hypertensives, diuretics, OTC cold preparations, arthritis medications, heart medications, antibiotics, mind altering medications, chest pain medications, pain medications, diabetes medications, ulcer medications, sleeping pills, OTC nasal sprays, steroids, blood agents, insulin, seizure medications & OTC asthma medicationFrequency: never, rarely, sometimes & regularlyIlomaki 2008 [25]Finland, community dwelling older adults N =1,77448.1% men63 years (NR)Range: 53-73 yearsCross sectional (mailed survey & interview; prescriptions brought if any problems)Regular use of psychotropic drugs at time of interview: antipsychotics, anxiolytics, hypnotics, sedatives, antidepressants & combinationsBeverage specific quantity-frequency past 12 months: frequent ≥2 times/week, binge (men ≥5 units/occasion: women ≥4 units/occasion) & heavy drinking (men: >14 units/week: women >7 units/week1 unit=12 g of alcoholIlomaki 2013 [26]Australia, community dwelling older men≥70 years N=1,705100% menNRNRCross sectional (Interview: medications brought)Antidepressants (including SSRIS, TCAs, MAOIs and others) & SADs (including benzodiazepines and benzodiazepine-like hypnotics)Beverage specific quantity-frequency past 12 months: daily (7days/week), binge (≥5 drinks at least once/month), heavy (>2 drinks/day) & problem drinkers (CAGE score ≥2). Nondrinkers: former or never drinkers1 drink=10 g of alcoholImmonen 2012 [27]Finland, community dwelling older adults≥ 65 years N=1,39535.5% men78.7 years (NR)NR…”

“…Nine studies reported on a wide range of prescription and/or over the counter (OTC) medicines with potential to interact with alcohol [18–21, 24, 27, 29–31] . Three studies investigated any medication use during the recall period [23, 33, 35], and a further eight focused on psychotropic medications [14, 22, 25, 26, 28, 32, 34, 36]. Of the eight studies focusing on psychotropic medications, five investigated psychotropic medications alone [22, 25, 26, 34, 36] and three studies also included analgesics [14, 28, 32].…”

The use of psychoactive prescription drugs among DUI suspects

“…Clinicians are challenged to provide safe and effective relief to their patients' symptoms, but at the same time they need to minimize the risk of misuse of medicines. This is important since risky drinking behavior and psychotropic drug use have been shown to be associated with each other (Ilomäki et al, 2008), in that heavy drinking predicts the initiation of sedative/anxiolytic use (Ilomäki et al, 2011). People with prescribed medication are prone to misuse it, especially if they have more extensive substance use and use-related problems (McLarnon et al, 2011).…”