Kenneth, a new patient, came to my clinic because his daughter, Natalie, insisted. Natalie had been a patient of mine for years, and she was worried about her father drinking while taking pain medication for a sore shoulder.

“Sometimes, I have a couple of drinks in the evening,” Kenneth said. “No big deal. But she’s acting like I’m headed for Skid Row.”

“It’s not the amount of alcohol you’re drinking, Dad,” Natalie explained. “It’s the fact that you’re taking two, three, four ibuprofen every day, along with a baby aspirin, and then you’re drinking.

“You said your stomach hurts so badly some nights you can’t sleep. And I’m telling you why, but you don’t believe me.”

Kenneth laughed and looked to me for help. “Maybe you can talk some sense to her, doctor,” he said. “How can a few little pills be a problem if I’m only having a couple of Scotches? Those drugs are safe, or they wouldn’t be selling them over the counter, right?”

In spite of their little disagreement, I could tell Kenneth and Natalie were very close. Neither one was budging, though. So it was up to me to settle the dispute, even though I knew Kenneth wouldn’t be very happy with me.

I had to tell him the truth—Natalie was absolutely right.

People who combine over-the-counter pain relievers, known as NSAIDs (non-steroidal, anti-inflammatory drugs), with alcohol are putting themselves at risk for serious stomach pain and major internal bleeding. And even though Tylenol (acetaminophen) is not technically an NSAID, mixing it with alcohol puts you at risk for liver damage and even liver failure.

That advice is especially true for anyone, like Kenneth, over age 50. And yes, that applies to the daily low-dose aspirin that many people take for heart health. Here’s a list of commonly available over-the-counter NSAIDs:

• Advil (ibuprofen)
• Aleve (naproxen)
• Aspirin

Side Effects Of Taking Painkillers With Alcohol

And here’s why washing an ibuprofen down with a beer isn’t such a great idea. NSAIDs block your body’s production of prostaglandins, substances that cause pain and swelling, but also protect the lining of your stomach.

When the prostaglandins are blocked, your stomach lining is exposed to normal digestive acids—and that can be very painful, as Kenneth discovered.

Nearly every day, I have a conversation like this with a patient. Too many people have the misguided notion that if you can buy something over the counter in a store—even if it’s medicine—it’s absolutely safe.

And the truth is, most over-the-counter meds are relatively safe to take—by themselves—as long as you carefully follow the dosing instructions. But when you combine these products with other substances, food, beverages, and medications, the results can land you in the hospital.

I think Kenneth learned two lessons in my office that day. One was to always take a few minutes to read warnings on product packaging. If Kenneth had done this, he would have seen that ibuprofen and alcohol should never be taken together.

The second lesson Kenneth learned could save lives and keep people out of the hospital, if only more individuals were aware of it.

NSAIDs are not harmless medications. They’re responsible for an estimated 16,500 deaths annually, according to the prestigious New England Journal of Medicine, which described complications from these drugs as a “silent epidemic.”

And fatalities aren’t the end of the story with NSAIDs. More than 100,000 Americans are hospitalized every year due to these drugs.

Quite a few people are allergic to NSAIDs, sometimes seriously, and that can be especially dangerous for asthma patients. In addition, NSAIDs elevate blood pressure, slow the flow of blood from the kidneys, and produce other unwanted side effects.

Natural Painkillers

That’s why I wish more people knew about safe pain-relief. When patients like Kenneth come to me with serious pain issues, my first recommendation is a daily dose of 500 to 2,000 mg of curcumin, an extract of the spice turmeric.

Curcumin is remarkably effective at combatting pain. In one recent study, for example, researchers found that curcumin performed as well as ibuprofen for treating knee osteoarthritis. And patients taking curcumin had less stomach upset than the ibuprofen group.

Omega-3 essential fatty acids (EFAs) are another pain-easing option. These good fats fight inflammation and lubricate joints, a common source of pain. I recommend a daily dose of 3,000 mg (3 grams) of purified marine oil daily.

It took a few weeks, but the combination of curcumin and fish oil got Kenneth back out on the golf course. Natalie was thrilled to see her dad back in action without NSAIDs. And if he wanted to have a drink occasionally, she didn’t have to worry about consequences.

“More people need to know they have a choice when it comes to pain relief,” Kenneth told me during a follow-up visit. “Never in a million years would I have thought that it was possible to feel this good just from taking a spice.

“But now I recommend it to my golf buddies, neighbors, anyone who might be able to use it—for the simple reason that it works!”

Last Updated: June 24, 2021
Originally Published: December 17, 2014