Mechanisms of drug interactions with alcohol

Pharmacokinetic and pharmacodynamic factors play important roles in alcohol-drug interactions. The combined acute administration of alcohol and many other drugs may result in potentially harmful interactions especially when central nervous system depressants are involved. Often the mechanisms responsible for an adverse alcohol-drug interaction include inhibition of biotransformation and enhancement of the central depressant effects. Long-term ingestion of alcohol can lead to hepatic enzyme induction and in many instances to enhanced biotransformation of numerous substances, usually resulting in reduced therapeutic effectiveness. Alcohol-drug interactions do not generally result in death, however, there is evidence for a contributory role of alcohol in many drug-related fatalities. The elderly and chronic drug users and abusers are especially at risk.