With service members continuing to return from deployments with physical and mental wounds, prescriptions are as common in the military as ever.

Silbert Grant, substance abuse control officer for Headquarters and Service Battalion, said cases of prescription abuse have been on the rise across the Marine Corps, whether it’s a wounded warrior taking too much of a legitimate prescription or a Marine bumming medication from a friend after a training injury. He noted that prescription use and abuse is continuing to rise across the civilian population as well.

Unforeseen consequences can arise, though, even when medications are used properly, if they’re combined with alcohol.

“Wounded warriors are typically on meds that cause sedation,” said Lt. Cmdr. Michael Mabry, Pharmacy Department head at Naval Health Clinic Quantico, adding that these include narcotics to treat pain, antidepressants for depression or anxiety, muscle relaxers and neurological pain medications, often in some combination.

“So when you add alcohol, it intensifies those effects and leads to greater potential for harm to yourself and the public in general,” Mabry said, noting that car and other accidents can result. “Those normal inhibitors you have in your decision-making process are gone.”

The combination can also affect the user’s ability to control the depression or other symptoms the drugs were prescribed for, he added.

Drinking when taking sleeping pills can extend the amount of sleep the user needs beyond the eight hours that drugs like Ambien require, Mabry said.

“If you wake up drowsy and drive, you may get in an accident,” he said, noting that both substances not only cause sleepiness but also impair hand-eye coordination and reaction time.

When alcohol is consumed in large quantities with narcotics, the consequences can be dire, Mabry said.

“You could potentially go into respiratory depression, which means your breathing could stop, and that could be fatal.”

Alcohol also dehydrates the body, which can cause medications to be absorbed either too slowly or too quickly, depending on the drug, Mabry said.

“So you’re either creating toxicities of drugs in your body, or if it’s absorbing too slowly, you’re not getting the effects of the drug you need.”

He added that dehydration from alcohol consumption also increases the constipating effect of narcotics.

Even over-the-counter drugs can produce dangerous effects when combined with enough alcohol. Mabry explained that non-steroidal anti-inflammatory drugs like Ibuprofen, Aspirin, Motrin and Aleve weaken the stomach lining, as does alcohol. Combining the two increases the chances of ulcers, which can lead to dangerous internal bleeding.

Acetaminophen, present in Tylenol and many cough and cold medicines, weakens the liver and, in large quantities, can damage the organ, an effect that is intensified with the addition of alcohol, Mabry said.

“It’s seen as benign and without a dose limit, but Tylenol has been known to cause deaths on its own,” he said.

Mabry said one route for Marines and sailors who feel they might have developed a substance abuse problem is Military OneSource, which provides short-term, nonmedical counseling.

Often, service members are afraid to seek help from the military for fear of impeding their careers, but Petty Officer 1st Class Todd Holman, drug and alcohol program advisor for Naval Health Clinic Quantico, said, “Yes, the military has zero tolerance for drug abuse, but at the same time, the first thing we want to make sure of is that the service member is taken care of.”

— Writer: mdicicco@quanticosentryonline.com