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Alcohol
and Drugs
Alcohol
Recreational drugs
Marijuana
Ecstasy
Speed
Heroin
Cocaine
Inhalants
Nicotine
Steroids
Alcohol
In our society, drinking
alcohol is a very acceptable form of socialising
and relaxation. A glass of beer can satisfy
a genuine thirst, whilst a glass of wine can
make a special meal more pleasurable, and a
measure of spirit can be a welcome relaxant
after a hard day’s work. Going to the
pub means contact with friends, and social life
is important for everyone.
Some common questions
are:
Can alcohol cause seizures?
The relationship of alcohol to epilepsy and
seizures is complex.
Alcohol is a substance that can cause
or worsen seizures when associated with alcoholism, ‘binge’
drinking or epilepsy.
Seizures related to
alcohol abuse are encountered more commonly than with any
other form of substance abuse.
How do alcohol
related seizures occur?
- Alcohol withdrawal
– When a chronic drinker or alcoholic
stops drinking. These mostly occur within
the first 36 hours of stopping drinking. If
these seizures occur often, and the alcohol
abuse is over a long period of time (years)
then degeneration of the brain may occur,
leading to epilepsy and chronic seizures.
- Alcohol toxicity –
When someone has ingested large amounts of
alcohol and the concentration in the bloodstream
is poisonous to the body.
- Excessive fluid and
metabolic changes in the body – Drinking
large amounts of alcohol will create an imbalance
of fluids and electrolytes in the body and
has a dehydrating effect.
- Trauma – Head
injuries that may occur from accidents or
falls while drunk.
- Vitamin or nutritional
deficiencies – Chronic alcohol abuse
will prevent the absorption of vitamins and
is often associated with poor diet.
How do alcohol
and anti-epileptic medication mix?
People taking medications for epilepsy are likely
to be more sensitive to the effects of alcohol.
Alcohol can:
- Interfere with the
metabolism of anti-epileptic medications,
- Enhance the side effects
of these medications,
- Some anti-epileptic
medications can enhance the effects of alcohol.
- So feeling intoxicated
after a small amount of alcohol is quite common.
Missing a dose, taking
extra medication or altering the time of taking
regular anti-epileptic medications before drinking
will not alter this reaction and may cause additional
side effects or seizures.
Can I drink
alcohol?
Medical opinions vary on whether a person with
epilepsy can drink alcohol. Some doctor’s
recommend that alcohol should be avoided at
all times, while others say a moderate amount
in most cases will do no harm.
It is up to the individual
to decide what suits them and to discuss any
issues with their doctor or an educator.
Good practice
People need to practice care when drinking alcohol
because:
- Alcohol can interact
with anti-epileptic medications preventing
them from reaching the necessary levels in
the bloodstream to control seizures.
- Large amounts of alcoholic
beverages can trigger seizures as can large
intake of non-alcoholic fluids. Both create
an imbalance of fluid and electrolytes within
the body by either dehydration or overhydration.
- Alcohol consumption
is often associated with late nights, missed
meals and forgotten medications, all of which
can trigger seizures.
What is moderate
drinking?
Consumption of alcohol should be carefully moderated.
This can mean different things to different
people, and the distinction between ‘social’
drinking and ‘problem’ drinking
can be very unclear.
National Health and Medical
Research Council (NHMRC) suggest sensible drinking
guidelines:
Men
– Up to 4 beers (285ml) OR 4 spirits (30ml)
OR 4 glasses of wine (100ml) per day
Women – Up to 2 beers
(285ml) OR 2 spirits (30ml) OR 2 glasses of
wine (100ml) per day
Everyone should have
at least 2 alcohol-free days a week
Anyone who drinks alcohol
must have a responsible attitude to it if they
are to avoid the often serious health and social
problems which can result from alcohol misuse.
Many people with epilepsy
choose to drink considerably less than these
recommended limits. Many find that by drinking
no alcohol at all a greater seizure control
is achieved.
For fact sheets on Alcohol and other
recreational drugs.... Click
Here
ABC Health Matters - Alcohol Fact File Click
Here
Top of Page
Recreational
Drugs
No recreational drug
is harmless. These drugs can be made up of many
different substances of unknown quantity. They
are illegal and there are no regulations to
control quality. Like alcohol, each person will
have different reactions to various drugs.
Many recreational drugs,
especially stimulants such as cocaine, ‘crack’,
angel dust (PCP), ecstasy and speed (amphetamines),
have the potential to cause seizures and it
is uncertain what interactions these, or any
recreational drugs, may have with prescription
medicines. As the name suggests, stimulants
are types of drugs that enhance brain activity
causing an increase in alertness, attention,
and energy.
Drug taking is often
associated with problems such as not getting enough sleep,
dehydration, and not eating properly. These in themselves
are common triggers of seizures.
The decision to take
recreational drugs is a personal one, but it
is important to be aware that there is the possibility
of an increased chance of seizure(s).
One can never predict
what side effects will be experienced in mixing
antiepileptic drugs and other drugs. This is
true for prescribed and non-prescribed medication.
Also remember that the recreational
use of these substances is illegal in Australia.
Marijuana
Marijuana is a frequently used recreational
drug and is now used in medicine to reduce nausea
and vomiting caused by some anticancer treatments,
or with AIDs patients.
Is it a useful
anti-epileptic drug?
Research about the effects of marijuana on seizure
activity is inconclusive. Initial studies suggest
that marijuana may have anti-epileptic effects,
but there is currently insufficient data to
determine whether occasional or chronic marijuana
use influences seizure frequency.
If tried as an anti-epileptic
agent, marijuana usually needs to be used in
high doses which can cause many unfavourable
side effects. Also seizures have been known
to occur if the dose is not maintained or following
withdrawal from marijuana.
Marijuana use in Australia
is not legal and therefore not recommended as
an anti-epileptic agent.
Is it dangerous
for people with epilepsy to use marijuana?
Use can transiently impair short-term memory,
and, like alcohol use, may increase noncompliance
or forgetting to take anti-epileptic drugs.
Marijuana use or withdrawal could potentially
trigger seizures in susceptible patients.
Because the data remains limited, and in some
cases conflicting, on the potential of cannabis
and cannabinoids to control epilepsy, people
should use caution when considering marijuana
for seizure management.
Some studies and anecdotal
reports show that high doses of marijuana can
trigger seizures
Ecstasy
Ecstasy is common used as a club drug. Some
of the known effects of ecstasy on the brain
are depression, seizures, strokes and memory
loss. (NIDA USA)
Taking ecstasy can lead
to other seizure triggers such as sleep deprivation
and dehydration. This may be as a result of
being hyperactive and, for example, dancing
all night. Problems may arise if someone with
epilepsy starts to drink excessive amounts of
water as this can lead to water intoxication,
which in turn could cause changes in consciousness
or a seizure.
Amphetamines
(speed)
Amphetamine is an addictive stimulant drug that strongly
activates certain systems in the brain. There are many health
effects associated with amphetamines. The effects on the
central nervous system (CNS) that result from taking even
small amounts of this drug includes increased wakefulness
increased physical activity, decreased appetite, increased
breathing rate, fever and euphoria. Other CNS effects include
irritability, insomnia, confusion, tremors, convulsions,
anxiety, paranoia, and aggressiveness. Fever and convulsions
can result in death. (NIDA USA)
As amphetamines are a
stimulant, people may use them to keep themselves
awake, for example, if they were going clubbing
until the early hours of the morning. The resulting
lack of sleep can be a trigger factor for many
people with epilepsy.
Heroin
Heroin is not a stimulant but a depressant,
and although it is associated with many serious
health problems, seizures are not common. More
often, seizures may be related to taking other
drugs or alcohol at the same time or to the
overall effect of a heroin overdose. As heroin
can be administered intravenously, some people
may experience seizures as a result of an infection
from using dirty needles or impurities in the
drug.
People with epilepsy
seeking helping for heroin addiction should
discuss their treatment medication with their
doctor.
Cocaine
(coke, crack)
Cocaine can provoke seizures in people who do
not have a diagnosis of epilepsy, as well as
making someone's epilepsy worse. This is because
cocaine can lower the seizure threshold, or
cause other medical problems, which can lead
to seizures. Seizures can also occur as an indirect
result of taking cocaine such as lack of sleep,
lack of food and not taking anti-epileptic medication
as prescribed.
Inhalants
Inhalants include solvents like petrol, cleaning fluids,
paints, liquid shoe polish, nail polish remover, and glue;
aerosols like spray paint, insecticides, and hair spray;
and anesthetics like nitrous oxide (laughing gas). These
chemicals temporarily stimulate before they depress the
brain (central nervous system)
Evidence suggests that
long term use of inhalants can cause brain/nervous
system damage, which may in turn cause epilepsy.
There is also a strong possibility that sniffing
solvents over a longer period of time could
make someone's epilepsy worse.
Steroids
Although anabolic steroids are used in the treatment
of some health conditions, abuse of these drugs
can lead to some irreversible health problems.
There is no evidence to suggest that steroids
used in some sporting activities can trigger
or provoke seizures.
Tobacco/Nicotine
Nicotine is both a stimulant and a depressant
to the central nervous system. There is no evidence
to suggest that smoking cigarettes or cigars
trigger seizures in people with epilepsy. However,
some nicotine preparations, used to help people
stop smoking, should be used with caution as
they can have a side effect of convulsions.
If someone with epilepsy
wants to stop smoking, before buying any nicotine
preparations, they should discuss this further
with their doctor.
Need to find
out information on a drug?
Everything from alcohol, tobacco, club drugs,
to street drugs
http://www.druginfo.adf.org.au/
http://www.drugscope.org.uk
http://www.adin.com.au/
http://www.alcoholguidelines.gov.au/
1300 EPILEPSY (1300 37 45
37)
Australia-Wide Priority Call
References:
Epilepsy & Marijuana. Do
they mix? Allan Sherwin, MD, FRCPC Neuropharmacology,
Montreal Neurological Institute & Hospital,
Montreal QC
Alcohol & Marijuana: Effects on Epilepsy
& Use by Patients with Epilepsy. Epilepsia
Vol.42; 10:1266 – Oct 2001
http://www.nih.gov/
The National Institute on Drug Abuse (NIDA)
USA
NDARC National Drug and Alcohol Research Centre
UNSW 2001
Medformation.com A community service of Allina
Hospitals and Clinics. ©2003 Source: The
Food and Drug Administration Updated on: 25/08/2003
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Understand Epilepsy
