According to the National Institute on Drug Abuse, use of tobacco is the number one cause of preventable diseases, disabilities, and death in the US. The good news is that there are treatments that can help a person to stop using tobacco and tobacco products. Nicotine is a main active ingredient in tobacco products. The transdermal nicotine patch is considered to be an effective way to help people to stop smoking. In fact, a person must stop smoking in order to use a nicotine patch.
The patch works, in part, by administering enough nicotine to a person’s system in order to prevent the onset of nicotine withdrawal symptoms, which can help to prevent a smoking relapse. When applied, the patch releases a steady dosage of nicotine over a 24-hour period. A nicotine patch can be purchased over the counter. While a prescription is not needed for a nicotine patch, one is required for a nicotine inhaler.
Typically, nicotine patch therapy lasts for 8-12 weeks and not usually for more than 3 months. The length of treatment can raise a specific concern: What happens if a person drinks or does drugs while in nicotine patch therapy?
Known Nicotine Patch and Drug Interactions
According to one credible source, nicotine patches can have interactions with drugs. There are at least 55 prescription medications (which covers 358 generic and brand drug names) that can have interactions with nicotine. Of this group, there are believed to be 13 moderate interactions (which covers 67 generic and brand drug names) and 42 minor drug interactions (which covers 291 generic and drug brand names).
The following is a list of some of the drugs of abuse that appear on the list of prescription and over-the-counter drugs that can have an interaction with nicotine (minor versus moderate is indicated):
- Acetaminophen ((minor interaction)
- Wellbutrin (moderate)
- Hydroxyprogesterone (moderate)
- Delalutin (moderate)
- Bupropion (moderate)
- Zantac (minor)
- Alert, which includes caffeine (minor)
- Blowfish for Hangovers (minor)
- Excedrin Migraine (minor)
- Heartburn relief extra-strength (minor)
According to Everyday Health, individuals are especially advised to tell their doctor if they are using a nicotine patch if they take any of the following prescription medications:
- Labetalol (Normodyne, Trandate)
- Prazosin (Minipress)
- Imipramine (Tofranil)
- Oxazepam (Serax)
- Propranolol (Inderal)
- Pentazocine (Talwin)
- Theophylline (Theo-Dur, Theochron, Theolair)
When a person takes a prescription or over-the-counter drug while using a nicotine patch, and should side effects emerge, it may be difficult to gauge the source of the side effects (i.e., it could be the nicotine patch, the drug, or the interaction of the two). According to WebMD, a drug interaction can increase the risk of a person experiencing a serious side effect.
There does not appear to be readily available research on the interaction between nicotine replacement treatments and most drugs. However, it can be helpful to know the side effects that can result from using a nicotine patch. The following side effects have been recorded in the case of approximately 1 percent of people who use a transdermal nicotine patch:
- Upset stomach
- Insomnia or trouble sleeping
- Burning, itching, tingling, or redness in the area where the patch is placed
Although they infrequently occur, the following are some of the known serious side effects associated with using a transdermal nicotine patch:
- Skin rash
- Swollen skin
- Chest pain
- Feeling dependent on the patch
- Having a problem stopping use of the patch after treatment ends
- Leg pain
- Irregular heartbeat
- Heart palpitations
- Severe, ongoing stomach upset
- Redness of the skin that persists for more than four days
For individuals who take prescription medications, the safest practice is to speak with a doctor about using a nicotine patch while on any and all prescription medications. Regarding over-the-counter medications, one safe approach would be to speak with the pharmacist. Conducting research is always important, but there is always a risk of misunderstanding the potential complexities involved in taking prescription medications or over-the-counter drugs while using a nicotine patch. There does not appear to be significant research in the area of using a nicotine patch while abusing street drugs. It is critical to speak with a doctor about the use of illicit drugs before using a nicotine patch.
Drinking while Using a Nicotine Patch
Nicotine patches are sold under different brand names, including NicoDerm CQ. According to one drug information site, the interaction between alcohol and NicoDerm CQ is considered to be minor. Further, a 2007 research study noted that nicotine replacement treatments, which are assumed to include the patch, are “commonly used” to help heavy drinkers who are also smokers.
But there is a potential drawback of drinking after nicotine patch therapy has begun. A person may make a strong connection between alcohol and using tobacco products. This mental connection can, therefore, serve as a relapse trigger. In this way, alcohol use can have a potentially negative effect on a person who is actively trying to stop using tobacco products, such as cigarettes.
Nicotine replacement therapy can have a lasting positive outcome on a person’s health. For some, stopping nicotine use may be part of an overall effort to optimize one’s wellness. In this instance, discussions about the use of alcohol or illegal street drugs may be of little to no significance. For individuals who have are actively taking a prescription medication, as noted, the best practice is to speak with the prescribing doctor about any known possible interactions.
Regarding individuals who are actively using alcohol or street drugs, it appears that a main concern is resuming smoking or using tobacco products again. Stopping nicotine use can have a healthy ripple effect across one’s life, stimulating better health choices overall. To get the most out of nicotine replacement therapy and its potential additional benefits, the best practice is to avoid all nonessential drugs, including alcohol. For individuals who would like group support from similarly situated individuals, attending a Nicotine Anonymous meeting is one potential option.