How Does Alcohol Affect COPD?

Medically Reviewed by Brunilda Nazario, MD on December 15, 2020
3 min read

Chronic obstructive pulmonary disease -- otherwise known as COPD -- is a chronic lung disease. When you have COPD, you might have a cough, shortness of breath, wheezing, or have trouble breathing. Cigarette smoking is the leading cause of COPD.

If you have COPD, managing the symptoms and making lifestyle changes can be one of the most important parts of your treatment plan.

The short answer is “it depends.”

In general, having a few drinks in moderation is OK.

“One or two drinks a day has not been shown to impact COPD,” says Neil Schachter, MD, a COPD specialist at Mount Sinai Health System.

But as COPD gets worse, it might be time to take another look at your drinking habits. It’s important for those living with COPD to follow a treatment plan. This can include taking medication, getting a flu shot every year, and getting a pneumonia shot regularly, Schachter says. If you smoke, it’s important that you try to kick the habit, he says.

But what about drinking alcohol?

“One or two drinks a week may reduce anxiety,” Schachter says.

But if you feel stuffy, have a runny nose, trouble breathing, or any other signs of an allergic reaction when drinking alcohol, you should stop drinking completely, he says. These are all signs of alcohol intolerance, which can potentially make your COPD symptoms worse.

Other signs you might have alcohol intolerance include:

The most common cause of COPD is cigarette smoking. That’s why if you’re a smoker, doctors recommend you stop smoking right away.

But with alcohol, there isn’t a clear-cut answer yet. Doctors say more research is needed.

Still, alcohol does affect your body when you have COPD. Drinking alcohol can make you more likely to get a respiratory infection.

“Alcohol increases the risk for respiratory infection by interfering with respiratory clearance mechanisms,” Schachter says.

That’s because it paralyzes the cilia, short fibers that look kind of like eyelashes. These are constantly sweeping mucus up toward your throat, where you either swallow it or cough it up, Schachter says.

Even though it’s generally OK to have a few drinks if you have COPD, there’s still a chance that drinking alcohol can cause COPD symptoms to flare up. That’s because alcohol lowers glutathione levels. Glutathione is an antioxidant in your lungs that helps protect them. The likelihood that you’ll have a flare-up is worse if you drink and smoke cigarettes.

Drinking alcohol can interfere with the medication you might take for COPD, such as antibiotics or steroids.

“Alcohol can independently lower the effectiveness of some antibiotics and steroids, both key agents for the treatment of COPD,” Schachter says. “With excessive use, it causes liver damage, which interferes with the metabolism of many drugs detoxified by the liver.”

This can lead to unwanted side effects.

Alcohol can increase the effects of anxiety or pain medications. It could potentially cause your heart rate and breathing to slow down. It’s a good idea to talk to your doctor about your specific COPD medications to make sure drinking alcohol won’t cause an interaction or unwanted side effects.

If you have COPD and an alcohol addiction, it’s important to get help. Heavy smokers are much more likely to be alcohol dependent, Schachter says.

“We do know that significant smoking addiction is associated with alcohol dependence,” he says. “People with alcohol dependence are several times more likely to smoke than individuals who don’t drink or those who drink modestly.”

Always talk to your doctor if you have questions about COPD and alcohol. They can give you advice specific to you and your treatment plan and can help find the best ways for you to keep your COPD in check.