Alcohol affects people more in middle age due to physical and lifestyle changes, according to The Wall Street Journal. As people start to take more medication in their 40s and 50s, the risk of alcohol and drug interactions also increases.

As people reach middle age, they experience changes in body composition, brain sensitivity and liver functioning, the article notes. “All of the effects of alcohol are sort of amplified with age,” David W. Oslin, a professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania, told the newspaper. “Withdrawal is a little bit more complicated. Hangovers are a little bit more complicated.”

Changes in body composition during middle age result in more alcohol circulating in the bloodstream. In addition, the liver, which metabolizes alcohol, gets less efficient as people age. The level of certain enzymes that break down alcohol decreases. Hormonal changes that women experience during menopause can increase their sensitivity to alcohol.

In middle age, people tend to drink less than they did when they were younger, notes Robert Pandina, director of the Center of Alcohol Studies at Rutgers University. So when you do drink “you might have a more sensitive response to alcohol because you’ve lowered your exposure to alcohol over all,” he said.

Drugs that can interact with alcohol include heartburn drugs such as Zantac, acetaminophen, and blood thinners like Coumadin. Mixing blood thinners with alcohol can cause bleeding. “People on Coumadin shouldn’t really drink at all,” Dr. Oslin noted. Combining alcohol with some pain medications and benzodiazepines can make a person “more prone to sedation, more prone to cardiovascular risk and more prone to overdose,” he added.

According to the Centers for Diseases Control and Prevention, about 52 percent of people ages 45 to 64 had at least 12 drinks in the previous year.