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Report Underscores Fatal Risk of Combining Prescriptions, Other Substances at Home
July 30, 2008

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Research Summary

While medication-related fatalities in clinical settings have long captured the attention of researchers and health authorities, skyrocketing rates of deaths at home from combining medications and other substances have gone largely unnoticed, ScienceDaily reported July 29.

Researchers at the University of California, San Diego examined records on 200,000 U.S. deaths from medication errors from 1983 to 2004 and found that the highest rate of increase in these deaths -- a staggering 3,196 percent -- was for deaths at home from combining prescription drugs with alcohol and/or street drugs. This issue received national attention in January after the accidental prescription overdose death of actor Heath Ledger at age 28.

By contrast with the numbers for these domestic deaths, fatal medication errors in clinical settings such as hospitals where alcohol or street drugs were not involved showed the smallest rate of increase among the types of deaths studied: 5 percent.

"The decades-long shift in the location of medication consumption from clinical to domestic settings is linked to a dramatic increase in fatal medication errors," the researchers state in their study.

Besides calling for possible changes in policy and clinical practice as a result of the trend, the researchers believe research on medication errors needs an expanded scope to focus on domestic settings and younger patients in addition to clinical settings and elderly populations.

The research, supported in part by a grant from the Marian E. Smith Foundation, is published in the July 28 issue of the Archives of Internal Medicine

This article summarizes an external report or press release on research published in a scientific journal. When available, links to the sources are provided above.

COMMENTS ON THIS ARTICLE:
(Comments now appear first to last)

Posted by Peter Rostenberg, MD FASAM on 31 Jul 08 09:16 AM EDT
typo-repair Posted by Peter Rostenberg, MD FASAM on 31 Jul 08 09:11 AM EDT The epidemic of premature mortality of young people, teens to early thirties, due to diversion and/ inappropriate use of prescription drugs, is on a par with, or worse than leukemia or fatal car crashes in this age group. I have treated hundreds of such people with Suboxone. I am continually shocked to learn that almost every patient knows someone who DIED using diverted Rx's, or heroin. One source of problem: pain management docs dont know when to stop..no skill set there. PR prostenberg@sbcglobal.net

Posted by John from Oceanside on 31 Jul 08 12:16 PM EDT
Thanks Peter for your insight. The article uses the phrase "medication errors", I've also seen "reaction to medication," let's get real, individuals are using these drugs to get high. My theory, no science behind it, is that pill use wasn't a big problem until ecstacy, before that pills wern't cool. I think ecstacy's popularity brough pills back into popular culture. I think the entertainment press agents came up with these phrases that minimize their clients drug use.

Posted by Stewart B. Leavitt, MA, PhD on 31 Jul 08 06:13 PM EDT
Due to data limitations, Phillips et al. could not determine the specific Rx medications involved, the quantity of alcohol, or the type of "street drugs." Despite what other respondents imply (below), whether abuse of ecstasy or misuse of opioid analgesics -- or any other specific agents -- are most culpable is not indicated by this investigation. The more cogent lesson to be learned from this study, as Phillips and colleagues note, is that better evaluation and education of patients prior to prescribing medications with harmful potential, along with better monitoring of outcomes, would go a long way toward preventing tragic "fatal medication errors (FMEs)." This would require more time and effort by healthcare providers.

Posted by kay on 01 Aug 08 04:21 PM EDT
One has to wonder why, with all the drug testing in the US, that drug courts, the workplace, probation, and rehab programs continually rely upon inadequate onsite tests that frequently only test for drugs of abuse, or few prescription drugs. The design of these tests misses entire classes of drugs, and people that are declared "clean" can, in fact, be postive for other drugs not picked up by these instant tests. We need to emphasize drug testing that is driven by science, not manufacturers of product.

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