Search the LHSFNA website
Published: September, 2007; Vol 4, Num 4

 

Accidental, Lethal Drug Mixes More Common

You see a couple of different doctors, and each prescribes some medications for one of your conditions. Then, you catch a cold and head to the drug store for some over-the-counter relief. No big deal, right?

Wrong.

You have to be careful and check for the possibility of a dangerous drug mix. According to the Centers for Disease Control (CDC), nearly 20,000 Americans die each year because of unintentional drug poisonings, usually the result of harmful drug mixes. Such mixtures are now the second-leading cause of accidental death in the United States, after automobile crashes.

The number of accidental drug deaths rose 68 percent in just the five years from 1999 to 2004, the latest year included in the CDC analysis. A big part of the problem is simply the increasing use of prescription medications.  Between 1994 and 2005, the number of written prescriptions increased by 70 percent, to 3.6 billion. In addition, sales of over-the-counter (OTC) drugs and dietary (or herbal) supplements are also rapidly increasing. Indeed, many drugs that are now OTC required a prescription just a few years ago and are very powerful medications in their own right.

In 2004, 82 percent of Americans reported taking at least one prescription drug, OTC or dietary supplement in the previous week and almost a third reported using five or more during that period. Among senior citizens, the danger is even greater. Three-fourths of all Americans over 65 took four drugs on a daily basis in 2005 while the average 75-year-old took eight.

Online Drug Interaction Checkers 

Source: The Washington Post (02/23/07)

Moreover, with patients seeing more specialists and becoming more proactive in the use of OTCs and supplements, the chances of consuming a dangerous mix is compounded. Drug allergies and the particular health problems of each individual further complicate the situation. Experts advise patients to maintain a list of all the prescription drugs, OTC meds and supplements they take and to consult a doctor or pharmacist before adding anything new. 

Pharmacies typically maintain patient databases that alert the pharmacist if a patient is ordering a potentially dangerous drug combination. However, for the database to work, it must be constantly updated. Thus, experts recommend that patients always use the same pharmacy and that they make the pharmacist aware of their OTC usage. If a patient has drug coverage such as LaboreRx, prescription orders are automatically scanned for potentially dangerous interactions with other prescriptions in the system.

A growing number of online resources can help you check your medications for potentially dangerous interactions (see box). However, the websites are unregulated and draw their information from different sources. The assessment from one site may vary substantially from that of another. Therefore, experts recommend that the sites be used for guidance only and to develop questions for the doctor or the pharmacist.   Also, just because a site indicates a possible conflict, experts say you should never discontinue a prescribed medication until you talk to your doctor. A sudden discontinuation can be dangerous in and of itself. It should also be noted that under the specific care of a physician, a combination that may be otherwise dangerous can be closely monitored to achieve intended results.

[Steve Clark]