Dangers of Prescription Drug Mixing

While mixing an alcoholic cocktail can be fun, prescription drug mixing can be dangerous, if not fatal. According to the Centers for Disease Control and Prevention (CDC), unintentional drug overdose mortality rates have been on the rise since the early 1970s.

Drug Interactions

When we feel ill or get sick, we discuss symptoms with a doctor while he measures our blood pressure, temperature and heart rate. After discussion and possibly a few tests, we are most likely given a prescription for a drug.

Let's say you've had trouble sleeping recently. You visited a sleep doctor who prescribed a medicine to treat your insomnia. A few weeks after your visit with the sleep doctor, you contract a lower respiratory infection. You make an appointment with your general practitioner.

Your doctor goes over your symptoms and runs a few minor tests. He tells you that you have a lower respiratory infection and it has progressed to the point that you need an antibiotic. He asks you if you are on any other prescribed drugs and you tell him about the sleep medication.

After a day or so, your arm starts to throb from that accident you had six months ago. It has not hurt this bad for a while. It hurts so bad that you go to your medicine cabinet and grab your old prescription oxycodone. Oxycodone is a narcotic pain reliever.

You take an oxycodone pill and, after a short time, you feel the pain dull. Now it is bedtime and time for your next antibiotic pill (for your infection). It is also time for your sleep pill (for your insomnia). You take both prescribed drugs and look forward to a sound sleep.

This prescription drug mixing is not good. While taken separately, each prescribed drug is fine and will do its job. Yet taken together or near in time, they can make for a deadly combination.

As for our prescription drug mixing situation, the sleep medicine is supposed to cause drowsiness and allow you to fall asleep. One of the possible side effects of oxycodone is drowsiness. In addition, you have taken your antibiotic pill, which can cause dizziness. This combination of drugs is ripe for drug overdose. Added to the mix is your lower respiratory infection, which causes shallow breathing.

Luckily for you, it is just harder for you to wake up in the morning and you feel tired all the next day. Yet for some people this combination can cause respiratory distress or even death.

Accidental Overdose

How many people die from drug overdoses? In 2005, 22,400 deaths were recorded from unintentional and intentional drug overdoses, according to the CDC. This number of fatalities is caused mainly by opioid painkillers, but other prescription drug mixes have played their part in these deaths.

People who take more than six different drugs have a higher incidence (an 80% chance) of at least one drug interaction, New York's School of Pharmacy found. While not every drug mix causes death, some can cause side effects that can confuse you about your condition and make it harder for your physician to make an accurate diagnosis.

Older people are taking more prescription drugs and have difficulty keeping track of what they take and when, according to the American Association of Retired Persons. Since their physcial makeup has changed from their youth, drugs may react differently, another recipe for disaster.

Tips to Avoid Prescription Drug Mixing

While there will always be some risk of prescription drug interactions when you take more than one drug, you can keep your chances of serious side effects down by following some simple guidelines.

• Make a medication list. Include any herbal remedies, vitamins, dietary supplements and over-the-counter drugs. Make note of older prescription drugs on this list that you used to take for a condition that you may no longer have. Do not take any medication without your doctor's knowledge.
• Update the list.

Prescription Drug Abuse and Pill Withdrawal

Prescription Drug Abuse, or pill addiction as it is commonly called, and, ultimately, 'pill withdrawal' have been with us since doctors began prescribing drugs, but has become more widespread since the advent of the ‘repeat prescription’ or ‘refill’, whereby patients can have a prescription renewed without having to visit their doctor. This can be as simple for many people as visiting a pharmacy and filling out a form giving their name, address and the drug they want. This is then returned to the surgery for the doctor to countersign. The problem is that these can often be signed as routine, rather than consideration being given to the need, and so facilitating prescription drug abuse.

If a certain patient begins to request repeats more often, would this be noticed? Theoretically it should, but in practice it is frequently not. Not, that is, until the next review. Frequently, twelve repeats are allowed before the patient must again speak to the doctor personally to review the treatment. Prescription drug abuse, and resultant pill withdrawal symptoms, are generally overlooked by the medical profession.

The type of prescription drugs which lead to pill addiction are wide and varied, and not just tranquilisers such as diazepam (Vallium) and nitrazepam (Mogadon). Common ones are codeine and codeine-containing painkillers such as cocodamol, and even over-the-counter codeine based painkillers such as Solpadeine which has its own addiction support group. Most prescription drug abuse is of one or other of these two types of drug: tranquilizers or painkillers. Tranquilizer pill withdrawal is very common in developed countries.

People involved in prescription drug abuse show any of a number of symptoms which are common to all patients suffering from pill withdrawal.

The main symptom of pill addiction is an increased tolerance to the drug, so that the user needs an increased amount to get the same effects they were used to. More and more of the drug is required, and four times is not uncommon. This leads to many problems, not the least of which is that it becomes difficult to control the symptom for which the drug was being taken in the first place. For example, it becomes increasingly difficult to control pain.

Those who suffer from pill addiction have not done so deliberately. Unlike other drug addicts, they have not taken increasing doses simply to get a 'buzz'. It happens to them gradually, over an extended period of time taking the same drugs to treat their condition. Cocodamol is commonly used in the treatment of arthritis, for example, and prescription drug abuse in such cases is hardly abuse in the real meaning of the word.

The pain-killing effect reduces as the body becomes more and more used to the drug, so the patient must take more or suffer increasing pain, resulting in pill addiction. It is not deliberate, but once it starts the patient can often do little about it due to the pill withdrawal symptoms compelling them to keep taking more and more. They know it is wrong but can do little about it, and try to hide how many they are taking from their family. They reach a stage where they are frightened to admit it, and are terrified to ask their doctor for help in case the drugs are stopped altogether.

Prescription drug abuse leads to physical dependence, and the person cannot function normally without a supply of the drug. The body adapts to the presence of the drug and can function while it is being supplied, but once the course of treatment is over, the patient suffers from pill withdrawal symptoms. These can be severe, including physical illness, mood swings and aggression, and depression. Ultimately pill addiction can lead to death through overdose. Paracetamol based painkillers containing codeine, for example, can be dangerous. The patient overdoses for the codeine content, but the paracetamol is insidious and can cause severe liver damage over a period of time.

The most obvious sign of prescription drug abuse is that the persons affected cannot stop taking them. They will increase the frequency of presentation of repeat prescriptions on a pretext such as needing extra since they are shortly going on holiday, or will resort to doctor hopping. The internet has also made it easy to purchase prescription drugs online, without a prescription from the patients own doctor being required. As has been previously explained, this type of pill addiction is not their fault and more could be done to control the circumstances which cause it.

Doctors, and in some cases the pharmacists, should be aware of the potential problems of long term use of such drugs, and give advice and help once the time has come to stop them. The dose should be reduced gradually rather than suddenly stopping the supply. Prescription drug abuse and pill withdrawal are becoming a serious problem in otherwise innocent law-abiding people. It should be possible to find a means of regularly changing the chemical nature of the drugs an individual has been prescribed with in order to reduce the possibility of this type of pill addiction.

Once dependence has been confirmed, or better still, admitted by a patient, steps can be taken to treat the addiction. Kicking prescription pill addiction is not easy, but better than a lifetime habit, and the doctor can help make it easier to achieve by using gradual withdrawal techniques.

Copyright 2006 Peter Nisbet

A Drug Detox Program Can Overcome Prescription Painkiller Addiction If Done Quickly and Thoroughly

Spencer McIllwain, promising football player and all 'round good citizen of Oklahoma died nearly four months ago from an overdose of methadone. His father, Rick, recently told Tulsa World of his two year battle with his son's addiction to prescription painkillers. "There are countless people in the same situation," he said, "not knowing where to turn." It seems that Rick did everything right, everything he could do. But Spencer is dead. Even drug detox and drug rehab failed him. Why?

Spencer was first prescribed OxyContin when he sustained an ankle injury in 2003. None of the reports available say how long he was on the drug but two years later, Spencer's dad received a call from a dentist who reported that Spencer had asked for a prescription for painkillers because of a toothache. Spencer's dad knew he didn't have a toothache, and decided to look into it.

Spencer's parents went to see him, and Spencer acknowledged that he had a drug problem. He said he could handle it on his own but when his parents checked on him a few weeks later he was a mess. They quickly got him into a 30-day drug rehab program followed by a six-week outpatient program. The articles don't say whether Spencer also did drug detox.

It appears Spencer was doing okay for several months after that, but another surgery - this time for an intestinal block - again pushed him into painkillers. He went back to rehab, where he overdosed on methadone and died.

How can you avoid such a situation happening to someone you love?

1. If it is necessary for a person to take painkillers for surgery or an injury, find out from the doctor if it's possible to take non-narcotic painkillers - no morphine, no methadone, no OxyContin or any drug containing oxycodone.

2. Whatever drug is chosen, ensure you research that drug fully so you know what to expect. Check the Internet, not just with your local doctor. As we found out in the OxyContin hearings, doctors can be misled by drug companies. Thoroughly familiarize yourself with the side effects, and with the drug's potential for dependency, abuse, and addiction.

3. As soon you can, within a few days if possible, get the person to stop the painkillers. This will reduce the risk of dependence and addiction. If they have to stay on them longer than a few days or a week, contact a medical drug detox program that helps with withdrawal from prescription painkillers. They can help you determine whether the person should stop trying to take the drug on their own or if they need medical drug detox.

4. If the person does develop an addiction, get them into a medical drug detox program as a first step. This will allow them to withdraw from the drug safely. It will also set them up to be able to go through drug rehab.

5. After drug detox, ensure they get into drug rehab immediately. Choose a residential treatment program that lasts at least two months, if not longer. This gives the person enough time to address the personal issues that caused the addiction in the first place and shores them up against the possibility of relapse. The person should not leave the drug rehab program until those issues are addressed and are no longer bothering them.

6. After they leave drug rehab, ensure they are not going back into the same environment and situation that got them involved in drugs in the first place. This would generally be addressed as part of a good drug rehab program, but keep you eye on it. Stay in very close touch with them. Watch for any signs of drug use, and also watch out for alcohol. Alcohol can sometimes fuel drug abuse.

7. At the first sign of any trouble whatever, assume the worst. Not a nice thing to say, I know, but with dangerous drugs you can't be too careful.

It is possible to help someone overcome prescription drug addiction and dependency with a good medical drug detox program and long-term residential drug rehab. Prescription painkillers are so common these days that no one can afford to not know about their dangers and what to do about them. Learn what you need to, teach others, be alert, and act fast. You could save the life of someone you care about.

Gloria is a freelance writer who contributes articles on health.

How to Find a Reputable Online Drugstore

Since every other business known to man has moved their business out onto the internet it should have come as no surprise when the pharmaceutical companies decided to do the same. Yet the concept of an online drugstore, particularly one that deals in prescription medications, is one that is disconcerting to say the least. The potential to abuse the anonymity that buying drugs online presents is great, particularly in light of the fact that not all online pharmacies require interaction with a health care professional (i.e. they will sell prescription drugs without a prescription).

In light of the fact that not all drug stores require a prescription it stands to logic that not all of the drugs sold by these establishments are top quality either. There is always the potential of adverse side effects to a medication because it was improperly manufactured, resulting in a minute change to its chemical composition which can have resounding side effects within the body of the patient that they never could have predicted because the medicine in its purest form would cause no such reaction.

Regardless of the consequences, there are a number of benefits of shopping from an online drugstore. For those individuals who live in isolated areas it can be a godsend, saving them the long journey into town every time that they need to fill a prescription. This is especially true for senior citizens and those with chronic health problems who use a number of prescriptions regularly. Many online drugstores will also sell their medications at prices well below that of a regular pharmacy, a service which is priceless to the hundreds of people currently living without health insurance to help absorb some of the exorbitant cost of prescription drugs.

The dilemma, then, lies in identifying which online drugstores are reputable. The first thing to do when looking for an online drugstore is to attempt to find a virtual branch of a pharmacy which has already established a name for itself, such as Eckerd’s. Another is to look for the Vipps symbol on a pharmacies website. This means that the pharmacist is nationally certified and decreases a number of the safety risks involved with purchasing drugs online.

The practice of shopping for drugs online is a risky one regardless, but with the proper precautions it is possible to locate an honest, trustworthy online drugstore and reap the benefits that would not be available to you anyplace else.

Online-Drug-Source.com, one of the Internet's largest sources of drug news, information and online pharmacies. This site will help you evaluate online pharmacy resources and enable you to find sources of medications at competitive prices.

What "No Approved Therapeutic Claims" Means On Herbal Treatment Packages

Herbal supplements have now become popular alternatives for the health needs of many people, as new safety regulations have been implemented. However, some still ask, are they good for you? Well, that would depend on the herb, your current health and your medical history. Herbal medications sometimes have active ingredients that can affect how your body functions, just as over-the-counter and prescription drugs do.

These medications could be particularly risky for certain individuals, and many herbal product labels are often vague, confusing and of little help when it comes to making a wise selection. It is advisable to remember that if you're considering herbal supplements or other dietary products, educate yourself about any medications you intend to use before purchasing them, and talk to your doctor about any herbal products you're considering taking.

Are Most Herbal Treatments Safe?

Until recently, government regulation and consumer protection were quite limited for dietary supplements. However, new rules noted by the Federal Food, Drug, and Cosmetic Act give the Food and Drug Administration (FDA), the federal agency responsible for regulating the safety of food and drug products, the authority to oversee the production of local and imported dietary supplements, including herbal treatments. Dietary supplements don't need to go through the rigorous review process that new drugs must undergo before being "approved" by the FDA.

However, the new regulations aim to enhance consumer safety by requiring supplement manufacturers to follow certain manufacturing practices and ensure that supplements contain what their labels claim, and are free of contaminants.

The FDA is responsible for monitoring the safety of herbal treatments after they're on the market and enforce punitive action against violators that sell unsafe supplements. These new regulations will be phased in over a three-year period so that by June, 2010, all supplement manufacturers should meet these requirements.

"No approved Therapeutic Claims": What It Truly Means

The proliferation of food and herbal supplements, which are being advertised and passed on as effective cure-all products, despite the fact that these have no established therapeutic effects, is a major problem for regulatory health agencies. To the common consumer, the phrase "No Approved Therapeutic Claims", would generally mean that a supplement has not yet been determined by the FDA to be as safe and effective as advertised.

It could also mean that no studies and long-term research have yet been done to determine the efficacy of the pill, or herb in actually treating anything. This phrase usually serves as a disclaimer of sorts. The Dietary Supplement Health and Education Act of 1994 (DSHEA) was passed by US Congress to ensure consumers' rights to access safe and effective dietary supplements.

This law gave the FDA the mandate to strictly monitor this sector, and ensure the products were safe and made in a consistent manner. The FDA also passed rules to require "Adverse Event Reporting", which requires herbal medicine producers to track safety data, as well as ensure good manufacturing practices. This also means that the herbal products must be made to standardized quality to ensure that consumers are getting good-quality and safe products.

Contact Lens Approval Process Has Similarities to Clinical Drug Trials

Contact Lenses are regulated by the Food and Drug Administration (F.D.A.) as Class 3 Medical Devices. Class 3 medical devices are defined by the FDA as those that support or sustain human life, are of substantial importance in preventing impairment of human health, or which present a potential, unreasonable risk of illness or injury.

Class 3 medical devices require the highest level of evidence for market approval which is a process to evaluate safety and effectiveness before the product can be brought to market. Clinical studies, scientific documentation, and reviews are required. There can also be post marketing surveillance studies after a new contact lens is released to look for further problems. Prescription drugs require a similar but much more involved process before they reach the market place.

A press release from the National Eye Institute in 2008 stated a phase one gene therapy clinical trial showed promising results for a blinding disease known as a congenital form (present at birth) of Optic Atrophy. The retinal pigment epithelium is the layer of the tissue lining the back of the eye, the retina, that nourishes the rod and cone cells we see with. A mutation in a retinal pigment epithelium gene causes these cells to respond very poorly to light and results in loss of vision. Frequently we see news on gene therapy and are led to believe everything will be cured by in short order. Patients in the study received a sub-retinal injection to replace the defective gene in areas of the retina that were still relatively healthy. Each patient had visual impairment that had been present since birth due to the defective gene. Over a 90-day period there was significant improvement in vision. Day vision was improved by 50-fold and night vision by 63,000-fold compared to levels prior to treatment. Restored vision was localized to the area of treatment in the eye that received the injection. We tend to think of new drugs and medical devices as overnight miracles but researchers have been working for 15 years to get to this point. The new generation of 30 day wear contact lenses actually started with research done in the 1970's.

All new prescription drugs and medical devices face the funding and regulatory structures that are required to pass the requirements for approval. While this process is frustrating and fraught with problems, if you spend a little time reading about the equivalent processes and equivalent oversight agency in China, you will gain a greater appreciation for the system we do have in place.

Clinical trials for prescription drugs proceed in four phases over a period of years and millions of dollars. Actually there is a new phase zero but since it is still in transition we will cover only the 4 main phases.

The first testing of drugs in humans as referred to as phase one. Typically this involves healthy individuals in a group less than 50. The main goal of phase one trials are the to make sure there are no glaring safety issues and gain some understanding of how the drug works and is processed in the body. Normally, a small (20-50) group of healthy volunteers will be selected.

Phase 2 trials are mostly just an extension of phase one with several hundred patients. They also pry a little more into the amount of drugs needed to be effective in treatment and what time intervals are needed to administer the medication.

Phase 3 studies are what brings a new drug to the corner pharmacy. Phase 3 trials may base tentative approval on only several hundred patients, and typically no more than 2000-3000 are in this phase. For you, that does mean a 1 in 10,000 lethal effect may not be known initially, or some other surprises may not be uncovered for several years. In Phase 3 patients are split into groups with one group receiving placebos (no active medication) and another group receives the actual medication, Researchers typically don't know who is getting what until the end of the study. Occasionally, it becomes so evident that a drug is saving lives or vision that the study is stopped as it is not ethical to deprive the patients receiving placebos of the full benefits of the new drug. The Woman's Health Initiative study on hormone replacement therapy for menopause was an example of this. The study was terminated early when it was determined that hormone therapy increased the risk of breast cancer.

Phase 4 is where the good, the bad, and the ugly comes out. This is also called the Post Marketing Surveillance Phase. Phase 4 trials involve the long term safety monitoring where the 1 in a million problems start to be seen over time. Also the interactions with other medications may become more evident, and strange reactions specific to an individual may appear. Long term effects like the diet drug that caused heart problems may show up after a number of years.

Our Fort Collins office has taken part in several optometrist clinical studies with contact lenses. These are somewhat like the phase 3 clinical trials for medications. A lens may be studied by eye doctors on 500-600 patients prior to approval. While there is no such thing as a placebo lens, a contact lenses that has been approved in the past can be used on one eye as a comparison control. It a lot of fun to be involved in these emerging contact lens products but also a lot of record keeping, and when patients don't keep their appointments the stipulations are pretty rigid about dropping them from the study. Generally we do not expect the same type of serious complications with contact lenses that can be seen with new medications.

One final bit of information. Sometimes things works out in odd ways. While drugs may have undergone all 4 phases and have approval for specific conditions, that does not restrict doctors from using medications "off label" in ways they have not been studied and approved for.The Food and Drug Administration regulates drugs and medical devices, not Doctors. Currently, the standard of care for certain eye infections is "off label eye drops." It would be considered substandard care to use the FDA approved medication in these special cases. This a very uncommon occurrence indicative of some weak point in the system where clinical experience is ahead of the curve. Someday there will be a way to account for these situations. Until then, we will continue to do the best with what we know today.

How To Safely Dispose Of Rx Drugs

According to the White House Drug Policy Office, prescription drug abuse among 18 - to 25-year-olds rose 17 percent from 2002 to 2005. In 2004 and again in 2005, there were more new abusers of prescription drugs than new users of any illicit drug.

Young people mistakenly believe prescription drugs are safer than street drugs, doctors say. But accidental prescription drug deaths are rising and students who abuse pills are more likely to drive fast, binge-drink and engage in other dangerous behaviors. Parents should be alert to these signs and changes in behavior.

Al Gore III's arrest may raise awareness among parents, said Dr. Donald Misch, director of health services at Northwestern University in Evanston. "This is an opportunity for people to understand this is happening in your household," he said. "These are your kids. The drug dealers they're going to are their doctors, their parents and their friends."

Parents should clean out their medicine cabinets and lock up any prescription medications. This is more than likely customary in homes with toddlers but is advisable no matter the age of the child, just to be safe. This would also prohibit giving them to friends if your child isn't a user.

Deputy drug czar, Scott Burns stated: "We found in focus groups of young people across the country that in large measure they're getting the drugs from their own medicine cabinets and the Internet. Some Web pharmacies deliver ordered drugs without legitimate prescriptions, but other sites steal credit card information and never fill orders, Burns said.

With the rise in prescription drug abuse, three federal agencies issued guidelines earlier this year for disposing of medications without harming the environment.

1. Remove unused, unneeded or expired prescription drugs from their original containers.

2. Mix prescription drugs with an undesirable substance, like used coffee grounds or cat litter, and put them in impermeable, nondescript containers, such as empty cans or sealable bags.

3. Throw containers in the trash.

4. Don't flush prescription drugs down the toilet unless the accompanying patient information says specifically it is safe to do so.

5. Return drugs to pharmaceutical take-back sites that allow consumers to return unused drugs for safe disposal.

Sources: White House Office of National Drug Control Policy, Department of Health and Human Services, Environmental Protection Agency.

Author's Note: A pharmaceutical sales representative can increase sales by volunteering to return expired or outdated medications for the wholesalers in their territory. This can be a daunting task for their employees. Offering customer service at this level is rare and not expected. This also gives the drug rep an idea of the inventory on hand and an opportunity to help sell their medications. The wholesaler can offer specials to the retail drug stores on your proprietary pharmaceuticals.

Avis E. Ward is a visonary called to unite the personal, spiritual and political through Love. She is an Ambassador of Love, Inspirational Speaker, Certified Seminar Leader and Action Coach. Avis is also an Orthodontic Management Consultant. Avis invites you to view her blog and participate in her forum.