Whitney, Heath and 37,000 More ... When Will It Stop?Feb22
2/22/2012 11:30 PM
It now appears likely that renowned singer Whitney Houstonʼs recent death was the result of an interaction between one or more prescription medications and alcohol, which, as we have seen far too many times before, can be a lethal combination. In another high-profile tragedy in 2008, actor Heath Ledger died from a combination of several medications. The report by the Office of the Chief Medical Examiner of New York concluded that he died "...as the result of acute intoxication by the combined effects of oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine” and that “...the manner of death is accident [sic], resulting from the abuse of prescription medications."
Although these two losses are tragic, they are but two of more than 37,000 other accidental deaths occurring each year due to prescription drugs in the United States, according to the Centers for Disease Control (CDC). In fact, the number of deaths caused by prescription drugs now exceeds those from traffic accidents, and has doubled in the past 10 years.
It has been suggested that a number of different factors underlie the precipitous rise in prescription drug deaths, including aggressive marketing of prescription medications directly to consumers by pharmaceutical companies, especially on television. In fact, this kind of advertising is allowed in only two countries, the United States and New Zealand, where the number of accidental deaths due to prescription medications is also rising. Physiciansʼ desire to help their patients may also play a role, with doctors reaching for the prescription pad more readily than in the past. Difficulty finding out what other doctors may have prescribed for the same person may also contribute to the problem.
In Heath Ledgerʼs case, an investigation showed that his doctors did not prescribe most of the medications involved in his death. Where he obtained them isnʼt known, but the widespread misperception that prescription drugs are safe may have played a role not only in his case, but also in many other drug interaction or unintentional overdose deaths.
In addition, because prescription pharmaceuticals generally target only one symptom or condition, and because many patients may have several different problems, doctors often find it necessary to prescribe several different medications. In some cases, even more medicines may required to treat side effects caused by the original medications, further complicating the situation. And although it is incumbent upon physicians to do all they can to prevent drug interactions, in the managed-care age of the 5-to-15 minute appointment that is not always easy. Furthermore, some patients with multiple medical conditions may see several different physicians, usually sub-specialists who may not always communicate with the other doctors involved in that patientʼs care. So the chance that problems might occur can rise exponentially.
Even individual pharmaceuticals can have serious side effects. The prescription medication sumatriptan, used to treat migraine headaches, has been implicated in a number of heart attacks, primarily in younger women, but also in older patients. including men. Aspirin is presumed to be safe because it is sold without a prescription and has been used for many years to treat pain. And while doctors may recommend low-dose aspirin to some patients to prevent platelets from sticking together and forming blood clots, aspirin taken in higher doses can cause bleeding that can be difficult to control, resulting in more than 1,000 deaths a year. In fact, over-the-counter medications cause an estimated 20,000 to 30,000 deaths in the US alone each year.
None of this should be construed to imply that there is something inherently wrong with prescription or over-the-counter medications. Modern pharmaceutical science has achieved some remarkable successes, such as in fighting infections that frequently resulted in death before the development of antibiotics, in prolonging peopleʼs lives and improving the quality of those additional years, and in preventing diseases with vaccinations. But the problems outlined above are real, and are alarming.
Contrast this with the effects of cannabis when used as a medical treatment option. There have been no verified deaths due to a cannabis overdose in the nearly 5,000 years of recorded human use of cannabis, whether for medical or any other purposes. In fact, there is no known lethal dose of cannabis in humans. This is not to say that marijuana doesnʼt have side effects, some of which may be undesirable, but they are generally mild, last only a few hours and disappear without any significant long-term sequelae.
It should be noted in this context that some people, in particular adolescents and children, may be more susceptible to other, as yet poorly defined and understood long- term effects of high-dose or frequent cannabis use, whether recreational or medical. Therefore, as with all other treatments, it is important to monitor the effects of cannabis and to use only the amount needed to treat or control a symptom or condition. As for recreational use, other commonly consumed substances such as alcohol are known to pose far more serious potential risks, including death from alcohol poisoning, and should also be avoided or used with caution, and not just by young people.
In fact, a recently published World Health Organization study found that alcohol kills more than 2.5 million people a year worldwide, more than AIDS, malaria or tuberculosis. The study concluded that alcohol abuse is the single most important health risk factor for the middle income people who make up half the world's population, far greater than obesity or tobacco use.
Any concerns about the potential health risks of cannabis, whether used recreationally or medically, pale to insignificance in comparison.
Although large numbers of clinical trials of cannabis have not been conducted, there is compelling evidence that cannabis is as effective if not more effective than many pharmaceuticals in treating a number of different symptoms and conditions. And although we will never know whether Whitney Houston, Heath Ledger, or any of the other people who have died from prescription drugs and drug interactions might still be alive if they had used cannabis instead of pharmaceuticals, the mere suggestion that marijuana, with its significantly greater safety profile, might be able to take the place of even some of those pharmaceuticals should spur much more medical and scientific inquiry into its potential benefits. We owe it to the memories of the more than 37,000 people whose lives are cut short each year simply by taking medicines they believe are safe.