Yet.

I don't have a doctor and aren't about to start having one now.

I think you need something stronger than Xanax.

The problem with our medical system is that it relies heavily on the patient to be in charge of and on top of their own care.

The people who want to abuse the system have an easy time doing it what with different Doctors and Pharmacies widely available. As long as you are willing to pay cash and don't make any mistakes you can easily go to many different doctors and pharmacies and never be caught abusing.

At the same time we expect that an individual knows every drug they are taking and how they interact. That may be fine for most people but for some, especially the old or infirm that is a lot to expect. You would be amazed at how many people refer to their meds by color and time of day ie "the little yellow one I take in the morning."

It is unfortunately not uncommon for us to catch a drug interaction at the pharmacy. We have had patients bring in prescriptions for drugs they are allergic to. People bring in two prescriptions from two different doctors for drugs which are basically identical. We have even had people bring in drugs which would counteract each other from the same doctor.

Doctors are busy and frankly don't know enough about drugs and how they interact, and while most people will go to the same doctor they think nothing about going to multiple pharmacies.

Just today we had a guest who went to the dentist and got prescriptions for Ibuprofen and Tylenol #4 when they are already taking Coumadin and Vicodin-ES. You cannot take any of those together. The T4+Vicodin is way more Tylenol than a person can have and may cause Liver failure. While Coumadin + motrin= nonstop intestinal bleeding. The patient told here Dentist about the Coumadin but not the Vicodin. Had she gone to the pharmacy right by the dentists office she would have taken the pills and she only came to us because their computers where down so they could not fill the prescriptions.

Very few people really understand all the interactions between medications especially about the dangers of Over-The-Counter meds mixed with prescription drugs. They make mistakes and those mistakes can prove fatal. People who want to abuse the system have an easy time doing it and only the stupid or lazy ever really get caught. While Heath Ledger died because of the mixture he was taking such abuse is not that uncommon and only a small percentage of the people who abuse such drugs have such a reaction.

It is easy when you have the meds prescribed to get then and easy to take them, not get the effect you want, and then take more or something else and not realize that even though you haven't yet felt the effect of them they are in your system and interacting with the drugs you just took.

In short the system in open to abuse and mistakes and only a complete overhaul of the whole system would make such abuse stop. As long as such abuse exists we will hear stories like this.

...and I can't talk, cos I'm on Insulin !! :p

...Just to re-iterate, If you are on meds, you'd have to have a room-temp IQ (or be really out of it) not to think to mention your exsisting meds to anyone who is about to prescribe more meds to you (even if they're the same doctor/therapist - although I think there's software now that checks for interactions automatically when writing scripts).

Not judging, just sayin'.

"oxycodone, hydrocodone"

A Doc I know gives some pretty good, basic advice. He says, "Don't combine pills that rhyme." It isn't a hard rule, but a good basic rule of thumb. Both of these are strong opiates so basically taking both is like doubling up.

So sad all around. Sounds like Ledger is the victim of either seriously bad info, trying to self medicate without proper knowledge or both. Almost makes it more tragic: could have been avoided altogether.

Thanks, Ken. :)

(Also, glad to see you post. :D)

I was always grateful that I worked for a dentist that really knew about drug interactions. We even talked with patients about the effects of antibiotics in conjunction with birth control. I see it happen all of the time, and it's not because people are dumb... well, maybe, but... you know... people just don't think all the time, and they expect their doctors to fix the problem. Maybe it's a greater symptom of a society that's hooked on dependence (something I see in so many facets of American life today), it's really hard to say.

I agree with Ken that only a complete overhaul could change something, but as much sense as such a thing might make, there would be many opposed to it, which is depressing, yet understandable considering things like this don't make news outside of cases like Ledger.

On an entirely different note, I've taken Xanax before, and not due to my being prescribed it. If I can be honest, (and of all places in the world I feel I can be honest, it's here) Xanax made the day fly by effortlessly, frighteningly so. I can understand why someone facing emotional trouble could be drawn to that, as well as other drugs.

It was a very difficult time in my life when I should have sought professional help, but instead helped myself to the "bottle" and a few bottles of prescription meds. I blacked out while in Mexico, lost my car, and was generally stuck down there while trying to get everything back together. That, along with a few family incidents stopped that train - I'm lucky things ended the way they did and when they did... with me safe, and not doing stupid sh*t like that any more. I'm always trying to remain cogniscant of my family history, as well as my own - but I'd like to think I stopped things nice and early.

I'm always amazed how many doctors offer me opiates as treatment knowing my history.

Just as aside, this is not always a bad thing. If my friend Ginny (with the giant brain tumor) hadn't been in charge of and on top of her own care, she'd have been dead six times over.

That's not to say that most people are more qualified than doctors, just that it takes a good dose of both patient and doctor involvment to get really good care ... and often the patient will know best about the care they need (and well, tragically, often not)


But at least a high-profile drug-mix accidental overdose of common mistake like Heath's will likely lead to more awareness of the problem and save at least a few lives, at least in the short term.

Ditto that, iSm, in terms of my mom. The coumadin clinic actually consults HER as to what she should be taking - after eleven years with an auto-immune disease and 28 years dating DVT-preventative medication, her charts and graphs give her way more perspective than the docs. And whenever she goes to the hospital, her very tricky medical cocktails (none anti-depressive, but most required due to side effects from the steroids - which, if she weren't taking them, she'd die right away) always get mixed up, and it's up to her in her ill state to realize they're mis-medicating her. This is why - hmm, I haven't talked about this on the board yet - this is why she is no longer seeking actual treatment and refuses hospital stays even though she's frequently bleeding internally and lately passes an average of 2 kidney stones per day.