Wednesday, March 26, 2008

Ten Deadliest Drugs

I was pointed to an article about a study published in the Archives of Internal Medicine rating the top 10 deadliest drugs based on deaths related to their use. The top 2 are potent pain meds, oxycodone and fentanyl. Deaths with these are most often related to misuse, either intentional (over-medicating yourself looking for release) or unintentional (over-medicating yourself looking for relief). But we have seen a very few related to over-prescribing because of lack of familiarity with their potency, pharmacokinetics, and/or synergism of side-effects with other meds (i.e. respiratory depression) and medical conditions (e.g. sleep apnea).

The 4th med on the list is morphine. I would have to wonder (without seeing the original study) if some of these might be heroin deaths in which the characteristic metabolite of heroin (and diagnostic of heroin use) was missed in the analysis. The 6th on the list is methadone which I have written about several times before.

The 5th med is acetaminophen, as alluded to in the article its ranking is likely due to its often being in combination forms of narcotic pain meds.

The one drug missing from the list is hydocodone (a frequently used and abused pain med) and I am a loss to explain that.

This study was based on voluntary reports to the FDA, so there is a possibility of some under-reporting and, pretty significantly, does not include illicit drugs. The caveat to be aware of and “respectful” of these drugs is well taken.

1 comment:

Anonymous said...

I would just like to emphasize on what you wrote, which I believe is all too often over looked.

"..."over-medicating for release.", and, ..."over-medicating for relief".

In my opinion, many people, doctors included, do not realize that those who over medicate many times do so because they are in need of some release/relief and they are not getting it. I have known people with severe depression and pain and they were not "stupid" or addicts. They were suffering and not getting relief.

Perhaps if we approached this issue with an attitude that the person suffering is unable to get relief from these medicinal methods, we could make a small difference in the tragic consequences of over-medicating and get suffering people some much needed relief.

I love your Blogs! Always interesting!