Several days after the passing of actor Heath Ledger, we commented on the rumors that were swirling about the presence of prescription drugs in Mr. Ledger's system and their possible role in his untimely death. This week the results of Mr. Ledger's autopsy became public knowledge, and the specifics of his death should serve as a stark message about the dangers of prescription drugs. At the time of his death, Mr. Ledger had several drugs in his system: the anti-anxiety medications diazepam (Valium) and alprazolam (Xanax), the pain relievers oxycodone (Oxycontin) and hydrocodone (Vicodin), and sleep aids temazepam (Restoril) and doxylamine (found in Unisom). The coroner ruled that Mr. Ledger's demise was the result of acute intoxication, and that the overdose that killed the young actor was accidental.
In many ways though, this report has done as much to raise questions as it has to quell them. Why did Mr. Ledger have prescriptions for so many powerful drugs? Where did the medications come from? If the prescriptions were written for a legitimate medical condition, who was supervising his treatment? We may speculate that Mr. Ledger was having trouble sleeping, and may have been having trouble with anxiety, which can be related to insomnia. But neither of those conditions would account for the Oxycontin or Vicodin. And no amount of speculation will uncover why a man with an alleged history of drug use was prescribed a bevy of very potent medications. There has been very little dialogue about Mr. Ledger's drug problems, largely out of respect for the deceased, but in refusing to discuss this specific situation, we are also missing an opportunity to discuss the larger issue of prescription drug abuse.
It wasn't all that long ago that we were discussing another celebrity who had died under similar circumstances. Prescription drug abuse, though, remains a topic that no one seems comfortable addressing. Rates of abuse have been rising for some time, and while there are the occasional legal battles or magazine articles it would seem that the status quo is acceptable. But when that status quo involves the deaths of thousands of Americans, action must be taken. As this website's founder, Dr. William Hapworth, made clear in a video post on the subject, it is physicians themselves that must take the lead on the issue of prescription drug abuse. Doctors need to be more aware of their patients' behaviors and reasons for seeking treatment. Prescribing physicians need to followup with and manage their patients' prescriptions, and ask specific questions about how any prescription may be affecting the patient's life. By forcing many primary care doctors to see as many patients as possible in an already crowded day, the health care industry has collectively created a situation that has turned doctors into unwitting accomplices in many instances of abuse, and the doctors themselves must be the ones that put a stop to it. Physicians are the ones best equipped to decide how and when regulation should happen, and by becoming leaders in this discussion physicians will ensure that future care meets the needs of their patients.
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