The Growing Problem of Prescription Drug Deaths

by Jim Orr

More people die from prescription drug overdoses than from heroin and cocaine combined. Part of the problem arises from prescription medications being obtained illegally—such as when pharmacies are robbed or teens steal drugs from their parents. However, another very significant part of the problem—that is not being adequately addressed—is the alarming number of deaths due to overdose on medications that were prescribed for the deceased by their doctors.

The Los Angeles Times recently reported on its investigation of drug-related deaths reported in the coroners’ records of Los Angeles, Orange, Ventura and San Diego counties. The Times indentified a total of 3,733 deaths from prescription drugs from 2006 through 2011 in those counties. The investigation found that in 1,762 of those cases — 47% — “drugs for which the deceased had a prescription were the sole cause or a contributing cause of death.”

As noted in that article, patients who die from overdoses of drugs which have been prescribed for them most often overdose on prescription opioid painkillers. Some of the most commonly prescribed opioid painkillers include:

  • Vicodin (sold generically under the name hydrocodone)
  • OxyContin (sold generically as oxycodone)
  • Dilaudid (sold generically under the name Hydromorphone)
  • Methadone
  • Duragesic or fentanyl pain patch (sold generically under the brand names Sandoz, Watson and Mylan)

The recent Times article also points to another problem: the doctors involved are always quick to blame the patient. However, earlier this year, the FDA declared that “mis-prescribing” of extended-release and long-acting painkilling opioids is part of “a critical and growing public health challenge.” As a result, the FDA found it necessary to launch a new program with the goal of ensuring “health care professionals are educated on how to safely prescribe opioids and that patients know how to safely use these drugs.”

The FDA stated in a publication entitled “FDA Blueprint for Prescriber Education for Extended-Release and Long-Acting Opioid Analgesics” provides that “[p]rescribers should be knowledgeable about general characteristics, toxicities, and drug interactions for ER/LA opioid analgesic products.” For example, prescribers should be educated about the following:

  • Respiratory depression is the most important serious adverse effect of opioids as it can be immediately life-threatening.
  • Drug/drug interaction profiles vary among the products. Thus, knowledge of particular opioid-drug interactions, and the underlying pharmacokinetic and pharmacodynamic mechanisms is necessary for safer administration of opioid analgesics.
  • Central nervous system depressants (alcohol, sedatives, hypnotics, tranquilizers, tricyclic antidepressants) can have a potentiating effect on the sedation and respiratory depression caused by opioids.
  • Some ER opioid formulations may rapidly release opioid (dose dump) when exposed to alcohol. Some drug levels may increase without dose dumping when exposed to alcohol.
  • Using opioids with monoamine oxidase inhibitors (MAOIs) may result in possible increase in respiratory depression. Using certain opioids with MAOIs may cause serotonin syndrome.
  • Tolerance to sedating and respiratory-depressant effects of opioids is critical to the safe use of certain products, certain dosage unit strengths, or certain doses of some products. Patients must be opioid tolerant before using any strength of Transdermal fentanyl or ER hydromorphone. For other ER products, patients must be opioid tolerant before using certain strengths or certain daily doses.
  • For transdermal products, external heat, fever, and exertion can increase absorption of the opioid, leading to fatal overdose. Transdermal products with metal foil backings are not safe for use in MRIs.

Heygood, Orr & Pearson fighting for patient safety

The lawyers at Heygood, Orr & Pearson are among the nation’s leaders in handling cases involving potent opioids, and our law firm has the experience to prosecute medical malpractice cases involving a wide array of serious opioid painkillers, including Vicodin and hydrocodone, OxyContin and oxycodone, methadone, hydromorphone, Fentanyl, and others. To receive a free legal consultation and find out if you are eligible to file a case, please call our toll-free hotline at 1-877-446-9001, or by filling out our free case evaluation form located on this page.

by Jim Orr

Jim Orr is a licensed attorney and a partner at HO&P focusing on business and personal injury litigation. Jim was selected multiple times to the Super Lawyers List and has tried 70+ cases to verdict.