One Year Later: Heath Ledger's Tragic Overdose Death Reminds Us More Must Be Done

Health Ledger was nominated for a posthumous Oscar award today for his haunting role as the Joker in the latest Batman film, The Dark Knight. The announcement happens to coincide with the anniversary of Heath Ledger's tragic overdose death last year in New York.

Since the late 1980s, it's become traditional to see Oscar presenters on TV prominently displaying red AIDS ribbons drawing attention to an epidemic that claimed nearly 15,000 lives in 2006. This year, the anniversary of Heath Ledger's death should call attention to another though largely unrecognized national crisis -- preventable deaths from drug overdose.

Accidental drug overdoses cause the death of more than 22,000 Americans every year. According to the Centers for Disease Control, drug overdose now ranks as a leading cause of preventable death, second only to motor-vehicle accidents. Accidental overdoses killed more Americans last year than did firearms. Yet no federal agency is tasked with mitigating this national health crisis.

Perhaps that's due to the misconception by some that overdose fatalities are mainly the problem of drug addicts, unworthy of our concern or compassion. That's nonsense. All lives are worth saving; all families matter and none of them should ever have to experience the devastating tragedy of a fatal overdose. In fact, as in Ledger's case, anyone who takes opioid painkillers or anti-anxiety medications is at risk. Perhaps surprisingly, there is evidence to suggest that pharmaceutical drugs, often misused and diverted, are now three times more likely to have caused a fatal overdose than all illicit street drugs like heroin, cocaine and methamphetamine, combined.

Fortunately, some cities and states are taking the initiative to address these preventable deaths. Boston, Chicago, Los Angeles, Philadelphia, New York and other cities are starting to make available naloxone, a low-cost, easy-to-use medicine with no potential for abuse that immediately reverses the effects of an opioid overdose. Naloxone, distributed to at-risk populations through syringe-exchange programs and other means, has already saved thousands of lives and returned loved ones to their families and friends. Naloxone starts working immediately by temporarily restoring breathing for 30 to 75 minutes, allowing someone enough time to call 911 and save a life.

Overdoses usually happen in witness of others and, if someone calls 911 right away, most people can be saved. One barrier to making that call to 911, however, is the fear of criminal prosecution for drug law violations. The fear is real. Drug arrests can ruin lives in another way, with incarceration and lifetime of stigma and economic destitution. It should never be a crime to call 911 to save a life.

States and elected officials are saving lives by making it easier to call for help with "911 Good Samaritan" immunity legislation. New Mexico broke ground in 2007 when the state legislature passed and Gov. Bill Richardson signed the first such law in the country that provides limited immunity from arrest to victims and witnesses of overdose who summon emergency services. Now New York, Maryland, California and other states are considering similar legislation.

Clearly, our country needs more education and outreach when it comes to preventing overdoses and reducing overdose fatalities. A shift in law enforcement's approach to drug problems from incarceration to treatment would do much to get this national crisis out in the open and begin a dialog. Many hope the incoming administration will take a hard look at our nation's drug policies, support for which Mr. Obama voiced while on the campaign trail. Congress should work with the president-elect to pass comprehensive overdose prevention legislation this year. There is nothing we can do to bring back Heath Ledger but we can learn from the tragedy and enact compassionate and sensible legislation to save thousands of others like him.

Isaac Skelton is the former director of publications for the Drug Policy Alliance www.drugpolicy.org. Meghan Ralston is the Los Angeles harm reduction coordinator for the Drug Policy Alliance, which is releasing a new report next month, "Preventing Overdose, Saving Lives: Strategies for Combating a National Crisis."

Comments

[biskitdaddy]

Let's see: you can take all the prescription drugs your doctor will prescribe, smoke all the cigarettes you want and develop lung/throat cancer, and drink all the booze you want and destroy your liver, but by God you better not get caught smoking a joint!

[twogunmojo]

i will keep posting this until it appears....don't tell the brady campaign that legal drugs are more dangerous than guns....if word gets out they will never get another dime...

[gretchenart]

my suspicion is that many of these so-called "accidental" overdoses are no accident, which means an overdose prevention might work best in conjunction with a suicide prevention effort.

[iskelton]

Actually, all of the poisonings caused by murder and suicide have already been subtracted out of the data. It is usually clear which ones were unintentional or accidental. But, you are correct in that the country needs much much more free and low-cost treatment... both for drug abuse and mental health. And, yes, in many cases the two are linked.

[luziannagirl]

Yeah---and a shift from incarceration & punishment to treatment and prevention would also free up something like 60% of the present jail and prison space, not to mention backlogged court dockets----for violent offenders.

De-criminalizing illicit and illegal drug use would also reduce the number of violent offenders by reducing the involvement of the black market.

Of course, there are those who are making boatloads of money off the prison industry, who don't want to reduce the number of incarcerated Americans-­---highest per capita in the civilized world.

[tbone99]

Sorry - a movie stars death does not move me.The man had every resource needed to seek help for his problems .Millions of people do not .

We need to make mental health funding a priority that everyone has access to, and rehab an alternative or at least a component to prison.
These issues are much more pressing.
Narcan for addicts is like chipping away at the paint job of a fast moving vehicle,

The real priority we need to consider is how can we convince our citizens that their efforts are important to all us and that all people count , so that people don't turn to drugs to quell their dis- ease.?

[BlackTom]

It is a good thing to have as much compassion for a movie star as for any other human being.
That said, there is no question that mental health issues need to be de-stigmatized and funded in the same fashion as physical health issues - since there is really no difference between them, except for the fact that anyone can see when a leg is broken, but brain issues are not so visible, and are much harder for the average person to understand.

There is way to make it easier to understand.
Emotions are physical. Thoughts can make the heart race, stimulate sweat glands, trigger the release of many different hormones, brain and body chemicals. Everyone has experienced this.
As a society, we do a very poor job of recognizing this simple fact, and all the consequences that follow. We can do a much better job, and this could really help to reduce the use of dangerous drugs, which can only treat an individual problem.

[CellarDoor]

His "problems" you say? As in having walking pneumonia and general exhaustion from overwork? And you are saying you have no sympathy? Have you a soul? The man took MEDICINES to treat his illness and those medicines killed him. But you go ahead and judge him based on your misplaced standards in this context.

It infuriates me to see people so callous and uncaring with their ego-driven need to condemn basically everyone who doesn't meet their personal standards of societal acceptance. Holier than thou, indeed! It's one thing to condemn a drug user stealing and robbing to feed his or her habit; it is another thing entirely to condemn a person for basically trusting in his doctors and the medicine they prescribed him.

More people died from accidental overdose of prescription medications last year than all illegal drugs combined. If you purchased some aspirin for a headache and it killed you, are you saying we shouldn't have sympathy for you as you had other resources to cure your headache? To "treat your problems"? With respect, that's nonsense.

[tbone99]

As a nurse I see people every day who die and are disabled because of their inability to afford medicine , shelter and healthcare as well a malpractice and medical side effects. You have no idea the stories that come through the hospital . None of these people get a single line in the newspaper or a drop of sympathy from the system, much less the general public

Just because someone is famous all at once people "care"
If he was sick he needed to take care of himself - not keep working. Whats the worse that would happen to him - lose a few thousands dollars in pay?he had a cushion - people who are not famous don't!

[Clem2]

You know what is really needed is serious study on sleep problems, including insomnia, delayed sleep onset insomnia, non-24 circadian rhythms, circadian rhythm disturbances.

those of us with sleep problems are basically incapacitated as no new breakthroughs have happened in 30 years, Same old, "sleep hygiene, keep a regular schedule" stuff that doesn't help folks with the above disorders.

Sleep labs are a waste of time unless you have apnea or narcolepsy, which they CAN help with. But the rest of us are perceived as lazy or depressed or anything other than having a problem with our brain sleep centers.

I can understand how Heath Ledger's need for, and anxiety about, sleep led to an overdose.

Let's have some research funding for this overlooked, non-sexy disorder!

[NounverbPOW]

You speak for me on this one. The fear of not sleeping is very real to those of us who live it. I feel almost handicapped myself when trying to keep my job and compete in a wlorld full of people who can take recharging their nightly batteries for granted. My doctor is very reluctant to hand out any meds (I get 14 Ambien at a time, and have to use them only as a last ditch effort.)

[tbone99]

Try 5 HTP - a natural serotonin precursor made of griffonia beans .I had a bad insomniac problem and it has reall helped. I've used it for a couple of years It is non addictive and I think helps with depression as well, which is frequently a factor in insomnia .

[Anandas]

There are quite a few informative books out about the very real issue of doctors
prescribing unnecessary meds like candy and big pharma pushing for more
use of meds daily. (Our Daily Meds is one place to begin the search)
I put the blame squarely on our medical ma*fia, primarly,
and secondarily on the people taking the drugs, however sadly and wastefully
their life ended. Frazzled overwhelmed people need long yoga retreats , rather
than drugs, hyperactive children need meditation, whole foods, and reduced
electronic stimulation more than drugs, people with physiological imbalances
need natural healing rather than drugs......get the picture?

[ThornInYourSide]

Accidental overdoses cause more preventable deaths than firearms every year? Is that legal or illegal drug overdoses?

It sounds to me like we need to have a "Brady Bill" for drugs. Maybe a 7 day waiting period for prescriptions? FBI background checks? Limit the dosage? Limit the size of prescriptions? Limit the amount of prescriptions allowed at one time?

If all of these ideas will work for guns, maybe they will work for drugs.

[BlackTom]

First off, dosage is controlled by the physician based on the circumstances of the patient. The size of the prescriptions are generally limited to a supply of two to four weeks. Often, there is a very long waiting period before people actually seek help, and then it often takes more time to find the correct medication, dosage, and/or combination to successfully treat the problem. Most abusers are recognized and turned away by the doctor because the DEA is very watchful over these issues.

For many with chronic insomnia, all the medications and other treatments still don't work, and these people tend to suffer in the long term - sometimes decades without a night of proper, normal sleep.

For patients with cancer, nerve damage, or other chronic, severe pain, the medications can allow them to function a little bit more effectively, and each person must make their own decisions on how to handle the problem. Yet even with strong meds, the pain is merely brought under control, and patients still suffer without respite.

Can you imagine telling someone who can barely get out of bed that they have to go the the pharmacy every day, because some other people abuse prescription drugs?

I hope that with better research, we can find less dangerous ways to treat these ailments, but treating patients like criminals is not a solution,

[ProudMormon]

I have an idea! How about if we make addictive drugs illegal and prosecute anyone trying to sell them to these innocent victims? There aughta be a law!

[iblogleft]

Because even though these drugs pose certain risks, giving up what control you have through regulation would be a horrible mistake.

Legality does not mean a free for all, it is exactly opposite. Legalization means we get to regulate and install systems of control to minimize risks to everyone, including access for children.

Allowing illegal drugs to be regulated and profited upon by gangs and dealers has proven to be the biggest mistake we ever made (Again). You would think that alcohol prohibition would have taught us this lesson.

But, as you know, science and intelligence has taken a backseat to fear mongering, corporate and faith based drug policy

[Spinzone]

If you chase the dragon, you'll get burned, maybe bad enough to tie. If you dance with queen Mab, she may take you life.

[trishl127]

There is so much more than overdose prevention that we need. My ex-husband was addicted to prescription drugs for a few years & it took his entire life falling apart before he realized that he had a problem. He thought that because his Doctor prescribed them then they were ok. His addiction wrecked our marriage, I would go into the bedroom at night & check on him to make sure that he was still breathing, we would have excruciating arguments because he thought that he was ok to drive with our children in the car & he ultimately became violent (that's when we split). I can remember HOPING that he would overdose so I could have some peace & it truly devastates me to this day.

We need comprehensive rehabilitation programs for the uninsured & we need to be able to hold Doctors criminally responsible when they give out prescriptions that are not needed, & yes I know that it could cause a problem with Doctors being scared to write prescriptions for patients who truly need them, but maybe if they were scared they would make sure that the Rx's were actually NEEDED or when their patient goes through a 30 day script in 10 days (like my husband did) month after month they will put a little bit of thought into it & what the consequences are not just for them or the patient but the wives, mothers, fathers, husbands, & absolutely most important the children of the people

[BurtR]

whew.
very heartfelt and intelligent comment
Drs are supposed to do everything in 10 minutes
my son died of an acidental overdose

[luziannagirl]

BurtR, I'm so sorry about your son. Please accept my condolences, though nothing can really touch your pain, I'm sure.

My mother-in-law was convinced that all her physical ailments and imperfections could and should be fixed by either surgery, or popping a prescribed pill---or two--or three---or...up to 12 by the end. She made no connection between herself and street drug addicts. She assumed no personal responsibility for her own health, and she had no trouble finding doctors who let her get away with it and enabled her to continue down the primrose path to premature disability and an early death.

Not a day goes by I don't miss her and wish it could have been different.

[SiberianRat]

"There is nothing we can do to bring back Heath Ledger but we can learn from the tragedy and enact compassionate and sensible legislation to save thousands of others like him." Absolutely! It's time for some compassion for those who struggle with drug addiction. Also, as Heath's case shows, it's not just addicts. Our drug laws and approach to dealing with drug-related issues have been a dismal failure. Moreover, families continue to lose their loved ones and our already-crowded prisons fill up with people who would be much better served by treatment (and thus able to give back to society).

[iblogleft]

Thank you so much for brining this to the front. In my opinion, you cannot fix societies ill's without completely changing the way we discuss recreational, medical, abuse and addition in this country.

We can do much with technology to better the health care in this country, including regulation of drugs. Almost the entire problem with pills can be negated by a national prescription database. We could have done this YEARS ago, however, when you are in the business of selling pills, you really wanna sell as many pills as you can, no matter the reason.

None of them died of Cannabis overdose by the way. Nobody ever has. Tylonol killed more people, so did aspirin.

[Dukedraven]

I have to different kinds of pills and I always forget what pill to take and when, even though I have a pill dispenser. I know it's extremely easy to overdose on prescriptions and it's a daily struggle for me to remember. I'm taking one now and I'm hoping I'm not double-dosing. It's scary.

[sdskelton03]

I am all for drug legalization, so I am with you on some of this.

However, the only person at fault for Heath Ledger's death is Heath Ledger. A person who uses drugs recreationally takes that risk, and the consequences are his or her's alone.

[trishl127]

These were not recreational drugs, they were Doctor prescribed & they were not lethal levels of any of the drugs, what killed him was the specific combination of Rx's he was taking & while I don't think that use or abuse should be criminalized, dealing drugs should be & unfortunately that's what a lot of these Doctors are doing. They over prescribe, they over book their patients so they can get as much money from the HMO's as possible in order to pay the skyrocketing malpractice premiums & probably wouldn't recognize you if they ran into you on the street, & because of the ever growing advertisements for prescription drugs most patients ask for the prescriptions that they want when they go into the Dr's office . It's negligence plain & simple.

[BurtR]

exactly

[sdskelton03]

My understanding is that Mr. Ledger was not using the Rx as prescribed, but rather was using them recreationally.

[mymatrix]

Once you become seriously addicted to opioids you are no longer running the show...the drug is. Those opiate receptors, when they are emptying, immediately send obsessive messages to the brain, complete with pictures and impulses. Brain hijacking. Opioid addiction is as powerful as addiction can be.
Most overdoses occur after a person attempts recovery then relapses and can not gauge their tolerance level accurately. The relapse rate with opioid addiction is startling.

[sdskelton03]

I don't disagree with anything you said, but I don't understand why you posted under me.

Your thoughts don't seem related to my post.

[ConstanceReader]

Your comment is factually inaccurate. Ledger was not a recreational drug user at any time in his life. By all accounts, he was quite the opposite.

He was taking legal medications legally prescribed by licensed physicians for legitimate medical conditions in their appropriate doses; it's the combination of the drugs that killed him. Unfortunately, it is a tragedy that happens many times every day in this country. See DukeDraven above, it can be difficult to keep track of a complex drug regimen, even when the patient is fully lucid. But Ledger had insomnia so was probably not entirely lucid.

What is at fault is a body weakened by illness and insomnia and a regimen of possibly contraindicated medications. Most patients trust that their doctors do not prescribe contraindicated drugs and most doctors do not have the time or resources to become so intimately familiar with every single drug available for prescription that they can be 100% certain of the regimen. Welcome to modern healthcare and drug development.