How Not to Die Like Heath Ledger, Part II

The toxicology results are in on Heath Ledger's death -- and sadly, they reveal the most common scenario in overdose fatalities. At least six different drugs were found in his system, including oxycodone and benzodiazepines.

This is, as I covered in my last post, a combination of opioids and other "down" or "depressant" drugs: the most dangerous combination. As I noted there, if you want to avoid dying, mixing depressants is a very bad idea.

What makes this even more tragic is that overdoses involving opioids (drugs like heroin, morphine, Oxycontin, Vicodin) are usually slow killers. Victims can be revived without lasting effects if the antidote-- a drug called naloxone (brand: Narcan)-- is given early enough.

Basically, opioids kill via respiratory depression: they make you go to sleep and forget to breathe. This is why it is possible that stimulants may counteract opioid overdoses in some instances: if you are awake, it's pretty hard to forget to breathe.

Mixing stimulants with depressants can kill via other mechanisms, however, so that's why it is not recommended to inject heroin overdose victims with cocaine or methamphetamine.

Anyway, as I've argued before in the New York Times and elsewhere, because the antidote to opioids is virtually harmless and cannot be abused, I believe it should be given out with every opioid prescription, in a pre-loaded syringe like an "epi-pen" used for people who are allergic to bee stings.

Naloxone should be kept in every first aid kit. Even when overdoses involve multiple drugs, simply taking away the effect of the opioid is often all that is needed to revive the victim.

By putting the antidote in every household, the risk of death would be dramatically reduced. That way, whether two-year-old Johnny gets into grandma's Oxycontin or teenage Jane decides to experiment by snorting it, the antidote is on hand in those precious minutes when giving the drug can mean the difference between life and death, or brain damage and normal life.

Anyone who wants to reduce overdose deaths should lobby for this position: truly, Heath Ledger did not have to die. My next post will give explicit instructions on how those who love people who are not ready to stop using opioids can prevent them from dying this way, even if they insist on continuing to use dangerous combinations.

Comments

[lynnlo]

I very much enjoyed ready this post. I am the founder of a group in Florida called PAPDA - PARENTS AGAINST PRESCRIPTION DRUG ADDICTION.
We are an awarenss group and rally for tighter controls over opioid prescriptions, we have a real problem down here as Florida is known as the black market state, we do not have a drup monitoring system in place and need to legislate this soon before more die. Every day here 6 people die from prescription drug abuse.
Thank you for all you do! Lynn

[MrsWakely]

How odd. It's like the scene in "Pulp Fiction" where Eric Stoltz jams a hypodermic needle into Uma Thurman's chest to bring her back from her heroin coma. "Whoa!" as Keanu Reeves' would say.
"Health Ledger didn't have to die," says Ms. Szalavitz, and "if you want to avoid dying, mixing depressants is a very bad idea."

So, just make sure you have a ready syringe full of Narcan to offset the "down," uh, dude.

Heath Ledger probably offed himself. Let's be honest. Not in a dramatic, suicide note typical way, but, in a cocoon of depression and, all too sadly, really bad judgment. I miss him, just as an admirer of his work, which was outstanding. But, with a young girl and a family who loved him? Maybe some rather intense therapy and intervention was what was called for. Maybe a little growing up. Maybe a family member, or a friend, who could put 2 and 2 together and say to him, "Heath? You have to stop doing movies. Now. You have to get your shit together. Being a star is clearly not good for you. So, get off the 'me' train, and get some help." But, nobody did that. To many other passengers on Heath's "me train." Don't wanna stop the train dude! Can somebody get Mr. Ledger some Narcan instead? THAT'S the answer!

Having Narcan around wouldn't have changed this. You don't take the amount of drugs that were in his system by accident. He wasn't an idiot. He knew what he was doing.

This is the kind of advice you'd get from a concerned drug dealer who wanted your return business: "Yo, dude, don't mix the downs man, and if you ever do? Stick this in your ass - pronto - whoa!"

[anniewade]

Thank you for this useful information!