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How to Avoid Prescription Drug Problems

10 rules for avoiding bad outcomes with medications.

Most drug deaths involve prescription medications, usually opioids, but other pharmaceuticals as well, including benzodiazepines and antidepressants, sedatives and sleeping pills (like Ambien), but also drugs as diverse as Viagra and alkyl nitrites (street name “poppers,” used to treat angina), nearly always in combination with one another or other drugs.

Here is a short list of prominent drug deaths with their toxicology report contents: Tom Petty—fentanyl, oxycodone, temazepam, alprazolam, citalopram, acetyl fentanyl and despropionyl fentanyl; Carrie Fisher—cocaine, methadone, ecstasy, alcohol, antidepressants, and opiates; Philip Seymour Hoffman—heroin, cocaine, benzodiazepines, amphetamines; Amy Winehouse—alcohol, benzodiazepines; Heath Ledger—oxycodone, diazepam, hydrocodone and doxylamine.

How can one avoid negative outcomes from prescription drugs, including deaths such as these?

First, let’s go over basic safeguards:

1. Don’t get multiple prescriptions for the same drug from different providers.

You probably already know that this is illegal and inadvisable medically. If you feel your medication isn’t working sufficiently well, discuss this with your primary care physician.

2. Clear all drugs through one medical provider/pharmacist.

It isn’t just doubling up on the same medication that can cause problems—there can be perilous interactions among different drugs. So you should have a primary care physician and one source for pharmaceuticals, both of whom keep track of all of your prescriptions.

3. Even under a physician’s care, increasing dosage more than once is a red flag.

Although it is not uncommon for a doctor to increase your dosage of a medication after you and the physician note your initial reaction to it, repeatedly upping the dosage is a danger signal. If this occurs, express your concerns to your provider—you must be your own protector.

4. Indeed, sensing that a medication isn’t working/having the desired effect is a warning sign.

When you note that your psychiatric medication is not doing what you were told it is supposed to do, either switch medications, or else seek non-pharmaceutical alternatives.

5. Above all, never mix sedatives/tranquilizers/alcohol/painkillers.

The overwhelming cause of what is termed “overdose” is the result of mixing narcotic painkillers with other narcotics (including heroin), sedatives (e.g., Ambien), tranquilizers (benzodiazepines such as Xanax) and/or alcohol. Don’t risk it.

Now let’s review some basic psychological principles for keeping you unhooked:

6. Maintain your general lifestyle and health.

Addiction both results from and causes deterioration in your mental health and functioning. So make sure that you keep up with your obligations—your work, your family, your exercise, your recreation—and stay healthy.

7. Seek psychotherapy or other alternative therapies (e.g., sleep or pain clinics, exercise).

Psychiatric medications will only go so far in remedying your problems. You also need to address the basic issues of your life—family and other relationships, sleeping, non-pharmaceutical pain relief and work satisfaction.

8. Select a non-medical partner to discuss the impact of your meds on your life.

While you must keep your physician and pharmacist in touch with your prescription use, you need also to check in with at least one person who knows you well. Your spouse, your adult child or any intimate can be your “pharm-buddy.”

9. Remember, pharms are not your natural mind at work.

There is a real you beneath the drugs’ effects. Of course, your consciousness or physical sensations may be unpleasant or dysfunctional for you—that’s why you got a prescription. Do your utmost to remain connected to the real, unmedicated you.

10. Suicide can be more subtle than you think.

All of the above points assume that you want to live. But suicides are included in prescription drug overdose statistics. I can’t tackle and resolve such a serious topic in this brief space. (That would take a book.) I will note here that, to some extent, misusing meds is like incremental suicide, even when you are not intentionally trying to kill yourself. Be aware of this with every mood or pain drug you take.

In the 21st Century, medications to make people of all ages feel better are commonplace—and growing more so. You must always be mindful that your reliance on such meds is not dominating—even consuming—the rest of your life. You can never lose sight of basic life satisfaction as your primary goal. Always retain your focus on the pillars of that satisfaction (i.e., relationships, work, play, health, family, community, self-love, purpose).

There are no shortcuts for gaining life satisfaction; the search for such shortcuts is addictogenic.

Remember, the first rule of medicine is to do no harm. You should have the same rule for how you deal with yourself.