In the first large-scale study of home medication consumption, researchers discovered the number of deaths from taking alcohol and/or street drugs in combination with prescribed medications have skyrocket.
The tragedy has gained significant press as of late as a recent victim was actor Heath Ledger, or the Joker in the current hit movie “The Dark Knight”.
Sociologists at the University of California, San Diego examined nearly 50 million U.S. death certificates from 1983 to 2004 focusing on a subset of 200,000 deaths from medication errors.
The study appears in the Archives of Internal Medicine, an official journal of the American Medical Association.
“The decades-long shift in the location of medication consumption from clinical to domestic settings,” the authors say, “is linked to a dramatic increase in fatal medication errors.”
“Increasingly,” says principal author David P. Phillips, professor of sociology at UC San Diego, “people take their medications at home, away from hospitals and clinics. But most studies of fatal medication errors have focused on those clinical settings.
“We wanted to know three things: how many of these fatal errors happen at home; how many involve alcohol and/or street drugs; and are these numbers going up?”
Phillips and his co-authors examined trends in four types of fatal medication errors. They note that the increase in fatal errors varies by astonishing amounts based on where the errors occur and the particular combinations of drugs.
Type 1 errors – deaths at home from combining medications with alcohol and/or street drugs – skyrocketed by 3,196 percent.
In sharp contrast, type 4 errors – non-domestic fatal errors not involving alcohol or street drugs – show the smallest increase, just 5 percent.
The intermediate types of errors increased by intermediate amounts. Type 2 errors – domestic medication fatalities not involving alcohol or street drugs – increased by 564 percent. Type 3 errors – non-domestic medication fatalities involving alcohol and/or street drugs – increased by 555 percent.
“Thus,” the sociologists say, “domestic fatal medication errors, combined with alcohol and/or street drugs, have become an increasingly important health problem.”
In addition to possible changes in policy and clinical practice, Phillips says, “it also seems advisable to expand research on medication errors. Much of this research has focused on elderly patients and clinical settings. The present findings suggest that more research should be devoted to middle-aged patients and domestic settings.”
The study was supported in part by a grant from the Marian E. Smith Foundation.