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Overdose and Heath Ledger, Part III: Shame About Addiction Should Not Obscure Truth About How Drugs Kill

It's conceivable that Ledger had an incompetent doctor, but the more parsimonious explanation, given his history of recreational drug use, is that he was not following doctor's orders at all.
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Before I provide information on what precisely to do should someone you love overdose, I want to address a few things I've been reading in comments about Heath Ledger's death, from fans and loved ones.

Addiction is a great source of shame to many people-- we don't like it when people we like turn out to be addicts because we associate addicts with bad, scummy, evil, lying manipulators who are "not like us" and who "deserve what they get." But the truth is, many wonderful, talented, humane, kind, sensitive and caring people are also addicts.

While addiction is not "an equal opportunity disease"-- like most health problems, it hits the poor hardest -- admitting that a friend or loved one is an addict does not mean admitting he's a bad person.

Of course, some addicts do bad things-- but they are individuals just like everyone else and need to be judged on the actions they personally take, not by some stereotyped view of "addicts."

The reason I want to stress this is that I have seen many comments and articles-- one in the Wall Street Journal, of all places-- suggesting that Ledger's death could have been due to medical error by a doctor, not his own misuse of drugs.

His family's statement stressed that the drugs he took were "doctor-prescribed" -- and that "Heath's accidental death serves as a caution to the hidden dangers of combining prescription medication, even at low dosage."

However, the medical examiner said the death was due to drug abuse.

The fact is, the vast majority of people who die from combinations of opioids and benzodiazepines -- especially with several drugs from the same medical class in their bodies, especially if opioid painkillers are involved -- are not taking their drugs as prescribed. They are addicts or, at least, drug misusers.

It's conceivable that Ledger had a corrupt or profoundly incompetent doctor, but the more parsimonious explanation, given his history of recreational drug use, is that he was not following doctor's orders at all.

This is important because blaming doctors for these deaths hurts pain patients and people with anxiety disorders who legitimately need these medications. Every time people avoid the hard truth about particular overdoses, legitimate patients get punished by restricted access to necessary medications and even denial of medication for excruciating pain or anxiety.

The vast majority of deaths linked to these drugs do not occur in patients taking their medications as prescribed -- you are more likely to die from taking aspirin or advil as prescribed [full text requires subscription: study shows 16,550 deaths a year related to complications of normal use] than from taking opioids correctly [PDF: 5528 opioid deaths, virtually all from taking incorrectly].

Since this has gotten seriously long, I will post the overdose information separately tomorrow.