Actor Heath Ledger's death at home from an accidental overdose may have finally made the public more aware of what is no surprise to physicians: There has been a sharp increase in the number of fatal drug overdoses, known as fatal medication errors (FMEs), occurring in the home. Most of these overdoses occurred as a result of combining prescription medications with illicit drugs and/or alcohol. Particularly at risk are baby boomers 40 to 59 years old.

There has been a sharp increase in the number of fatal drug overdoses ... occurring in the home.

Findings published in the July 28 issue of the Archives of Internal Medicine show that the death rate due to FMEs climbed over 360%. Breaking the data down further, the study found:
  • At-home deaths from overdoses from a combination of prescription drugs and alcohol or illicit drugs increased by over 3100%.
  • FMEs occurring away from home but in combination with alcohol and/or drugs climbed by 555%.
  • FMEs not occurring at home and not in combination with alcohol and/or street drugs increased just 5%, so such deaths rarely occur in a hospital or clinic setting.
  • Even without concurrent drug and/or alcohol use, FMEs from prescription drug use rose 564% over the period studied.
What is behind this epidemic of overdoses? The study's authors point out the steep increases are probably due to several factors including, decreasing oversight in the administration of medications as settings change from the hospital to the home; the increased popularity and demand for prescription painkillers; and patients' hesitancy to inform their doctor about recreational drug use. These factors, coupled with the fact that many patients take more than one medication, including over-the-counter remedies, has led to increases in the FMEs seen over the last two decades.

Unfortunately, few clinical studies examine the combined effects of medications with illicit drug use, so precise data is scarce. The only sure preventive is patient education regarding the risks of combined drug use, particularly in combination with illegal drugs.