Prescription Drugs And Deaths In Florida
12 CommentsBy Ed Silverman // July 7th, 2010 // 7:06 am
Last week, the Florida Medical Examiners Commission released its most recent report on the number of drug-related deaths in the state. The sad bottom line is that 8,653 - out of more than 171,300 deaths overall - were attributed to a drug that was listed as a cause of death, according to toxicology reports.
Data was collected on various drugs, including benzodiazepines; cannabinoids; cocaine; ethyl alcohol; gamma-hydroxybutyric acid; methylated amphetamines (including Ecstasy); and various opioids, including fentanyl, heroin, methadone, morphine and oxycodone (read the report). However, one class of drugs that has, unfortunately, been associated with deaths, specifically suicide, is not included - antidepressants. Despite curiosity over this omission, Florida officials say there is a reason.
There has been immense interest in these meds, you may recall, over links to suicidal ideation and behavior, prompting FDA warnings and litigation. However, the report is designed to gather info on substance abuse, as opposed to any and all deaths that may be attributed to a drug. One state official says that including this class may cause the state to conclude that a death was, indeed, attributed to one of these pills, but that is a conclusion officials feel they are not prepared to make.
“You can attribute a death to suicide and then go back to look at the suicide and see mental health issues,” Bruce Grant, the director of the state’s Office of Drug Control, tells us. “But at that point, you’re drawing a pretty dramatic conclusion that it caused a death…To make a conclusion the reason a person committed suicide was solely due to a drug, that’s a huge leap.” In fact, the report does try to be specific, noting that state medical examiners were asked to distinguish between drugs that were a cause of death and those present in the body at the time of death.
In response to the observation that Grant recited the same argument made by those who maintain antidepressants should not be blamed for particular suicides, he says that, “certainly, we’re well aware of that connection. It’s not like we got our head in the sand here, but this report was initiated way back when there was an epidemic with cocaine in the 80’s…To be included, a drug has to be listed as cause of death…It’s a metric we try to use to measure how well we are doing to reduce substance abuse. And nothing more.”
Salient point
To be fair–any trained lab tech can tell what drugs were in a person’s body at the time of death, & any well trained medical professional could use that info to determine which drugs (if any) caused the death, even without knowing much about the deceased.
The properties of modern antidepressants do not lead to physical deaths in the way narcotics do. To link them with suicidal acts would involve knowing more about a patient’s state of mind, what changes took place during time of usage, etc, which is more involved–and expensive–research than a post-hoc tox screen & ME evaluation.
Ken Kramer
Officials are reluctant to conclude that antidepressants cause deaths because it’s possible a mental health issue caused the deaths? Why not list all the drugs present at death and not worry about concluding a thing.
“this report was initiated way back when there was an epidemic with cocaine in the 80’s…” The report should advance to the 21st century with all the computer technology available. Tracking all drug deaths would highlight
problem drugs. The knowledge obtained may save lives.
Newspapers quote the annual report and state the number of prescription drug deaths in Florida. Antidepressants, antipsychotics and other drugs are not tracked in this report. So the actual number of prescription drugs deaths in Florida are certainly much higher.
M. Black
As with many antidepressants, one could say that over the long term, and used for perhaps the wrong reasons, they do more harm than good. The nature of SSRI’s (paxil, lexapro) supposedly “levels out” one’s mood. A couple of things on that… If the physiology of someone’s brain calls for it, then absolutely IMHO, it should be used for the long term. If someone is clinically suicidal, their chances of a longer, more healthy life and quality of life will be enriched by these drugs. Yes, there are different forms of depression. But when you go to a psychologist, and they give you a “quiz” with a gaggle of questions with a likert scale this is perhaps the worst in this process. If someone is clinically not well … the reason they are in the doctors office in the first place … not having the true ability to tell heads from tail, is this approach valid? I’m not strongly for nor against either one, but one with deep, psychological issues should not be the one to fill out a likert quiz which the doctor will use to “treat” said people.
~ M. Black
Mark Carberry
If the FDA assigns a black box warning for a drug, attempting to alert the public that the drug may lead to suicidal and/or homicidal tendencies and then someone on these drugs suicides or kills or attempts to kill or harm someone else then the statistician is duty bound to report the fact that that person was on those drugs. Withholding the data harms the public as they are then left unaware of potential dangers of the drugs.
On the other hand, if a drug doesn’t have a warning but statistics show that the drug is dangerous then the public can be warned of newly understood adverse events and can make rational decisions to risk taking the drug or to seek alternative solutions.
Hiding statistics or avoiding publishing known facts about drug reactions does more harm than good. In science exact conclusions cannot be determined if the facts are unknown or secreted away.
How would you like to take a drug thinking that it is beneficial but finding that you now want to harm people you love or that you now want to kill yourself?
The scientist’s duty is to reveal the facts, the raw data, any compilation of statistics or intermediary conclusions, any theories developed, the methods used and final conclusions. By leaving out the statistics of psycho pharmaceuticals the report is biased and deficient.
Sally Nicks
It is pretty simple to look at this information and draw a parallel to the FDA warnings on Antidepressants. The FDA puts the suicidal warnings on these drugs for a reason. If the Medical Examiners are showing that many of these people who died were on different prescription drugs, including antidepressants, we simply need to admit that these drugs are dangerous and inform the public of this. Also, offering the public safe alternatives to these drugs, is a simple answer to these many tragedies.
Tony Miller
Two points stand out to me.
Number one, if “report on the number of drug-related deaths in the state.” is the purpose then ALL drugs should be reported as a ‘combination’ of drugs could have caused death.
Number two; “state medical examiners were asked to distinguish between drugs that were a cause of death and those present in the body at the time of death.”…not to report ALL nullifies the findings as perhaps other examiners or better data WOULD attribute a death to anti-depressants.
Remember most all street drugs were once dispensed by doctors.
Jimmy Joe
Much of science, like all of mental health in fact, is based on the gathering of statistics and then making a claim. It would seem that since that sort of science is considered valid enough to prescribe mind altering drugs for unpleasant emotions then that same science can be used to follow who has mind altering drugs in their system upon death to see if there is a link with the drugs and the deaths.
ErnestR
A valid point was made by Kramer. Why not list all the drugs present at death and not worry about concluding a thing? You can’t make valid conclusions for public safety based on false data or data that was never collected and is now uncollectable due to decomposition or the body being buried. When medical examiners do not test for or report the presence of antidepressants and antipsychotics in the body of a person who committed suicide, they are ignoring a huge cause of drug-related deaths. To not gather this information because you only want to gather info on substance abuse is short-sighted and wrong. And who says that millions of persons put on antidepressants is not substance abuse?
Ignoring the suicidal effects of antidepressants and antipsychotics has been a windfall for the drug companies. It is pretty hard to prove that someone died from taking an antidepressant because they don’t have a physical toxicity like taking a handful of sleeping pills. Antidepressants and antipsychotics have a mental toxicity comparable to but worse than LSD. Talk to enough people on antidepressants and many will tell you it is quite normal to think about just driving their car into the next bridge abuttment.
The greater toll taken on society isn’t the suicides, it’s the homicides people on these drugs commit. The school, workplace and military-related shootings that people on these drugs carry out causes ripples far deeper into society than mere suicides. Drug companies know this. It’s almost too late to worry about counting how many people who died were on antidepressants because the shell game is changing. Drug companies are putting everyone onto antipsychotics now and it will take another 15 years for enough anecdotal data to be collected to realize that antipsychotics also cause people to commit suicide and homicide. Just listen to the latest TV commercial for the antipsychotic Abilify, “If you are one of the two out of three people who still suffer depression after taking an antidepressant, ask your doctor about adding Abilify.” So they’re now admitting that the miracle drugs like Prozac were only effective on 33% of the population, if that. No, we need to keep the Black Box labels on these drugs and Medical Examiners need to test for and record the presence of antidepressants and antipsychotics in the body of every suicide they examine. This should be clearly stated on every toxicology report along with any other drugs found present.
Solace Prescription Addiction Counseling
It is the difficulty that most of us find, that drug-related suicides are hard to determine as being directly drug-related. If the suicide was by drugs, that can be accidental or purposeful, but that is hard to determine without observation of the person’s mental state.
M. Black
There is one solution to all this Boo-ha-ha, and it grows wild in some places.
Synthetic antidepressants cause the backlash on harming themselves and/or orhers, especially after stopping usage.
There - someone said it.
ErnestR
Solace you are right and that makes it all the more important for Medical Examiners to just list on the Toxicology Report every drug present in the body of every suicide case. In many instances you can go back and find what was in a suicide victim’s mind. Many of these Columbine-like school shooters who were on antidepressants have blogged about how the drugs made them feel. Terrible nighmares is one thing they frequently speak of. Often close friends or relatives will be able to provide important clues. If you want a good first-hand account of how an antidepressant like Prozac can make a middle-class professional adult suicidal or homicidal just read the account of Stephen Leith at http://psychrights.org/Stories/StephenLeith.pdf.He was arrested before he had the chance to commit suicide but he did shoot several people and killed at least one as a reaction to Prozac by his own account. There’s lots of this stuff around but it comes down to individual investigation. After 16-year-old Jeff Weise, who was on Prozac, killed 10 people including himself at Red Lake, his aunt who was also his guardian attributed it to his taking Prozac. Proving that a drug is the cause of a suicide is hard as you say. However when you see a suicide these days, you’ll very often find the person was on an antidepressant or antipsychotic. This is especially true of murder/suicides. We’re seeing this whole school-shooter thing now play out in the military with so many soldiers on these drugs. With antipsychotics however many of these soldiers are simply dying in their sleep of cardiac failure which is a side-effect of antipsychotics. Proving that is going to take quite a few deaths however. But we’ll get there with the help of these Abilify commercials.
Cassandra Auerbach
This data needs to be gathered.
Without it, we won’t have an independent way of finding out about many, many types of drugs and their occurrence in instances of death.
It is precisely this kind of data that leads to further studies that can pinpoint what is a causative factor and what is not.