Inspired to Educate
All the media coverage of Michael Jackson's sudden death has me concerned. Right away, I assumed it was a drug overdose. Words like sedative, demerol, and pain medicine hadn't even been uttered yet, but the nurse in me began to speculate at which drug was going to be blamed this time. Society's dependence on medication is out of balance with the level of knowledge required to safely manage them. And MJ's death, should it be proven that it was drug related, only amplifies my point.
From an ER perspective, we live in a medication happy society, much like Aldous Huxley's Brave New World. Young, otherwise healthy people come in to triage with lists of medications, many of them with opposing effects. "I take this one for depression and this one to sleep," they tell me. Even small children are on uppers (Adderall) and downers (Klonopin) to balance their moods. Many patients can not explain to me what they take and why.
In many ways, I don't blame the general population for their lack of knowledge. I have trouble keeping up with the latest and greatest medications on the market. Lately, I've felt the need for a refresher pharmacology course just to familiarize myself with the drugs that have been created since I was in nursing school. I feel overwhelmed; what must a non-medical person be feeling?
Too many people have become so comfortable with prescriptions that they fail to see the danger in treating themselves. According to a
recent article I read, a FDA panel reported the same has proven true for over-the-counter (OTC) medications as well, most noteably, acetaminophen. The panel recommends that manufacturers remove acetaminophen from Percocet and Vicodin. This is because people don't know that these prescriptions contain acetaminophen and take OTC acetaminophen with it, creating a lethal liver toxicity.
Also, the panel wants to reduce the recommended dosage from 1000 to 650 milligrams. Again, the goal is to protect the consumer's liver by limiting the amount per pill. Ironically, though, acetaminophen will not be removed from combined OTC cold remedies. Why? I'm not sure.
I wonder if education would work better than a ban, especially a ban that doesn't entirely make sense to me-taking acetaminophen out of some things, but not all. And, since Percocet is prescribed, shouldn't it come with instructions/warnings? I would also like to know why people aren't aware of the dangers. Don't they read the labels? Maybe we, as health care providers, are not educating the public well enough. So many nights I work, I dole out medications hour after hour. I hand over prescriptions at discharge, assuming people will read the instructions. But, apparently not all do.
I am sad this world had to lose an icon like Michael Jackson and so many others before him. But maybe, if his death does prove to be a result of polypharmacy, we can learn from it. I know I will take a few moments longer to educate my patients about the drugs I am sending them home on. In MJ's memory, I will remind as many people I can that BOTH prescription and OTC medications can hold serious risks. I hope you will join me in educating our public.