Combating accidental drug overdose

Reports on prescription drug overdose often focus on the number of people who intentionally take more than the prescribed dose of a drug. According to Vaibhav A. Parekh, MD, FACP, an Internal Medicine physician at GBMC Health Partners, there’s a bigger issue at play.

“The prescription overdose problem is twofold,” he says. “There are people who intentionally take more than prescribed, which is a mental health issue we can’t ignore. But the other problem is unintentional overdose where people accidentally take more than what’s been prescribed.”

Dr. Parekh says accidental overdoses usually fall into three categories.

1. Patient-related issues in keeping track of prescriptions.

“They’re on so many medications, it’s hard to keep things straight,” Dr. Parekh says. For example, a patient is told to take a medication once a day and they accidentally take it twice a day for an extended period. Dr. Parekh adds many patients, especially the elderly, get confused because of the number of medications they’re taking. This is something many organizations, like GBMC, are working to change. “We really focus on trying to minimize the number of medications our patients are prescribed so they have less to keep track of. We have to be convinced the benefits of a medication outweigh the risk for elderly patients.”

2. Inappropriate dose of medication prescribed

“As we age, the efficiency of our organs decreases, which may need for dose adjustment of a medication. Dose of a medicine that would seem appropriate for someone in their 30s or 40s, would need to be lowered for age related decline in kidney function” Dr. Parekh says. Similar adjustment would need to be made for a patient who has heart failure or compromised liver function.

3. Drug interactions.

Doctors prescribe certain doses of medications, with the expectation that the drug will react a certain way in the body. “If a patient goes to urgent care and gets a prescription for a separate issue, it can make the medication more potent and lead to overdose,” Dr. Parekh says. “If one medication is going to affect the other, the amounts need to be adjusted.”

The most common medications involved in accidental overdoses are mental health medications, such as antidepressants and anti-anxiety medications. But Dr. Parekh says medications taken for high blood pressure and diabetes can also cause negative reactions if taken in the wrong amounts.

“Any time a patient is starting a new medication, we advise them to communicate with us and to be aware of any new symptoms that they begin to feel,” he explains. “If accidental overdose is addressed in a timely manner, the vast majority of issues, it can cause, are reversible.”

The easiest way to avoid accidental overdose is to limit how many medications you take and the dose of each medication you take.

“Ideally, we want our patients to be healthy without medication,” Dr. Parekh says. “If there’s an opportunity to negotiate a lower dose of medication by making lifestyle changes, that’s the way to go.”

Dr. Parekh adds that patients can avoid many prescription medications if they are simply willing and committed to making healthy lifestyle changes.

You should always discuss any new or current medication plans with your doctor(s).