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Drug Cocktails Don’t Mix

In September of 2010, the Drug Enforcement Agency held their first national prescription drug take-back program. The program was created in an effort to raise awareness of lethal and addictive qualities of prescription drugs. The statistics and dangers of prescribed drug use are astounding and although thousands of old prescriptions were voluntarily collected by the DEA, not enough people are aware of the dangers of mixing pharmaceutical drugs.

The Centers for Disease Control has reported that more than 20,000 people die from accidental prescription drug overdose annually. The news is full of celebrity deaths as a result of pharmaceutical cocktails including Heath Ledger, Anna Nicole Smith and Michael Jackson. Heath Ledger died from a devastating combination of pain killers, depression and anxiety aids including, oxycodone, hydrocodone, alprazolam, diazepam, temazepam and doxylamine.  To some, mixing drug prescriptions, what we call drug cocktails, may seem to some the only feasible way to deal with common disorders such as depression, anxiety and sleep issues.

There are many variations of over the counter sleeping pills and sleep aids combined out of desperation, in hopes of producing better sleep. Alcohol is commonly found in antihistamines such as Nyquil or Benadryl and widely understood to initiate a quick sleep but will actually interfere with deep restorative functions. In fact, drinking alcohol keeps your body from progressing to Stage 3 or 4 sleep and you will awaken more frequently throughout the night. For even those of us who are able to breath normally during sleep, we all have apneic events throughout the night. Unfortunately, alcohol can increase apneic events by repressing respiratory function in the brain.  Thus, people wake in the morning feeling unrefreshed or groggy with a hung-over effect.

I have treated patients that were using some combination of 1-3 shots of hard alcohol, Nyquil, Benadryl, and a short acting benzodiazepine such as Valium, Ativan, or Xanax. For someone who has been using this combination for multiple years, they tend to be very anxious about not sleeping, particularly when they have a high responsibility job the next day.  It can take 4 to 8 months to eliminate each medication and replace them with Cognitive Behavioral Therapy (CBT) strategies known to be effective in treating insomnia and anxiety.  When I’ve titrated an individual off a single sedative hypnotic (such as Ambien, temazepam, clonazepam, etc.), and we are concurrently implementing CBT, this process could take anywhere between 4-10 sessions (1-3 months).

It is not uncommon for people to have concurrent symptoms of depression, anxiety and sleep issues.  Prescriptions taken with OTC medications or alcohol can lead to severe addiction and oftentimes, death.  It is necessary to reconsider how to treat these disorders with alternative methods.  Psychologists and therapists now have a wide range of tools to help address these issues.  Many different methods including CBT, nutrition analysis and exercise can play a key role in recovery.

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