Alabama Drug deaths surge higher - deadly cocktails include psychiatric drugs

From the Birmingham News, (full story at the link)

A rising number of deaths from illegal and prescription drugs is hitting Alabama, and in some areas, including Jefferson and Shelby counties, fatalities caused by drugs are now surpassing those caused by traffic accidents.

The lethal trend was revealed in death statistics and records provided by coroners and public health officials. The data, gathered by The Birmingham News in recent weeks, provide a rare look at causes of death that often escape public view - fatal heart attacks triggered by cocaine use, acute poisonings and addiction.

Records show:

In Jefferson County, 119 deaths occurred last year in which legal and illegal drugs were largely responsible, an increase of 42 percent since 2002. Eighty people died in the county in traffic accidents during 2006.

In Shelby County, drug deaths have been increasing at an alarming rate as the population grows. The coroner's office responded to 18 overdose deaths in 2005 and 24 in 2006. This year, from Jan. 1 until May 14, the coroner responded to 18 drug deaths. Eleven traffic fatalities have been reported so far this year in Shelby County.

Statewide, drug deaths are steadily increasing. Death certificates show fatal poisonings from drugs jumped 67 percent from 2000 to 2005. Deaths from drug addiction jumped 94 percent from 2000 to 2006.

Jay Glass, chief deputy coroner in Jefferson County, said the public lacks awareness of drug deaths. These deaths don't attract the urgent media attention of crime or traffic accidents. Determining the cause of drug deaths often requires toxicology, and sometimes it takes weeks to get results. Reports aren't readily available.

"There's a lot of hidden stuff," Glass said.

[...]

Toxic cocktails:

As problematic as cocaine is, it is not the No. 1 drug found by toxicologists investigating unusual deaths. That's alcohol, said C. Andrew Robinson, toxicologist at the University of Alabama at Birmingham division of clinical pathology.

But alcohol by itself typically doesn't kill people, said Robinson, who sees blood chemistry on most questionable deaths in Jefferson County.

All too often, he finds combinations of alcohol, cocaine, opiates such as Lortab and methadone, and benzodiazepines such as Valium and Xanax.

These drug mixtures, particularly opiates and benzodiazepines, often kill by shutting down a user's respiratory system.

"It's got an additive effect," Robinson said. "It's a deadly combination."

The parade of drug deaths he sees is constantly expanding in complexity, as pharmaceutical companies march out new sleeping pills and antidepressants.

A week after ads for Lunesta appeared on television, there was a lethal Lunesta overdose, Robinson said. "I think we ought to outlaw drug advertisements on television the way we outlawed cigarette advertisements."

Most people don't know they can kill themselves with antidepressants such as Lexapro, he said. "Most of them are respiratory depressants in high enough quantities. We've got an overdose death right now from one called Effexor."

He also has found that people who die of drug overdoses often "doctor shop," or have several doctors writing overlapping prescriptions.