A Sydney woman whose son died of an accidental overdose of prescription
medication is urging people to ask questions about the drugs their doctors
prescribe.
In 2016, Daniel Bogart was on a skiing holiday in Canada with six of his
friends.
On Christmas Day, he didn't wake up.
"He was perfectly fine before he went to bed," Daniel's
mother, Sally Wilkinson, said.
"And he literally went to bed and never woke up."
At age 40, Daniel was prescribed Valium for anxiety and oxycodone to
treat the pain of pancreatitis, a condition developed from alcohol use.
Oxycodone is a common opioid medication; Valium is a benzodiazepine, or
benzo, often prescribed to treat insomnia or anxiety.
Together, the combination can be lethal.
"I thought overdose meant you took too much," Mrs Wilkinson
said.
"All the medication he took was at sub-therapeutic levels, which
means they're at or below the correct dosage."
Dr Meredith Craigie, the Dean of the Faculty of Pain Medicine of the
Australian and NZ College of Anaesthetists, said the risk was caused by the
drugs depressing the central nervous system.
"The risk is related to the added sedation that we get from both
medications, and when added together they can have powerful effects on
breathing and making people stop breathing," she said.
"If you're heavily sedated with another drug, it may be that the
brain simply doesn't wake you up to start breathing again."
After Daniel's death, Mrs Wilkinson went in search for answers.
"I did read his medical records and there were conversations about his
ongoing battle with alcohol, and there was no mention at all of any risk with
having combined the two different drugs," she said.
And stories like Daniel's are on the rise.
Accidental drug
deaths involving prescriptions on the rise
The Annual Overdose Report, commissioned by
not-for-profit public health research organisation the Penington Institute,
showed a surge in drug-related deaths in all states in the years up to 2016.
This includes a doubling of deaths related to the use of sleeping and
anxiety medication (benzodiazepines).
Another recent report from the National Drug and Alcohol Research Centre found of the
1,109 people who died of an opioid overdose in 2016, three-quarters had taken
prescription opioids, 45 per cent had mixed opioids with benzos, and 83 per
cent of deaths were considered accidental.
Mrs Wilkinson said there was a clear need for greater awareness.
"[Daniel] told me he was taking some pain medication but I didn't
know what it was, and to be honest I knew nothing about opioids.
"I did talk to him about the Valium and said to him, 'that can be
addictive,' but he said, 'yeah, look that's fine, I'm not taking it very often,
only if I really need it', and I didn't realise there was any issue with combination.
"And that's the only reason that I'm speaking up now.
"It's obviously still a really heartbreaking situation but we need
to have the awareness raised, we need to let people know to empower them and
ask their doctors more questions and to be aware that this is a real problem
which does and can happen a lot."
Awareness needed
for doctors and patients
Dr Craigie said while GPs should be aware of the risk of taking opioid
and benzodiazepine medications at the same time, there was still work to do.
"It's certainly being highlighted in medical journals, but I think
when you're familiar with medications and you're familiar with your patients,
it might be easy [for doctors] to say, 'oh, but my patient needs this for this
reason and needs that for that reason'."
And she said a lack of affordable allied health services might lead
doctors to prescribe medication rather than offering long-term treatments like
psychological therapies.
"It might be [that] we don't have a suitable allied health team
that can help managing with this patient, or it might be that this patient
can't afford those services in the private sector, because a lot of people that
live with chronic pain have financial difficulties as well."
In July 2017 the Federal Government committed $16 million to the rollout
of real-time monitoring of prescription drugs.
The system is expected to provide an instant alert to pharmacists and
doctors if patients receive multiple supplies of dangerous prescription-only
medicines.
Dr Craigie said while the monitoring would not change all cases, it
should make some difference.
"Any system like that, it needs to be national, it needs to be
mandatory, and we need to get information from interstate.
"That's part of the solution."
August 31 marks International Overdose Awareness Day.
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