The toxicology results are in on Heath Ledger's death -- and sadly, they reveal the most common scenario in overdose fatalities. At least six different drugs were found in his system, including oxycodone and benzodiazepines.

This is, as I covered in my last post, a combination of opioids and other "down" or "depressant" drugs: the most dangerous combination. As I noted there, if you want to avoid dying, mixing depressants is a very bad idea.

What makes this even more tragic is that overdoses involving opioids (drugs like heroin, morphine, Oxycontin, Vicodin) are usually slow killers. Victims can be revived without lasting effects if the antidote-- a drug called naloxone (brand: Narcan)-- is given early enough.

Basically, opioids kill via respiratory depression: they make you go to sleep and forget to breathe. This is why it is possible that stimulants may counteract opioid overdoses in some instances: if you are awake, it's pretty hard to forget to breathe.

Mixing stimulants with depressants can kill via other mechanisms, however, so that's why it is not recommended to inject heroin overdose victims with cocaine or methamphetamine.

Anyway, as I've argued before in the New York Times and elsewhere, because the antidote to opioids is virtually harmless and cannot be abused, I believe it should be given out with every opioid prescription, in a pre-loaded syringe like an "epi-pen" used for people who are allergic to bee stings.

Naloxone should be kept in every first aid kit. Even when overdoses involve multiple drugs, simply taking away the effect of the opioid is often all that is needed to revive the victim.

By putting the antidote in every household, the risk of death would be dramatically reduced. That way, whether two-year-old Johnny gets into grandma's Oxycontin or teenage Jane decides to experiment by snorting it, the antidote is on hand in those precious minutes when giving the drug can mean the difference between life and death, or brain damage and normal life.

Anyone who wants to reduce overdose deaths should lobby for this position: truly, Heath Ledger did not have to die. My next post will give explicit instructions on how those who love people who are not ready to stop using opioids can prevent them from dying this way, even if they insist on continuing to use dangerous combinations.

See source - HuffingtonPost February 6, 2008 - for links.


Also see article Part 1 and article Part 3.