Take two pills and call me in the morning.
That's what family doctors may have told us at one time, but the tragic deaths of high-profile stars in recent years highlight just how far beyond that simple prescription medication has moved.
"We've seen a significant increase in these types of drugs in the deaths of people," said Bruce Goldberger, director of the William R. Maples Center for Forensic Medicine at the University of Florida. "It's a very common occurrence."
And it could be getting more common.
Each year drug companies put new medications in doctors' offices. On their own, these drugs can cure illness and alleviate pain, but together they can make deadly cocktails.
So if you're taking prescription drugs, here are some important guidelines to follow to avoid tragedy.
Tips to Stay Safe
Tell your doctor what medications you are on. This seems like a no-brainer, but not providing your doctor with a detailed personal history and list of medications you're already taking can have serious effects, particularly if you see multiple doctors. If none of them has a full, medical snapshot of your condition, the likelihood of drug crossfire increases as different doctors continue prescribing medications.
"People need to understand that the more they are taking different medications for a single indication, the more they need to be carefully supervised," said Dr. Vatsal Thakkar, clinical assistant professor of psychiatry at New York University Medical Center.
In this case, it is important for both you and your doctors to share information about medicines you take.
Get a tip sheet. An information sheet should cover how and when to take the medication. For example, does "take two pills four times a day" mean to take eight pills in a 24-hour period or eight pills during waking hours? The sheet should also describe any side effects that might occur and how to store the medication (typically in a cool, dry place like a closet or drawer). Bathrooms and kitchens are not ideal because the heat and humidity can damage the medication and make it ineffective, or even toxic.
Know what to avoid. Did you know that grapefruit juice can be harmful to your health? Well, it can, mixed with the wrong drug. Drinking alcohol and caffeine, lifting heavy objects and taking over-the-counter medications like Tylenol or ibuprofen can also be dangerous activities when combined with the wrong drug. It is important to be as open and honest as possible when discussing drug options with your doctor so that you know what to avoid.
Do not share medications. In grade school we were taught that sharing was a kind thing to do, something that made others happy. But when it comes to medication, we have to unlearn our school teachings.
"Two people can take exactly the same number and combination of drugs," said Dr. Donna Seger, medical director of the Tennessee Poison Center at Vanderbilt University Medical Center. "One person may be a bit sleepy, and the other may be in a coma."
How drugs react in the body varies from person to person. Medications are prescribed to specific individuals. Taking drugs intended for others, or offering someone drugs meant for you, could have lethal consequences.
Patience is a virtue. Different drugs act differently in the body. While some may be absorbed and begin working immediately, others may take longer to start working and even longer to feel the effects. It could be easy to think you need to increase the dose rather than wait for the medicine to begin working. In these cases, understanding what a drug does and how quickly it works is very important to avoid a potential overdose.
Throw out expired medications. Expired medications should be thrown away or flushed down the toilet -- anything to prevent their being ingested. Some drugs can become toxic when they are old because the chemicals in them break down or recombine with others.
Don't take medicine in the dark. If you cannot read the label on a pill bottle, do not take what is inside. Particularly if you keep all your medicines in the same place, the potential for popping a harmful dose of a prescription-strength drug instead of two Tylenols is very high. You need to be certain of what you are taking, and why, each time you open the medicine cabinet.
Don't chew, crush or break pills. While the sight of a mammoth pill is enough to make anyone gag, avoid the urge to break it into smaller, easy-to-swallow pieces. These smaller pieces can get absorbed into the body faster than they are meant to and may have effects similar to a drug overdose.
Make a crib sheet. Keep a list of all the medications you take, along with their appropriate doses, in your purse or wallet so that in case of emergency, you can tell a medical team what you have taken and why. Share the list with your doctors to keep everyone up to date.
More is not better. Taking more medications as you feel worse may seem a logical course of action, but this is very often not the case. Often, medication just conceals the underlying cause of why we are feeling ill, such as a vitamin deficiency or stress. Some doctors advise finding non-drug solutions to ease sickness or pain, such as counseling for stress or time management, seeing a nutritionist to improve eating habits or increasing physical activity. These changes can be just as effective, and longer-lasting, than getting another prescription filled at the drugstore.