Death by Medication-Alcohol Combo Up 3,000 Percent

July 28, 2008— -- Accidental deaths from mixing prescription medications with street drugs or alcohol have shot up by more than 3,000 percent in the last 20 years, according to a new study in the Archives of Internal Medicine.

Researchers at the University of California in San Diego analyzed all U.S. death certificates between 1983 and 2004. They found that while the estimated years of life lost to other accidental deaths by car crashes, drowning, falling, gun accidents or fires went down, general medical error deaths (200,000 in total) went up by 500 percent.

However, that increase was nothing compared to the jump from deadly drug and medication interactions.

"I've been studying mortality forever," said lead author David Phillips, a professor of sociology at UCSD. "The kind where the person takes the medication at home -- that was certainly a big surprise."

Phillips believes the deadly trend is rooted in two changes: First, the number of medications people take has increased in the last 20 years, automatically increasing the chance for an interaction. Second, the general trend in hospitals to send people home earlier from a procedure puts patients in charge of their medication, and therefore in charge of their own safety.

Is Self-Care Safe Care?

Ben S., a member of the support group Al-Anon for family members of alcoholics, said the findings of the study hit home for him.

"I just happened to have this sort of thing on my mind because this is what my week is like," he said.

Ben, who asked ABC News to refrain from using his full name, has a wife who is an alcoholic. He said she has been drinking a fifth of vodka each day for a toothache, and Ben was at a loss for what to tell her doctor when she went in for surgery.

"If you're already in denial about your alcoholism, then you don't think it's necessary to mention it to a doctor," he said. "An addiction is a blindness to your own health care, obviously. It's a self-destructive path."

Dr. Nicholas Pace, an addiction expert and a clinical professor of medicine at New York University in Manhattan, doesn't believe most people fully understand the danger of mixing alcohol and medication.

"When you take a drink and you have a pill, a tranquilizer for example, you increase the effect of both drugs," Pace said. "One drink and one pill don't make two, they make 10."

At the moment, Ben is worried that his wife will either be going through alcohol withdrawal symptoms while recovering from surgery, or worse, he worries that she'll start drinking and risk an interaction with pain medication.

"Is it my responsibility to tell the doctor that this person has been drinking?" Ben asked. "Doctors want to talk to the adult as a responsible adult -- they don't want to have a side conversation."

But Phillips said his study is evidence that doctors should second-guess the responsibility of some adults and take more time with the conversations about medicine.

"Because the patient is expected to take a bigger and bigger role in controlling their medication," Phillips said, "it's very important for clinicians to say, 'Listen, you know, we really mean it that you have to be careful with this medication.'"

Phillips added, "It may be that certain kinds of patients, no matter how often you say this, they may not be able to do it."

Such people, who may just need the old-fashioned longer stays in hospitals, include those who have trouble reading labels or non-native English speakers, he said.

"They have indeed saved a great deal of money [by shortening hospital stays]," Phillips said. "But they've lost some lives because of this."

Are Numbers the Real Life?

Dr. Robert Gwyther, a professor of family medicine at the University of North Carolina at Chapel Hill, doesn't doubt that deaths by medication and alcohol interactions have increased. In 1983, he would see patients who took 10 medications at most, he said, but now he sees patients on 20 different medications.

"And I'm just talking about prescription medications that we know about," Gwyther said.

Despite that, he was skeptical that the number of such deaths could really have increased 3,000 percent.

"That's a pretty huge increase and it makes me wonder about classification," he said. "Are we comparing apples and apples? It's interesting to talk about it as a medication error -- someone overdoses [while] on heroin, but is that a medication error?"