![]() Using daily medication checklists and having another person keep track of medicines is helpful. Mistakes happen when people get foggy yet still can’t sleep and take more medication - these mistakes are particularly common among older patients. Impaired memory and hazy thinking are side effects of many medications. Skipper says another danger is that people can sometimes forget that they have already taken a medication, and then accidentally take a second dose. One can draw the conclusion that in these cases, people might “self-medicate” or misuse their medications by taking extra doses or mixing prescriptions in an attempt to increase, or even feel, the beneficial effects. Studies show that in anxious or depressed patients with high stress or trauma, insomnia is associated with an increased likelihood of substance abuse as well as non-responsiveness to treatment. Or, if you double up on a dose or pop two different meds into your mouth at the same time and swallow them down with a drink, you increase your risk for CDI.” Intentional Self-Medication and Accidental Misuse Medications can stay in your system for a while, so even if you take your meds a few hours apart, you can still have high levels of the previous dose in your body, and this leads to problems. “What people need to know is that certain combinations are highly toxic. “It is surprising how many people continue to combine medications, even after a number of high-profile cases of combined drug intoxication have brought attention to the inherent dangers,” says Greg Skipper, MD, Director of Professional Health Services, Promises Malibu. ![]() Toxicity can be exacerbated if a person also drinks alcohol while the medications are still in their system. Often confused with drug overdose, combined drug intoxication (CDI) or lethal polydrug intoxication is different - it causes problems that are not necessarily from too high a dose, but from the simultaneous effects of drugs that, together, cause toxicity. How can combining medications cause death? Depending on which combination of medications is taken, the mixture can suppress your respiratory function to the point that you stop breathing, and it can also affect your heart, leading to cardiac arrest. The medical examiner reported that Ledger’s death resulted from the misuse or “abuse of prescription medications,” but it was their toxic combination that killed him. The cause of death? Accidental “acute intoxication” from the combined effects of six prescription medications, including sleep medications, anti-anxiety medications and opioid painkillers. Ledger told his sister not to worry, but 24 hours later, the talented performer and aspiring film director was gone at the age of 28. Like many people, Ledger took multiple prescription medications together. ![]() Insomnia occurs in 50% to 90% of people with these mental health conditions, so it is not unusual for a person to receive coinciding prescriptions for insomnia, anxiety and depression. It is common for someone who suffers from anxiety to suffer from depression - more than 50% of people diagnosed with depression also have anxiety. ![]() Ledger’s overlapping conditions were not unusual. She knew he had received prescriptions for co-occurring anxiety, depression and insomnia, and warned him not to mix his medications - she understood the dangers. I might have to take a couple of Ambien to go to sleep,” actor Heath Ledger told his sister on the phone the night before he died. Motivational Interviewing Therapy Program. ![]()
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