For several years now I have been talking to colleagues and friends about my developing interest in raising red flags regarding harmful prescription drug use. Considering the Center for Disease Control and Prevention is now admitting that tens of thousands of people a year are dying from poisoning and/or ‘accidental death’ related to prescriptions, and that we have a full blown epidemic on our hands, I would hardly consider this a subjective call for alarm. Accidental prescription drug deaths are more prevalent than deaths from firearms and car crashes.
The single most frequent question I get asked when I tell people of my concerns is “what drugs are you talking about?” That is an excellent question. I was asked it again this morning. “Which class of drugs are you suggesting people get off of?” Is it the painkillers in the news? (Oxycontin, Hydrocodone, Vicodin, Codiene…..) The psych drugs such as antidepressants, anti-anxieties, ADHD types, or anti-psychotics? What about sleeping pills such as Ambien? Or how about the statins, Lipitor and the like? What about antacids such as Prevacid? Many of these have received some very negative press recently. People keep asking me, “what are the bad ones and what are the good ones?”
What I discovered immediately in my time at a rehab center in Utah and in my practice, is there exists in treatment and in prescription patterns something I refer to as class confusion. The boundaries are murky. An excellent illustration of this is the death of Leslie Carter, a member of a family of pop musicians who died last week of what appears to have been an overdose related to three different prescriptions. She was 25 years old with a 10 month old child and stopped breathing in a bed at her fathers home. My heart extends to her and her families tragic loss.
Leslie Carter is the sister of brothers who became music stars in the 1990’s. One of the brothers was in a famous group, ‘The Backstreet Boys.’ A musical genre developed known as ‘boy bands.’ Leslie had a hit song in her own right, ‘Like Wow,’on the soundtrack of the movie ‘Shrek’. She had a record deal with Dreamworks that was never realized. Apparently she suffered from a history of mental illness which included depression and schizophrenia. The way the story of her death unfolded in the media was telling.
The first report stated simply that Leslie Carter had died at age 25. The article was accompanied by a photo of Leslie with her famous brother Nick. There were few details included there. Being admittedly biased I wondered right off if prescription drugs were involved. Which is not much of a stretch since many fatalities involving entertainers often include drugs and/or alcohol.
In the second day of the news cycle it was reported that three bottles of different prescription drugs were found near her bed and that she had a history of mental illness. It was revealed that Leslie had a 10 month old daughter, was estranged from her husband and was residing at her father’s home. Her stepmother Ginger found Leslie not breathing and called in the emergency. Earlier that day Ginger helped Leslie following a fall in the shower. The three prescription bottles indicated that Leslie had been taking Zyprexa (olanzapine) for schizophrenia or bipolar depression, Flexiril (cyclobenzaprine) for muscle spasms or fibromyalgia, and Xanax (alprazolam) the benzodiazepine , referred to in a previous post, for anxiety. Xanax is a highly addictive tranquilizer and can be treacherous to withdraw from. It is very popular amongst abusers. Though the first autopsy report was inconclusive one has to wonder about this cocktail of medicines involved in the incident.
On the third day of the news cycle the drama of the dysfunctional show business family began to unfold. The most striking component of the family story had to do with the stepmother, Ginger. The authorities who arrived on the scene found a somewhat incoherent stepmother who was slurring her speech. When asked about it, she replied that she too was on the Xanax and had taken an extra pill in reaction to Leslie’s death. Is this a matter of the family who takes prescriptions together…….? Are these legitimate prescriptions or is something else going on?
I couldn’t help but feel so much sympathy for Leslie, her baby and the family. We probably will not discover all the answers but this story may be more common than you think and raises some important questions on the heals of the Michael Jackson case.
What exactly was Leslie Carter being treated for? Had she been ‘doctor shopping?’ The story said she had a standing problem with addiction. What was the nature of the addiction? Was she an ‘accidental addict’, one who followed doctor’s orders? Or was substance abuse at play? Was she properly monitored? Did the drugs cause her to stop breathing? If so, were all the drugs responsible? One more than the others? The combination or the amount? Was it long-term use and could that be the reason she died? Was Leslie taking the drugs as prescribed, assuming they were prescribed legitimately, or was she taking increasing doses to achieve levels of previous relief? How high were the individual doses? Was it safe to mix a muscle relaxer with a benzo and a drug for schizophrenia/bipolar depression? Did she take too many pills? Was alcohol involved?
As I said in my first post, I am not an expert in pharmacology but it doesn’t take a rocket scientist to contemplate these somewhat obvious questions. Quite honestly, I don’t know the answers. The line between safety and harm emerges as a complex and often elusive one. But one thing I do know, we and people like Leslie and her loved ones deserve the truth. I believe there is a way for drug class confusion to be clarified.
For Leslie’s memory it will be interesting to see if the toxicology report comes back conclusively. My final questions being, will we know who or what was responsible for Leslie’s death? Will there be an honest drawing of conclusions? Will a prescribing physician be held accountable if the drugs were the cause or will a victim be blamed? It takes 6-7 weeks for the report to come in. Perhaps the media will have lost interest, in this not so well known pop star, by then.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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