ANNE T. DENOGEAN

Tucson Citizen 

As newspapers trumpeted the sordid details surrounding the death of Anna Nicole Smith, another story on the back pages of some of those same papers whispered our collective dirty, little secret.

And that is, if Smith was, in fact, a reckless abuser of drugs, an indiscriminate pill-popper, she wasn't alone. 

Death by unintentional drug overdose is the second-leading cause of accidental death, second only to auto crashes, The Associated Press reported.

And while some of those deaths are caused by therapeutic errors in dosages of prescribed medications, most happen when people abuse prescription and illegal drugs, said the Centers for Disease Control and Prevention report the AP story was based on. 
The national rate of overdose deaths increased by almost 70 percent from 1999 to 2004, the most recent years for which data are available. 

The CDC researchers attributed the increase mostly to abuse of prescription pain medications and sedatives, with cocaine use also a factor. 

Smith's only son, Daniel, died of what was ruled an accidental drug overdose Sept. 10. He had a variety of prescription medications in his system. 

Her death, as anyone who watched five minutes of television last week knows, is also being investigated as a possible prescription drug overdose. 

Neither the new CDC report nor the Smith story is all that surprising, really, given the pharma-centric era we live in. 

I'm not so old, only 40, but I recall when most generally healthy people took nothing more than the occasional aspirin for a headache or Rolaid for indigestion. 

How things have changed over just a few decades.

Depressed? Anxious? Stressed? Overactive? Undersexed? Too fat? Can't sleep? Can't stay awake? 

There's a pill or potion to cure your "disease." 

And don't worry if your doctor won't prescribe it.

Borrow a few Vicodins from a friend. Pick up some Valium in Mexico or over the Internet. Stop by the Chinese shop down the road for that herbal tea that kills your hunger pains and leaves you feeling zippy. 

Jude McNally, managing director of the Arizona Poison and Drug Information Center, said it's traditional for mornings to be spent handling calls about kids who have gotten into the kitchen cabinet and household products, while the evenings bring calls about adults who have gotten into the medicine cabinet. 

"Medicine, in and of itself, is all good," he said. 

It's the inappropriate use that's dangerous, he said. 

"As drugs become more available, we can become more cavalier about their use," he said. "An area where we see that, more than any other, is people taking medications not prescribed for them, getting medication from friends or family members." 

Even over-the-counter drugs can be deadly. 

"Tylenol in very high doses will destroy the liver," McNally said. "There's some very wrong thinking associated with medications. That is, if a little bit is good, a lot is better. And if it's an over-the-counter medication, it must be safe. Certainly, in the right dose, any medication can be dangerous." 

Showing a bit of respect for the power of modern pharmaceuticals would go a long way toward keeping us safe. 

"It's a matter of educated use, education on the part of the physicians to not prescribe medications that would interact or adversely accumulate and education on the part of the patient to realize these are potentially dangerous substances," McNally said. 

There is a certain twisted irony that Smith's most recent turn at fame came as she was the spokeswoman for TrimSpa, an over-the-counter diet drug. 

Modern medicine is a marvel. It can cure some cancers. It can make incurable diseases more bearable. It can relieve pain. And it can extend life. 

But, like all things, modern medicine is best when taken in moderation.