We usually think of overdoses being caused by one drug. We imagine someone overdosing on heroin, fentanyl, sleeping pills, or alcohol, but that’s not often the complete picture. For example, whenever a celebrity dies of an overdose, it’s never one drug. Philip Seymour Hoffman had heroin, cocaine, benzodiazepines, and amphetamines in his system. Heath Ledger died from a combination of oxycodone, hydrocodone, diazepam, temazepam, alprazolam, and doxylamine. Carrie Fisher had cocaine, methadone, heroin, and ecstacy in her system, in addition to the prescription drugs Abilify, Prozac, and Lamictal. Most recently, Tom Petty was found to have died from a combination of fentanyl, oxycodone, temazepam, alprazolam, citalopram, acetyl fentanyl and despropionyl fentanyl.
You might say, “Sure, but they’re rich celebrities; normal users don’t have that kind of stash.” It may be true that they all had more resources than the average person, but mixing drugs is common and far more likely to cause fatal overdose. For example, benzodiazepines alone almost never cause a fatal overdose, but according to the CDC, benzodiazepines were involved in nearly 10,000 fatal overdoses in the US in 2015. Most of these involved mixing opioids and benzodiazepines, compounding the suppression of the central nervous system.
Alcohol is another common amplifier. Alcohol is ubiquitous and enhances the effects of most drugs. It isn’t just a case of adding the effect of alcohol to the drug; in many cases alcohol also increases the potency of other drugs. People often underestimate the magnitude of this effect and put themselves in danger by drinking while using other drugs. Even prescription drugs can become dangerous when used with alcohol, which is why many prescriptions carry a warning against taking them with alcohol.
The body is a massively complex system and it’s impossible to predict how drugs will interact. The more drugs you take at once, the more you are likely to have a dangerous multiplicative effect or interaction. Prescription medications complicate this further. Many people take medication daily and don’t even consider that it stays in their system and might affect the potency of other drugs.
There would certainly be fewer fatal overdoses if people only took one drug at a time, but that is actually rare. Few people stick to exactly one drug. Most users–like most people in general–drink alcohol too, and that combination is enough to be dangerous.
Smarmore Castle Private Clinic in County Louth, near Dublin was founded in 1988 as a residential rehabilitation hospital treating people suffering from drug and alcohol purposes. Smarmore Castle believes in helping patients lead a life of abstinence through 12 Step programs, detox and medical treatment, psychotherapy, and complementary therapies. For more information, please call 041-214-5111. For those who live out of the country, the international number is 00353-41-214-5111.