I confess to being conservative about drugs.
Not just street drugs. Generally, the most you'll see me take is aspirin, acetaminophen or ibuprofen, because I'm not big on prescription or over-the-counter medicine either, too often overused and abused.
Perhaps growing up with family members who were quick to take medicine and stocked plenty of it, I developed an aversion to it. More likely, my own experience working in medicine made me cautious about its use.
So it is when I hear a story about an overdose in the news, whether it's Heath Ledger or Shawn King, it makes me enormously sad. I try to understand the thought process behind abusing prescription drugs to that level.
Drugs have simply become too convenient, too much of a placebo for too many. Too many kids are strung out on Ritalin, too many adults on Ambien, Ativan or Prozac. ADHD is overdiagnosed and overmedicated, as are anxiety disorders.
It's become too convenient.
I appreciate that modern medicine has brought important pharmacological advances, advances that are crucial to the treatment of serious illnesses and disorders. But I've known people, as many others have, who are walking drug stores, who think a pill is a cure for everything, who run to the doctor with every headache, every sniffle, every bad day, demanding a prescription.
Far too often, they get them. If they don't get them at Doctor A, they move on to Emergency Room B or Walk-In Clinic C or Celebrity Doctor D. The Elvises and Michael Jacksons and Anna Nicole Smiths and Jane Does of the world find their enablers.
I've known Shawn Southwick King only a little online. She was one of a handful of celebrities I exchanged tweets with after they found themselves trying to get their sea legs on Twitter. Some months ago she messaged me to say she liked my blogs and had enjoyed making some of the recipes she found linked there. I followed her on Twitter, as I did her talk king husband Larry when he arrived, and noticed that in recent months they weren't saying much. Shawn's last tweet was on April 2nd of this year, when she said, "Cousin Johnny passed away this morning. He is well loved. The power of your prayers were felt. Thank you so much for your kindness."
Then silence. It was the first she'd said anything in a couple of months. In early February she said this: "Yes, I've been silent for a while. If I told you why, it could be the "tweet heard 'round the world." ...so I'll save it for the book:)"
Their marriage difficulties have been all over the press. News that surfaced late Wednesday that she'd overdosed on May 28th at her home in Provo, Utah (coincidentally, the same day child actor Gary Coleman died at Utah Valley Regional Medical Center in Provo, where Shawn would have been taken by paramedics) initially confirmed only that she'd overdosed. Subsequent stories evidence that she left a suicide note, burial instructions and several empty pill bottles that had been filled in the last ten days, according to the police report, including Compro (prochlorperazine), Prometrium (progesterone), Ambien (zolpidem), Klonopin (clonazepam), Subutex (buprenorphine), Cymbalta (duloxetine HCl) and Lyrica (pregabalin). She was apparently listed in critical condition at Utah Valley Regional Medical Center in Provo that night and is said now to be recovering.
In the 9-1-1 call made public Wednesday Shawn's father, Karl Engemann, tells the emergency operator he does not believe his daughter, 50, intentionally overdosed, but he does confirm she is taking medicine for anxiety and depression.
I have no doubt she was both, anxious and depressed, and probably had reason to be, but I confess a disconnect from the mindset that decides to overdose, celebrity or not. I also disconnect from the family members in denial who think it's all right for their children, even adult children, to be taking that much medicine without fighting for their survival.
I've known people in my own extended family who decided emptying the medicine cabinet into their stomachs was a capital idea. Whether it was a cry for help or a serious attempt, the result was the same.
Shawn King wouldn't have been able to overdose if she didn't live in a culture where it was too easy to get prescription medicine for every ache, every pain, every heartache, every pain in the backside. Having money, celebrity status, and access to physicians willing to overprescribe doesn't help.
Not every child needs to be on Ritalin just to make the lives of parents and teachers easier. Not every headache patient needs to be on Elavil to make their doctors' lives easier. Not every man over the age of forty needs to be on Viagra or Cialis to make Big Pharma bigger. I've seen all of this firsthand, and know these medicines, while helpful in certain cases, are being widely overprescribed and a culture of people are believing they can't live without them.
One of the grandest, most lavish events I ever attended was in Toronto many years ago when I worked in neurology, hosted by a big pharmaceutical firm which had flown in dozens of doctors and their companions and wined and dined them for several days, all expenses paid. This particular occasion was at a palatial venue hosted by Lord and Lady X, a cocktail reception, a grand ballroom with large orchestra and elaborate dinner, the sort of thing the drug companies can no longer do but used to do to excess, just to get physicians to prescribe their drugs.
It apparently worked.
I confess to not understanding our current drug-dependent culture or being fully sympathetic to it. Too many people believe they need drugs they don't and are getting them. Too many doctors are prescribing drugs people don't need. The real clear help that pharmaceutical advances can give in medical treatment are being obscured by abuses in the system, abuses that are complicated to unravel and undo.
The answer to everything shouldn't be "take a pill," and the solution to life's difficulties shouldn't be "take several."
On the Web:
List of celebrity drug related deaths on Wikipedia
Police report: Larry King's wife suffered drug overdose - CNN
Larry King's wife recovering from drug overdose - Salon
Designer consciousness - Machines Like Us
Prescription drug abuse - Mayo Clinic
Report details suicide attempt by Larry King's wife - Reuters
(photo credits: top: Morguefile; center, Shawn Southwick and Larry King: Getty Images; bottom: Trends Updates)
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Ted Frier
Cleverley
J. P. Major
ohsillyme
Lauren B. Davis
Rochelle Skaar
Salon.com
Comments
We are an over-medicated society! I try not to take an aspirin. They don't like me very much.:) Excellent post!
Its sad, but drugs have been good business for centuries.
It's just a matter of how 'stamped and legal' it all seems to the public eye.
Rated for Truth, however, which is rare these days.
I'm sorry for people who feel life is not worth "feeling"...it most certainly is, the good, bad and the in-between.
We were not there this time to visit her. She was no longer there. We had come to help her sister who had come the night before to see why her sister had not joined the rest of us for Thanksgiving dinner as had been planned. Depression had won and she was gone. She found her sister dead.
We were there to help her sister clear the apartment, look for papers and whatever else you need to do at moments like these. Mostly she needed not to be alone. Once there, we knew why.
There were pills, all kinds of pills, hundreds of pills, perhaps more. They were in every room. They were in bottles. Bottles were in envelopes, mailers. Until that moment I had had no idea that anyone could get her hands on so many pills. She had ordered most of them online. Her sister had been there long enough to make some sense of it.
Her sister was not famous. She was sad and she missed her mom. Thanks to computer links and God knows what other means, she found a way out. Had she meant it? Had she wanted to be found? We rarely know the answers to these questions.
We were there and we loved her and she knew that. Sometimes when we met she would talk and we would listen. Sometimes she simply needed quiet company and she knew she could have that with us. But we were not her mom. Nor were the pills. But because she wanted them, they were easy enough to obtain.
How many others are walking this same path and walking it because they can?
I hear the wisdom of your words here, Kathy. I wish our friend could have heard them too.
I (and many of my family members, though not all) have a chemical imbalance in my brain that causes depression. It is genetic. It cannot be "cured". It is permanent. It also happens to be fatal if untreated. I've got enough dead relatives in cemeteries or on their way there to prove that.
Sound familiar? No? Look at it this way - I have no choice but to take antidepressants for the rest of my life. It is precisely the same as having to take insulin for diabetes, which is another debilitating and deadly disease that afflicts many thousands (millions?) or people.
I grew up listening to people telling me to "snap out of it". They offered crappy advice guaranteed not to work, but in they're own twisted little mindsets made some sort of sense. "Just study harder. You'll be fine." How about "once you have a boyfriend, you'll feel better." This is a good one, "All you need is more sleep and a super-duper special diet."
It's all crap. Every single statement I listed is an outright lie, told by people who try to convince each other that drugs are some sort of "cop-out", and anyone who needs them is "weak" in some way. I have no idea why they do this. I suspect it has to do with a feeling of superiority and to reinforce their smug assumption that they're somehow "better" than anyone who confesses to being miserable. It's like whistling past the graveyard for them.
No amount of talk therapy with help with this kind of depression. NONE. Take it from someone who spent YEARS bawling on various therapists' couches. Therapy makes it worse. Much, much worse. Most therapists, you see, try to convince you that it's somehow better to navel-gaze and wallow in the misery rather than deal with the actual cause of the depression.
I realize it's easy for you to criticize and deride people for taking drugs. Babbling about "Big Pharma" is popular among people who need to see conspiracies all over the place. No doubt if you hadn't swallowed the Kool-Aid about drug companies you'd be seeing monsters under the bed or talking about black helicopters or something.
Do not presume to judge people who have depression or other conditions that require medication. If you haven't been there, then you have no idea what you're talking about. And just by writing this post, you've proven that you have no idea.
I'm also a huge fan of Darwin.
Strong in the heart people tend to avoid the weak that need a pill for every stray emotion. therefore the weak tend to be with the weak, but since the weak are to weak to deal with anothers problems they tend not to have children.
I know that comes across as cold, and I don't intend this to insult people that have actual needs, but I'm just tired of holding hands and saying it's going to be OK instead of telling people to suck it up.
I feel terrible for your friend Shawn.
R.
I have always thought that doctors should be accountable for the prescriptions they write. It seems that many - and CERTAINLY not all, or even most - doctors just don't pay attention to patient charts before they write a prescription for something the patient asks for. Some sort of database would be helpful. People die every day not only of misuse of pharmaceuticals, but from drug interactions that they had no idea were dangerous in the first place.
I know, I know. People are now going to yell and scream about privacy and how no one wants anyone else to know what they're taking. Whatever. The simple fact is that it would stop people from shopping for doctors to get what they want in the way of drugs. Several times, when reading about celebrities that overdose or die because of prescription pills, I've wanted to smack the doctors who never thought to find out what their patient is already taking.
I think, however, that people who search out drugs from doctors are to blame as well. What they're doing is no different than buying heroin or cocaine from a dealer. They seek out someone that has what they want and is willing to sell it, money changes hands and the deal is done.
The real tragedies, and I've seen some of them in person, have to do with older people who really do have some health issues, but have bags of drugs in their homes. It frequently turns out that various doctors have written prescriptions for side effects or make a diagnosis based on something they observe, assume is health related rather than a side effect.
I know one elderly person whose children were getting ready to put her in a nursing home. A doctor had told them that she was hopelessly senile and was only going to continue to lose her mind. Thankfully, one of the kids went through her cabinets, put all of her prescriptions into two grocery bags and took them to one doctor.
Once the woman was off all of the drugs except for her blood pressure medication and her arthritis meds, she was fine. She lived another decade in her own home and never showed a sign of mental deterioration.
We don't hear about the grannies in the news, and this is a shame, because they are true victims.
(The question.)
How many people around Shawn Engemann Southwick King knew she was taking pills, and how many? How many were in denial she needed help? How many were in denial she was potentially suicidal? I find it interesting that the father mentioned neither the empty pill bottles nor the suicide note, both of which should have been apparent. Keeping her name out of the press might have been a noble goal; keeping her alive even more so.
The fact is that the woman didn't die -- one reason being the lethality of the medications is lower than earlier generations of drugs.
It's impossible to disagree that there are excesses. The notion that there are negative trends is much harder to demonstrate. Prescription drugs seem to me to be much safer and more effective in general than alcohol and tobacco.
Shawn Southwick is clearly a desperately unhappy person who is unable to resolve her psychic tensions and uses drugs to quite those tensions.
Some people can understand themselves well enough to handle their problems, but others simply can't. They reach out for any possible remedy. It is not entirely the increased number of drugs and their availability that is the primary problem.
This is a personal issue for me. My mother had depression issues from the time I was fourteen on and when Prozac came out (replacing the side-effect riddled trycyclic antidepressants, her life was completely changed.
While I agree that there are many people who ride the wave of pharmaceuticals, the same in true of alcohol and illegal drugs. Just another perspective.
I make very clear in the post that I believe drugs are appropriate for those who need them. As I say in the article: "I appreciate that modern medicine has brought important pharmacological advances, advances that are crucial to the treatment of serious illnesses and disorders." I absolutely believe and maintain that, and do not mean to suggest that drugs should be eliminated or are completely unnecessary. I am talking about the abuse and misuse of drugs.
Also, I believe the internet is going to undercut the huge advantage those companies had in the past (shaded and limited data). Doing a quick search does more for patient's sense of control and self education than most things these days. Patients are going to find each other faster, discover unhealthy trends sooner, and work together to help others.
I think the rein of misinformation selling drugs is almost over. People looking for additional support may discover natural alternatives and turn away from the chemical cocktails pushed by big corporations.
Thanks for this post!
Patients can be very compelling in their pleas for pills. Sometimes their lives really are that empty/sad and hopeless, so getting a "happy pill" would be the only bright spot for them. I tell people no all the time. But I'm not perfect and sometimes it's easier to give in, even a little, to shut them up and get them out of your face. I had a colleague tell me "I can't be like you, when someone tells me they are in pain, I have to believe them, I can't promise you I won't give her pain pills if she asks me for them". This was in response to my telling him I had taken his patient off of all the pain pills and benzos he was giving her.
Yes, some diagnoses are over used. People who self diagnose are often "rewarded" by busy primary care doctors who simply go along with what the patient is telling them about their "adult ADHD" or their bipolar disorder that they read about on the internet. We do not have a perfect system.
However, I don't think doctors and "big pharma" as people like to call it now, are to "blame" for all the people who overdose intentionally or accidentally. You can just as easily overdose on over-the-counter medications or find other ways to take your life. People who successfully kill themselves typically aren't just "sad". They are typically cripplingly depressed and feel trapped/alone and feel as if there is no other way out. Sure, sometimes people who probably didn't REALLY want to die are successful by accident. Someone who serially tries to kill themselves, or makes a suicidal "gesture" (an attempt of sublethal means with imminent rescue) or just says "I'm going to kill myself" for attention may actually kill themselves at some point while trying to manipulate a loved one or make someone feel "sorry". Suicide is never the right answer as far as I'm concerned, but I see people every day who for many reasons, feel it IS an option. Luckily, for the ones that make it to me, there are OTHER options to explore.
Modern medicine is not the bane of our existence and it's not the eternal answer to every problem. Medicine is simply a tool that we try to use to improve the length and quality of human life. Medicine is an art and a practice as much as it is a science.
Thanks for writing this, calling attention to the situation. My mother was from the generation of doctor worshippers. Sadly, a nurse in our family believes my mother's stroke—recurring and ultimately fatal—was caused by excessive use of non-prescription NSAIDs prescribed and unmonitored by a physician in our family. The NSAIDs were previously prescription only for a a reason. Extended use for pain by unmonitored people over 60 can be extremely risky.
For example, it's accepted that depression is caused by a shortage of serotonin and therefore can be cured by serotonin re-uptake inhibitors, however, there's no evidence that people undergoing a depressive episode have lower serotonin than the average person, or lower levels than they do when not depressed.
SSRIs clearly do alter brain chemistry in the short term and have a short term effect, but the brain adapts to them, so it's not clear that a return to depression after stopping SSRIs is due to the end of an effective cure or just withdrawal symptoms. They do clearly have side effects, which is why many people end up on a cocktail of drugs, each curing a side effect of another.
Anyway, part of her point is that the science that supports the theory of chemical imbalances in the brain being the cause of mental illness is not at all as rigorous as evidence of physical ills, such as heart disease. But that the pharmaceutical industry strongly encourages this view.
The result is that, along with insurance pressures, the average psychiatrist sees their patient for 15 minutes and prescribes a drug.