Why We Shouldn’t Rush to Blame Heath Ledger’s Death on Doctors

Over on the Huffington Post, STATS’ Maia Szalavitz takes on some of the responses to the medical examiner’s report on actor Heath Ledger’s death, particularly the suggestion that one or more doctors may be “responsible” for his death rather than it being a consequence of drug abuse.

The problem, she argues, is that there is often a stigma to acknowledging that someone is addicted to drugs. But

The fact is, the vast majority of people who die from combinations of opioids and benzodiazepines — especially with several drugs from the same medical class in their bodies, especially if opioid painkillers are involved — are not taking their drugs as prescribed. They are addicts or, at least, drug misusers.

It’s conceivable that Ledger had a corrupt or profoundly incompetent doctor, but the more parsimonious explanation, given his history of recreational drug use, is that he was not following doctor’s orders at all.

This is important because blaming doctors for these deaths hurts pain patients and people with anxiety disorders who legitimately need these medications. Every time people avoid the hard truth about particular overdoses, legitimate patients get punished by restricted access to necessary medications and even denial of medication for excruciating pain or anxiety.

Also check out Maia’s earlier post “How not to die like Heath Ledger, Part II“

Dept of Unworkable Solutions: Nasal Flushing

Rebecca Goldin, Ph.D and Jenna Krall

A study published in the Archives of Otolaryngology-Head & Neck Surgery recommends pinning children down six times a day to spray saline up their noses. According to the Washington Post, this

alternative to the many cough and cold medications that line drugstore shelves comes not a moment too soon…The saline technique could provide a more holistic alternative to such over-the-counter medications, and has the added advantage of having little downside and not contributing to the growing problem of antibiotic resistance.

But for those doing the math, that “little downside” adds up to approximately one tantrum every two and a half hours. The Post mentions that the spray might lose effectiveness because “compliance […] may become an issue,” but neglects to question the change in quality of life. Though kindergarten teachers everywhere may be praying for a product that makes kids less germy, in the world of children, sniffling trumps six daily nasal washes.

The study suggests that after eight weeks of saline treatment, kids had fewer fevers, fewer missed days at school, and used less medication than those who didn’t rinse their noses. With the controversy surrounding children and over-the-counter cold medications, it seems like a long-awaited miracle treatment.

But the study may have been particularly laden with sick kids – after eight weeks, a full third of those not on the saline rinse were still on fever reducers, and 47 percent were still on nasal decongestants (compared to nine percent and five percent, respectively, of those on saline). Doctors might worry about the general health of any child with an eight-week-long cold.

The main result of the study may well be that we’re less sick if we keep our noses clean. But can we really imagine a world in which nasal flushing becomes as prevalent as hand-washing?