Thursday, March 06, 2014

How About Taking Responsibility For the Medications You Take

Ruth Marcus seems oblivious to the fact that sedating medications, including Ambien, are frequently abused.
[Kerry] Kennedy may have taken the pill by mistake, they contended, but she ought to have known she was impaired and pulled over.

Excuse me, but maybe they should have tried taking this drug before filing criminal charges. Ambien and other sleeping pills are powerful. You take Ambien, and 15 to 30 minutes later, you begin to zonk out. A toxicologist who testified at Kennedy’s trial — for the prosecution, no less — said that someone under the influence of Ambien could fail to recognize that she was having a problem, or even to remember, later, what happened.
I think we can infer from Marcus's statement that she has taken Ambien, and thus knows how sedating it is. What Marcus probably has not seen is what happens when somebody takes Ambien and deliberately stays awake. The superficial affect is one of significant alcohol intoxication. Why do some people do that? Just as with abuse of common benzodiazepines, ecause they like the way it makes them feel, and some of them use other drugs or alcohol at the same time so that they can enjoy a magnifying effect.

Ambien may be something of an extreme case, given how quickly the sleepiness can come on, but how far would Marcus extend her "Let's assume it was an accident" rationale to other sleep aids? She draws a distinction between "medications with drowsiness as a side effect, [and] the ones whose sole purpose is sedation", but why? Many people take Benadryl to sleep, and sometimes pharmacists recommend it as a non-prescription sleep aid. Many people take opiate and opioid medications for pain, but they can be highly sedating and are commonly abused.

Marcus seems to feel that nobody who drives down a road after taking Ambien should ever face a criminal charge for driving while impaired by drugs, even if they injure or kill somebody. I have no problem working from the perspective that if you are too drugged to drive you shouldn't get behind the wheel, even if you took the wrong medication by accident. When somebody is intoxicated behind the wheel, I don't mind putting the impetus on that person to convince me both that it was a mistake and that they had no reasonable opportunity to recognize the mistake so as to get off the road. Kerry Kennedy was able to convince a jury that she took Ambien by accident, and didn't recognize its effect in time to safely stop her car. Marcus thinks that's too high a price for Kennedy and other Ambien users to pay, but it's not as if either of them are unaware of the dangers of that drug. They are both certainly aware of this case:
U.S. Rep. Patrick Kennedy said Friday that he will enter a rehabilitation program after crashing his car on Capitol Hill a day earlier....

He said in a statement Thursday evening that he was apparently disoriented at the time of the crash after taking the prescribed amounts of a sleep aid and an anti-nausea drug.

"I am deeply concerned about my reaction to the medication and my lack of knowledge of the accident that evening. But I do know enough to know that I need to seek expert help," he said Friday....

In his Thursday evening statement, Kennedy said he had returned home after final votes in the House of Representatives around midnight Wednesday and taken the sleep aid Ambien and an anti-nausea drug....

In his comments Friday, Kennedy said, "The recurrence of an addiction problem can be triggered by things that happen in every day life, such as taking a common treatment for a stomach flu.
Assuming she takes Ambien, Marcus, I expect, is very careful with Ambien due to the stories she recounts, including one that put one of her own children in danger. How many stories do we need, and how close to home do they have to hit, before we can reasonably expect people to look at their pills and read their pill bottles before swallowing a sleeping pill then getting behind the wheel of a car?

I won't argue with Marcus that manufacturers could create pill colors and shapes, or package sleep aids in a different manner, and thereby all-but-eliminate the "I was confused" defense. Perhaps at that point Marcus would accept that people intoxicated by Ambien should be subject to prosecution for driving in that condition. But for now, if people have multiple, similar-looking medications, they owe it to themselves and others not to confuse their pills. If people who have serious health conditions requiring them to juggle dozens of medications can keep their pills straight, I think it's reasonable to ask that people with minor medical conditions and two or three prescriptions to do the same, more so when incidents of carelessness will pose serious risk to themselves and others.

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