Tiger Woods’s DUI and the growing American painkiller problem

When police found professional golfer Tiger Woods, he was asleep over the steering wheel of a running car in Jupiter, Florida. His speech was slurred and he failed the basic roadside tests for sobriety. He was arrested on a charge of driving under the influence

Woods’s troubles – along with the recent deaths of a number of high-profile artists, including Prince – are just the tip of the iceberg of much larger problems affecting millions of Americans. More Americans are driving under the influence of prescription medications and illicit drugs. 

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The number of drivers involved in fatal crashes who have tested positive for drugs has almost doubled in the last 10 years, according to National Highway Traffic Safety Administration data. And in 2015, the Governors Highway Safety Association released a study showing nearly 43 percent of fatally injured drivers had either prescription or illegal drugs in their bodies, compared with 37 percent who had consumed alcohol.

 

There's no doubt we are a pill-popping nation, but a growing, less publicized problem involves patients taking too many prescription medications, over-the-counter drugs and supplements. 

Nearly half of men and two-thirds of women over 65 are on five or more medications, a situation referred to as polypharmacy. 

Accidental overdoses are common and can be the result of patients not fully understanding the impact of mixing prescription medications with other substances such as alcohol, over-the-counter allergy medication, or a class of sedatives referred to as benzodiazepines. 

What can we learn from Tiger Woods? The police report listed four medications Woods told officers he was taking — Vicodin (an opioid pain reliever), Torix (an anti-inflammatory medication), and an un-identified sedative or sleep agent.

On April 19, Woods had back surgery, his fourth surgery in three years. The recovery time is usually several months and can be longer because of the longstanding chronic pain issues.

The type of medications that Woods was on would not be an unusual combination of post-op drugs following major surgery.

There is a vital need to control pain after surgery. Not only does this help in physical rehabilitation, but uncontrolled pain releases a stress hormone called “cortisol,” which breaks down tissue and ligaments and decreases our immune system. That affects our recovery and makes us more susceptible to infection. 

Not all patients need opiate medication, but some do and the medication should not be withheld from them. Uncontrolled acute pain can lead to a chronic pain situation. 

All opiate medications, however, come with a stark warning on the bottle to not drive or operate heavy machinery. There's a good reason for that. Opiate medications can impair reflexes and reaction times — and the situation is even worse when mixed with other drugs.

For example, the class of sedatives called benzodiazepines stimulates neurotransmitters in the brain, causing drowsiness and reduction in anxiety. When these are combined with opiates, this effect is multiplied and can cause serious problems. Ambien, a common sleep aid, stimulates these receptors in a more profound way and initiates unconsciousness. 

As with all medications, some people have memory-related side effects from Ambien. Some have reported sleepwalking, sleep driving, eating at night causing weight gain, and a number of bizarre behaviors they can't remember having done. 

What if a patient on multiple medications forgets they already took the recommended dose and inadvertently takes more, which can lead to an accidental overdose? How many patients on multiple medications are at risk for accidentally taking too much? 

In fact, we really don't know the ­­side effects and complex interactions when patients are on multiple prescribed medications, over-the-counter drugs and supplements. It is not uncommon for patients to be on multiple meds from multiple doctors at one time. 

There are several proactive steps patients should take to avoid negative reactions and possibly dangerous incidents like driving under the influence.

Talk to your pharmacist about drug interactions with other medications and supplements to spot problematic interactions, and prevent bad combinations.

Have a frank discussion with your primary doctor who is your gatekeeper and can help sort out the medications you are on from different specialists. Organize your medication, because it’s sometimes hard to keep track of what you have taken daily. And lock up medication, many tragic accidental overdoses of children and teenagers can be prevented by being super vigilant and safeguarding your medications. By taking the right steps, we have the power to avoid harmful and dangerous outcomes from prescription medication.

Dr. Pawan Grover is an interventional spine specialist and television medical correspondent. He is a graduate of Rutgers’s Robert Wood Johnson Medical School and did his residency at the Texas Medical Center.


The views expressed by contributors are their own and not the views of The Hill.