Dear C;
I work at a busy coffee shop. One of my regular customers, Sam, has always been a laid-back dude but recently, he’d complained about feeling dragged out and tired. I didn’t know that much about his personal life, and he seemed to want to talk, so I asked a few questions and discovered he was on nine different medications, five of them psychiatric drugs!
When I asked how he came to be on so many medications, he told me that it started because he had no health insurance or primary care physician and would go to the ER every time he had a problem. The series of unfamiliar doctors he saw there would just hand him another prescription, without checking into his records for interactions. Trusting the doctors, he kept taking them.
It seemed pretty likely that his constant fatigue was being caused by too many drugs so I told him this and asked if he had a primary care doctor now. He did, but admitted he’d never revealed all the medications that he was on because he was afraid she would judge him. I suggested he tell her and get help in tapering off some of his drugs.
Unfortunately, he decided he didn’t have to bother with going to the doctor and quit cold turkey the same day without telling anyone.
Several of his prescriptions had warnings that it was dangerous to stop them without tapering off slowly. Within 24 hours, Sam was in a semi-psychotic state. That’s when he made another bad decision to call an old buddy that he used to do drugs with, and ask for advice. The “buddy” told him to take a double dose of one of the pills, and chew it so it would work faster.
Sam ended up in the emergency room with his mouth burning, his heart pounding, and on the verge of a serious medical crisis. Turns out the drug he chewed on in a double dose should never be crushed before swallowing and his system had been hit with the equivalent of a triple overdose.
I’m wondering if there’s anything that I could’ve done as his friend? Did I give him bad advice in the first place by suggesting that his medications were causing his fatigue and that he should probably try to get off of them?
C says:
This isn’t your fault. Your advice to decrease his meds was well-intended, but your friend only heard the first half of it – the part about being honest with his doctor went right over his head.
People who are overly medicated tend to be vague listeners, which is something to keep in mind for the future.
We all want to help our friends when they are in trouble, but unfortunately we all tend to do what Sam’s “buddy” did – hand out anecdotal advice. We relate what works for us or what worked for a friend. This would be great if we were all the same person, and our bodies all reacted in an identical way, but that rarely happens. In the case of your friend Sam, his buddy’s advice could’ve been fatal. A common way for people to overdose is to suddenly take a high dose of something that they’ve been off of for a while. Their resistance is down and taking the same amount that a regular user ingests could be enough to send their own system into shut down.
Here’s something else to consider – whether he was over-medicated or not, there was a reason that Sam was initially placed on those prescriptions. You don’t know what lies beneath his medicated laid-back surface. If he is bipolar or on antipsychotics, this is nothing to fool around with.
The next time a friend has a problem on this level don’t hand out advice yourself even if the solution might seem obvious. A little learning can be a dangerous thing when it comes to handling pharmaceutical emergencies. For a serious, life threatening situation, go to the ER and call the MA and RI Poison Control Center on the way. Their hotline is 1-800-222-1222.
Sometimes in order to be a good friend, the best thing you can do is take a step back and let the professionals take over.