The Ministry of Health will be asked to consider improving
education about the risks associated with combining some
prescription drugs, following a finding by the southern
region coroner into the death of of an Oamaru man who was on
the methadone programme.
Coroner David Crerar found that Lindsay Glen Angus, casual
worker, died at his home in Oamaru in November 2007 from
cardiopulmonary arrest due to the combined effects of
consumed drugs he had taken voluntarily.
He found there was no intention of suicide.
Mr Crerar recommends that the ministry considers enhancing
its education, drawing attention to the users of central
nervous system depressant medications that effects may
accumulate and that while such drugs taken separately may
have no adverse effects, they may have toxic or fatal
consequences taken with other such drugs.
Evidence was given that Mr Angus, an intravenous drug user
and member of the methadone programme, had methadone and
other prescribed drugs amitriptyline and diazepam at
therapeutic levels in his system.
Morphine and clonazepam, which were not recorded as being
prescribed to him, were also detected.
The report from crown research institute Environmental
Science and Research (ESR) noted that amitriptyline, diazepam
and clonazepam would have added to the central nervous system
depressant effects of the methadone.
Drugs such as diazepam and clonazepam, taken with methadone
could increase upper airways obstruction.
Approached for comment on the issues raised by the coroner,
Pharmacy Guild of New Zealand chief executive Annabel Young
said pharmacists routinely checked with patients about
combined medications.
They also often referred prescriptions back to doctors if
they had concerns about how medicines might interact.
About 30% of prescriptions resulted in some sort of
intervention by the pharmacist, which could include both
clinical concerns and matters relating to subsidies.
While Ms Young made it clear she was not commenting on Mr
Angus' case, she said it was difficult for pharmacists to
give appropriate advice if patients received prescriptions
from several different doctors.
Work was being done in Auckland on the possibility of having
an electronic record of all prescriptions, which could be
checked by pharmacists, but the usefulness of that would also
depend on patients consistently using their own names when
visiting doctors.
There was nothing pharmacists could do about drugs which
people might buy from someone while at the pub, she noted.
A Ministry of Health spokeswoman said since Mr Crerar's
recommendation had yet to be considered, it was inappropriate
to comment.
