what is the nature of drug-drug interactions and what are the implications for drug users as well as for society when newer drugs become increasingly more sophisticated and more widely available
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There is an ample amount of drugs for just about every ailment. Prescription drug misuse and abuse is very widespread and very deadly. There have many deaths regarding the misuse of painkillers. In some cases, it is a simple matter of not following instructions. And of course in some cases people have become addicted to the medicine.
I think one of the major concerns with illegal drugs is the way that so often they are rarely sold in their "pure" form. Often drugs are cut by dealers with other substances, that can be innocuous, such as sawdust, or they can be much more harmful. Taking a number of different drugs only adds to the difficulties and gives a greater risk of complications occurring. For doctors trying to treat such cases, they can never be fully sure of what their patients have actually taken, making it highly problematic to treat them.
Another difficulty is the ease with which drugs can be obtained from different sources. The days of having one pharmacist at one drug store where you always went to obtain all your prescriptions are gone. It's very easy to have prescriptions filled in different locations, making it much more difficult for any one person - be it a pharmacist, physician, nurse, family member, or patient - to track what drugs are being taken, what doses are being used, and what the interactions between those drugs may be.
Much as I don't want Big Brother watching me, there would be something to be said for a single nationwide registry record for all prescriptions, perhaps identifying patients by Social Security numbers - some way of double-checking for interactions and duplications with every addition or refill.
One of the difficulties in this area is that there are so many drugs already on the market as well as ones that are now being developed, on top of the illegal drugs in circulation, that detecting drug interactions and correctly informing all pateitns of them is increasingly difficult. The testing and clinical procedures employed by the FDA are relatively thorough, but far from infallible. The warnings given by drugmakers in ads on TV are a rapid-fire litany of possibilities listed in seconds, and are ignored by most people, so the educational value of those announcements are limited at best. Unfortunately, this means we often discover dangerous drug interactions only after the adverse side effects have been reported, collected and studied.
Along with what post 4 has said, many patients neglect to tell their doctors and pharmacists about the over the counter drugs they are taking. It is important to realize that simple, over the counter medications can have dangerous interactions with prescription medications or even with each other. Even herbs can cause interactions. For example, a patient should never take St.John's Wort with an antidepressant. Herbal supplement stores will often claim that St. John's Wort is side effect free. This might be true, but it can have dangerous interactions with other medications. As medications become more and more complex, their interactions with each other will become more complex as well.
Basically, the more kinds of drugs there are out there, and the more that people use those drugs, the more chances there are for the sort of thing that the previous post is talking about. We have gotten to the point where we try to medicate for so many conditions and we have a lot of kinds of illegal drugs floating around as well. Because there are so many kinds of drugs that get used so much, the chances of harmful drug-drug interactions is much greater than it previously was.
This is also true because there are so many new drugs that we are not necessarily aware yet of all the potentially dangerous interactions that could be possible.
Concern over drug interactions with other drugs is based upon the danger that may be present when two drugs are combined. In some instances, taking two different drugs that are used for two different things make cause similar responses. If the response of one slows the heart, the second may dangerously slow the heart, breathing, etc. It could cause death.
Many years ago, there was a famous case of a young woman named Karen Ann Quinlan. I remember this vividly. She had taken two different kinds of drugs and alcohol as well. She stopped breathing several times. She was taken to the hospital—she had lapsed into a coma and doctors could not bring her out of her "vegetative state." Her parents, after long months of waiting, with no hope in sight, asked the doctors to remove her from the machines that kept her body alive. The hospital refused and the disagreement ended up in court where the "right to die" question was strenuously debated. Ultimately, the parents won their fight, but even after the machines were turned off, Karen remained alive (while her mental state never improved) for nine years until she died because of complications from pneumonia. This was a precedent-setting case.
The implications for drug users on any drug comes with risks. Watch and listen to many commercials or read the warning on pill bottles. Even the birth control pill introduces an elevated risk of blood clots. However, when drugs are mixed, the chances for drug interactions rise. This is why drug stores keep your medications on record and are supposed to let you know if there is a danger. Often warning labels will be placed on bottles to provide special instructions. Keeping your doctor advised of all medications you are taking, especially if you are under the care of another doctor (a specialist, for instance) is of paramount importance, as he or she can then monitor your risk of drug interaction.
Of course, if you are unsure, you can always contact the drug store and ask to speak to a pharmacist. I would hesitate to use the Internet only because of the ease with which people can provide information that may not be accurate.
What a drug may do by itself is one thing. A drug mixed with another drug because a totally new "entity." For some people, the mixture could be like taking poison.
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