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The Death of Anna Nicole Smith and the Epidemic of Prescription Drug Addiction

Allan N. Schwartz, LCSW, Ph.D. Updated: Feb 11th 2007

Although there is not yet any definitive information from the coroner's office about what caused the death of Anna Nicole Smith, there is plenty of evidence that prescription drug use may have been the culprit. First, she had been treated for addiction to pain killers at the Betty Ford Clinic a year or two ago. Second, Ms. Smith had undergone a weight loss program that used the now banned drug ephedra. Ephedra was taken off of the market because it damaged the lining of the heart of many of its users. Third, many prescription medications were found in Ms. Smith’s hotel room, including Valium, an anti anxiety drug that can be addicting if misused.

Whether or not prescription drugs are found to have caused Anna Nicole's death is less important than the fact that there is a major epidemic of prescription drug abuse in the United States. In fact, Smith's twenty-year-old son recently died as a result of a deadly drug interaction between his anti depressants and methadone. My guess is that he was being treated with methadone as a result of addiction to pain medications.

There are several alarming issues with regard to prescription drug addiction:

1. Prescription drugs are being distributed and used in schools by children as young as 12 years of age.

2. Medical doctors are often the unwitting distributors of these drugs. Users will go from doctor to doctor or dentist to dentist in quest of prescriptions. In many cases, these users will forge prescriptions and fill them in unsuspecting pharmacies.

3. Many of these drugs are available through online illicit pharmacies that deliver in plain wrapped packages.

4. Children, teenagers, and adults are able to obtain drugs by simply looking in the medicine cabinets of their parents. Doctors tend to prescribe more medication than the patient needs. Many unsuspecting people simply store the unused medicines in their medicine cabinets and quickly forget they are there. This is how youngsters are able to obtain and distribute some of these drugs at school or in the neighborhood.

List of Dangerous Prescription Drugs:

1. Prescription Pain Killers:

A. Codeine

B. Demerol

C. Percocet

D. Vicodin

E. Oxycontin

As you go down the list of pain killers from A. thru E., the strength of the medications increases. Large amounts of Vicodin and Oxycontin are no different from Heroin in their ability to cause addiction in the individual user.

These drugs are dangerous and deadly when overdosed and when mixed with alcohol can lead to death.

2. Prescription Anti Anxiety Medications:

A. Zanax

B. Valium

C. Klonopin

D. Librium

E. Ativan

Anti anxiety drugs are also addictive when misused and are dangerous when over dosed and when mixed with alcohol consumption.

3. Prescription Amphetamines:

A. Ritalin

B. Concerta

C. Adderal

These drugs are stimulants and are mood altering and addictive. However, they are extremely effective in the treatment of ADHD. Unfortunately, these drugs have become highly sought after on college campuses by those students who want to stay up late at night to study for exams without getting tired.

A few years ago, amphetamines were used to help people lose weight. It was at that time that the dangerous effects of amphetamines were discovered.

Note: In no way is the reader to believe that this is a complete list.

However, it does give an idea of how serious the problem is. Dr. William E. Hapworth, MD, a New York City psychiatrist, has written and spoken about the serious problem of prescription drug abuse. He points out that since New York State started to require medical doctors to use a triplicate prescription form to prescribe addictive medications, there has been a big reduction in abuse. He suggests a similar type of procedure throughout the United States in order to control the flow of these dangerous but useful medications.

Some Suggestions:

1. While I agree with Doctor Hapworth, I want to urge all readers to be vigilant at home with the way they handle their medications. Well meaning people, in the safety of their homes, tend to accumulate extra medications. These extras become available to the entire family. Frankly, it is not safe to take any prescription medication without a new prescription from a medical doctor. Even antibiotics can be harmful if saved in the medicine cabinet and used later on by someone who thinks they are treating an infection. Medicines degrade over time with the result that, when taken by unsuspecting patients, they actually increase resistance to medical treatment of infections. Medications are dangerous and do not belong in the hands of children or, for that matter, in the hands of anyone other than the patient being treated by their doctor.

2. I also want to urge everyone to keep their medicine cabinets closed, even locked, and the contents made unavailable to anyone but the patient, if that is practical.

3. It is my impression and that of others in the mental health and health fields, that this is a silent epidemic. For some reason, information does not seem to get out to the public about how dangerous and widespread are the misuses of prescription medications. Too many people are still under the illusion that drug abuse and addiction have to do with heroin, cocaine, and methamphetamine. It is simply not true.

4. If you wish, there is no harm in writing to your congress person on the local, state and national levels about this issue and about the need to pass legislation to better control the use of prescription medications.

I want to invite you to engage in a discussion on this web site about this issue. Every reader is invited to contribute their opinions, or experiences with this problem.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

oxyconton,oxycodiene and methedone - d davis - Jun 27th 2009

Those are the killers.That mixture killed my mom on November 7,2007.I had done cpr on her in august of that month and had her hospitalized and we the doctors and nurses we worked together to see which doctor was prescribing the meds to her.guess what? he prescibed the stuff after she got released from the hospital.Albany oregon is bad on pain meds there are alot of creepy doctors who continue to prescribe the meds even after the knoweledge of patient of being addicted to the pain meds.I think karma will fix his ticket to his own hell for that.But people--your system will eventually give up for taking those kinds of meds.Ya need to stop, there are other alternatives for your pain.

Pain killer list is NOT in order of strength ! - - Mar 14th 2009

List of Dangerous Prescription Drugs:

1. Prescription Pain Killers:

A. Codeine

B. Demerol

C. Percocet

D. Vicodin

E. Oxycontin

The list should be as follows :

A. Codeine

B. Vicodin

C. Percocet

D. Demerol

E. Oxycontin

The first one Codeine can be either class IV or III. Vicodin is always class III . Percocet , Demorol , and Oxycontin are the most dangerous and are always class II, meaning NO REFILLS or prescription call ins ...must be a fresh written prescription  each time ! There is more...Vicodin is a trade name for a pill containing  HYDROCODONE . Percocet and Oxycontin both contain the drug OXYCODONE . Demerol is actually  meperidine hydrochloride , a drug that is much stronger given I/V than with pill form.

Just my two cents

my older sister died from alcohol and klonopin overdose - Sherry - Sep 4th 2007


 My name is Sherry. I have used klonopin for a movement disorder since 1996. In the past (before 2,005), I many times took lots of klonopin and alcohol (usually beer) trying to kill myself while I was very depressed and I always woke up the next morning.

 Well, this past spring, on 4-9-07 , my older sister Melody did the same very sadly with tragic results. She had her own script and she got upset about a family matter, and she drank from Sat. the 7th til ??? , then my stepdad found her dead of the floor of her bedroom. I was notified and my world fell apart. I am bi-polar type 1 with mixed states (meaning I get manic and depression at the same time).I lost it there for a while is an understatement!

 I can't tell you how many times I asked why did she die from the combo and I didn't.!!!! I still haven't found the answer but I just want anyone reading this to know that mixing alcohol and prescription drugs CAN kill you.!

Please don't mix them. If she had not, she'd still be here and I'd have my best friend and sister back. I'll be forever grateful for the yrs. we had but she was only 49 (I'll be 46, this Sept.18th). May she rest in peace.

My heart is broken but I must move on.



Anna Nicole - Lisa Peacock - Feb 28th 2007
Too many people think that they are pharmacologist and mix different drugs and drink, etc.. without realizing that they could ultimately mix a very toxic combination. I think that there needs to be more awareness of what is a deadly combination and hopefully it might help people to be more aware of what they are combining. Some people might need drugs for mental health reasons, pain, etc.. but may not be aware of all that is entailed. Most of the time when you go to dentist, etc.. they are not going to ask you what meds you are on, then next you go to your nurse practionner and get a prescription, etc.. so the health care providers need to step up to the plate and one should be able to and required to pull up a person's name and get a print out of medications the person is on for health and safety reasons before prescribing a drug which would cut out pill hoping and hopefully save a couple of lives. This could have saved Anna's life if more health care providers where involved in her care especially with the death of her son recently. My understanding is that she was prescribed methadone under an alias name which i'm sure contributed as it was not being monitored for its usage. I hope there will be an increase in regards to the toxic combinations as children also are under the impression these days that it's cool to take pain meds, drink, etc... its nothing to get several pills from kids and the lack of awareness of what mixing drugs can do is contributing to several people's deaths. I am a social worker and see my client's doing alot of the same which is why its our responsibility to educate client's on drug usage and their responsibility to take responsibility for their actions.

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