Combining anti-anxiety medications with painkillers can be particularly lethal

Heath Ledger's death falls into the celebrity news category. I don't mean to seem hard-hearted, but Mr. Ledger was firmly in the column of people I don't know -- given that there are around 6 billion of them and they live to around 60, 100 million of them should die every year, 300, 000 every day, 10 thousand an hour.

But, the great thing about celebrities is that they take things that happen to everyone, and bring them into the popular conciousness. So, when Jim Brady gets shot in the head, we can talk about gun control.

The New York City chief medical examiner’s office has ruled that the actor Heath Ledger, whose body was found in a SoHo apartment on Jan. 22, died of an accidental overdose of prescription medications that included painkillers, sleeping pills and anti-anxiety drugs.

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Told about the drugs found in Mr. Ledger’s body, Dr. Vatsal G. Thakkar, a psychiatrist at N.Y.U. Medical Center and a clinical assistant professor at the N.Y.U. School of Medicine, said in a statement, “Six different sedative drugs in Heath Ledger’s system show something was amiss. Whether that was in taking combinations of drugs without proper medical guidance or sloppy prescribing, it was an unfortunate situation and with a tragic outcome.”

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Dr. Andrew J. Kolodny, the vice chairman of psychiatry at Maimonides Medical Center and an authority on deaths by accidental overdose, said that combining anti-anxiety medications with painkillers can be particularly lethal. Both types of medications can lead to addiction, he said, making it more challenging for someone using the two types of drugs to avoid combining them.

When Heath Ledger combines prescription medications with an over the counter antihistamine, we can talk about that.

And, by the way, prescription anti-anxiety medications taken under a doctor's supervision are entirely safe. I don't mean to suggest that they're not. It's just that they make painkillers lethal.