SEATTLE - People usually associate drug overdoses with cocaine or heroin users, but there's another kind of overdose that can happen to anyone. It's when people accidentally overdose on prescription drugs and it's being called an epidemic here in Washington state.
It happened to 32-year-old Angie Burrell of Renton in February. Her mother, Sara Taylor, is still trying to figure out what went wrong. As she empties out a garbage bag full of leftover pill bottles, Taylor tells us that Angie spent most of her final day alone in her bedroom.
"And we went up to check on her and she was dead," Taylor said. "She looked like she was trying to get out of bed."
Angie had been battling chronic pain ever since undergoing surgery three years earlier. Medical records obtained by the KING 5 Investigators list 17 current prescriptions in her chart two days before her death. The King County Medical Examiner ruled that four of those drugs combined killed her.
The KING 5 Investigators asked Sarah Taylor: "Do you think she understood the dangers?" Taylor said: "No, I think she did not. I don't think she did."
The two most potent drugs in Angie's system were methadone and oxycodone. Both are opioids, narcotic pain killers considered so powerful and potentially addictive they were once limited to patients dealing with severe medical conditions, like surgery or cancer.
But in the mid-1990s, Washington and other states began encouraging the expanded use of prescription opioids for everything from backaches to headaches. It wasn't long before people started accidentally overdosing and dying.
"Washington State, similar to seven or eight other states, are in the highest ranges of death rates in the country," said Dr. Gary Franklin, Medical Director for the Washington State Department of Labor & Industries. "None of this is acceptable."
Franklin was one of the first people nationwide to sound the alarm. He identified 32 injured state workers who had apparently overdosed.
"I haven't seen too much, anything really, sadder than a worker coming into the system with a low backache and then dying four years later from an accidental overdose of prescription opioids," Franklin said.
The KING 5 Investigators analyzed data from law enforcement agencies and health departments to see how big the problem is in Washington. We found unintentional prescription overdoses have increased 17 times in little more than a decade.
Accidental poisonings, primarily overdoses, now kill more people than car accidents.
Prescription drugs containing opioids do help some people, especially people with chronic pain. But there's a big debate over how much is safe.
"We also know that people often don't get better on high dose narcotics," said Professor John Loeser, former director of the University of Washington Pain Center. "What worries the pain world the most is the patient who takes just what I told them to take, who dies from it," Loeser said.
That's why Loeser joined Dr. Franklin and other medical directors in writing state guidelines, including an opioid dose calculator, which measures the morphine equivalents of various drug combinations.
The guidelines say the patient should see a pain specialist when the total hits 120 milligrams. It's good in theory, but even Loeser questions whether it's really workable.
"The problem right off the bat is there must be 15,000 people in the state who are over 120 milligrams," Loeser said. "Where are the pain specialists going to come from?"
The state is being sued by a doctor and group of patients who claim the recommended doses are based on flawed data and could lead to the under-treatment of chronic pain.
At the time of her death, Angie Burrell's morphine equivalent dose was more than twice the red flag dose - roughly 300 milligrams.
Sarah Taylor wants some answers.
"I don't know where to turn to," she said.
From looking at Angie's chart notes, we do know the doctor was concerned about the risk of combining powerful drugs.
Just two days before she overdosed, the doctor warned Angie not to take prescribed drugs for insomnia and anxiety too close together. They could cause her to stop breathing. Ironically, neither of those drugs was listed on her death certificate. It was four other drugs that killed her.
"This just should never have happened," Taylor said. "It should never have happened."
So why did it happen? Was Angie taking her medications as prescribed or did she overdo it? We couldn't get that answer from either the King County Medical Examiner or the University of Washington, where she was being treated. But a medical team is reviewing Angie's case and promises to meet with the family this month.
There is no exact formula for what's safe. That's what the state guidelines are trying to determine. But experts say people should be very wary of combining painkillers containing opioids with other depressants, including anti-anxiety medications or sleeping pills. The combination can be very dangerous.
Because of the pending lawsuit over the opioid dosing guidelines, Washington State's health department put its widespread educational campaign for doctors on hold.
It's considered a landmark case for the rest of the country.
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