The death of Heath Ledger from an accidental overdose of prescription drugs last month has exposed an alarming trend among the rest of us.

Heath Ledger died of an accidental overdose of six different types of prescription drugs, a coroner ruled Wednesday. (Getty Images)

Unintentional deaths from prescription and illegal drug abuse are now the nation’s second-leading cause of accidental deaths — only auto accidents claim more victims. But the fastest and most alarming increases are due to prescription drug misuse.

According to the Centers for Disease Control and Prevention, deaths from accidental overdose rose from 12,186 to 20,950 between 1999 and 2004.

CDC officials this year plan to study patterns among the deaths — what kind, how much and how many different drugs the victims used.

The medical community already knows some of the causes: “Doctor shopping” and “pharmacy hopping” make it difficult to track patients and prescriptions; the use of painkillers has increased nationwide: and people don’t see risks in medicines prescribed by doctors.

A medical examiner concluded this week that Ledger, the Oscar-nominated star of “Brokeback Mountain,” died of “acute intoxication” from using six painkillers, sleep aids and anti-anxiety drugs.

The very same drugs are found in many home medicine cabinets: painkillers OxyContin and hydrocodone; anti-anxiety drugs Valium and Xanax; and sleep aids Restoril and Unisom. Only Unisom is over-the-counter.

Local physicians said there is no medical rationale for taking such a deadly combo. Ledger, who was shooting a movie at the time, reportedly was having trouble sleeping and was depressed over last year’s breakup with the mother of his child, actress Michelle Williams.

Authorities said Ledger died from the cumulative effect of the drugs — most of them safe when used as recommended but highly addictive nonetheless.

“He may have been given prescriptions for all these legitimately at one time. But he mixed them all,” said Mark Williams, pharmacist-owner of a Medicine Shoppe in Kansas City, Kan.Ledger, who is believed to have had pneumonia when he died, could have been disoriented when he mixed the deadly cocktail, Williams said.

Ledger’s death recalled that of Anna Nicole Smith, who died one year ago this week. The former Playboy playmate also suffered a “combined drug intoxication” from taking a variety of drugs, which included anti-depressants and anti-anxiety drugs.

But this trend extends beyond Hollywood. Pain management expert Bob Twillman, a clinical psychologist at KU Hospital, said the number of different drugs Ledger was taking was rare, but not uncommon.

“I’ve seen similar things,” Twillman said. “Not necessarily to that extent.”

Many patients don’t know anything about how their various prescriptions could interact. Some people throw away the informational pamphlets they get with new prescriptions without reading them.

“You’d be surprised by what patients don’t know about their medicines,” Twillman said.

People also can overdose when they lose track of how much medication they’ve already taken — a recurring problem among senior citizens.

It’s also difficult to track all the prescriptions of one patient when many people see more than one doctor. Some, searching for an elusive solution to their pain or ailments, intentionally “doctor shop.”

“People who see more than one physician do not always share information about drugs they’ve been prescribed by all their doctors,” said Twillman. “They’ll get one medication from one physician and another from a second physician and another from a third.”

That could have happened in Ledger’s case, said Lindsey Schnabel, assistant director of the Drug Information Center at the University of Missouri-Kansas City.

“He may have had a doctor in the U.S. and one elsewhere,” she said, “and they were giving him two different sleep aids or anti-anxiety drugs.”

Pharmacies have drug-interaction checkers that red-flag potentially harmful combinations of medications for their customers, Schnabel said. But that system only works if a person uses the same pharmacy for all their prescriptions — not as common when prescription drugs can be purchased online and when people switch pharmacies as they change insurance plans.

Len Paulozzi, a CDC medical epidemiologist, said that most deaths from prescription drugs are related to the use and misuse of those medications.

The profile shows that “the rates are higher in men, higher in middle age,” Paulozzi said. “Studies have been done in some locations by medical examiners who have found a history of substance abuse in a large fraction of these overdoses.”

The rise in deaths from unintentional drug poisonings also has paralleled a rise in the amount of prescription painkillers prescribed in the United States.

Between 1999 and 2002 the number of overdose death certificates that mention poisoning by opioid painkillers — such as oxycodone, fentanyl and methadone — went up by 91.2 percent.

Studies also have found that many overdose victims “have drugs in their system for which they don’t have a prescription, suggesting that they got the drugs through some sort of diversion, such as buying it off the street or perhaps taking it from a friend or family member, theft, a drug dealer,” Paulozzi said.

(The Drug Enforcement Administration is investigating where Ledger got his drugs.)

In a statement this week, Ledger’s father, Kim, said that “Heath’s accidental death serves as a caution to the hidden dangers of combining prescription medication, even at low dosage.”

Pharmacist Mark Williams hopes Ledger’s high-profile death will serve as a wakeup call, but he’s not optimistic.

“I just don’t see it happening,” he said. “I don’t know how you get it through their heads.”

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