Turning tragedy into cautionary tale
EL CENTRO — It still pains the Nunemacher family to talk about the accidental death of their son Joe Nunemacher, but if it helps save another family from the same pain, they recognize an opportunity and want to have that conversation.
“Even though it is painful for me to continually relive this tragedy, my desire is that other fathers, mothers, brothers and sisters can help avoid this same heartbreak,” Chuck Nunemacher told the Imperial Valley Press. Chuck is Joe’s father.
The 37-year-old gym owner and bodybuilder’s death on April 20 sent shock waves rippling throughout the Valley. Many residents are still coming to terms with Nunemacher’s untimely passing this past spring.
He was a well-known and well-liked businessman, as well as a local celebrity who helped showcase bodybuilding through his gym, Joe’s Powerhouse, in El Centro.
He is also remembered for his charity work as featured in a moving tribute at the annual Bailando Por Un Sueno event last week.
So recent news of an Imperial County Sheriff’s Office Coroners’ report attributing Nunemacher’s cause of death as an accident stemming from the combined effect of multiple prescriptions and over-thecounter drugs provoked renewed grief within the community. Although the report was shocking, it served to dispel rumors that had swirled right through the community.
The coroner’s report listed several pain medications in his body combined with common over-the-counter medicines associated with combating cold symptoms as leading to his death.
The technical term for what killed Joe Nunemacher, according to the Coroner’s Office, is “multiple drug intoxication,” also known as “combined drug intoxication.” MDI differs from an overdose in that it is the mixture of drugs in the system rather than the dosage that can prove lethal.
MDI is not necessarily exclusive of use of alcohol or illegal drugs, but more and more people are dying from unintended misuse of medications they received from their physicians or even an aisle in the local supermarket.
That’s what happened in Nunemacher’s case. The coroner found painkillers that can be obtained by prescription including morphine, hydromorphone, tramadol and traces of methadone in his system, along with an over-the-counter pain reliever, acetaminophen.
In addition to the pain medications, the coroner found drugs associated with combating cold symptoms. These included codeine, a prescription-only ingredient found in some cough syrups, and diphenhydramine, an over-the-counter antihistamine.
Chuck Nunemacher said his son told him he was taking these medications for pain from injuries related to extreme bodybuilding exercises. “This is from information he volunteered to me, and I know of no other reasons for the medicines,” he said.
The fact is this happens more often than most people realize. According to the Coroner’s Office, Joe’s death was one of eight in the county known to be attributable to MDI so far this year, following 16 in 2016 and 11 in 2015.
These untimely deaths are a part of a national trend that has been on the rise for decades, according to a report published by David Phillips, a professor at the University of California in San Diego. Phillips is a widely-published medical researcher.
In the report “A Steep Increase in Domestic Fatal Medication Errors With Use of Alcohol and/or Street Drugs,” Phillips and his colleagues found that while some combination of street drugs or alcohol factored into the highest percentage of deaths involving prescribed medications, there was still an enormous increase in deaths where alcohol or street drugs weren’t a factor at all. Deaths where medications were consumed at home exclusive of street drugs or alcohol increased 564 percent, the study said.
Phillips’ report concluded, “These findings suggest that a shift in the location of medication consumption from clinical to domestic setting is linked to a steep increase in FMEs (fatal medication errors).”
These results reflect a trend toward more medications being taken at home with little professional oversight.
Chuck Nunemacher said he believes it’s a lack of awareness as to the fatal consequences of mixing opioid medication that is increasing MDI deaths. “The information on the dangers and proper use of, especially opioid pain medicines, should be as ‘in your face’ as the advertising of these meds,” he said.
That’s because it’s too easy to make mistakes. “I have experienced severe pain and completely understand the temptation to go beyond recommended doses of pain relievers because it’s not working fast enough or the pain just won’t quit,” Nunemacher said.
It’s up to the medical profession to lead the change on the awareness of combining prescription medication. “Doctors, pharmacists and medical researchers must be the force behind solving the problem of abuse of pain medicines,” he added.
Nunemacher said that his son often coached others on the merits of keeping a healthy body and mind. “I just assumed that Joseph had been given the same instruction and warning, and as a consequence of that assumption, lost a loving son.”