Reader's Digest-Look who's hooked

[Guest guest]

Ok, here is that article on Look Who's Hooked from Reader's Digest. If someone could forward this to RSD-Retreat for me, thanks. I would have to go to the group page and retype everything from there otherwise.

Teenagers, executives, actors, moms, even doctors - there's no typical profile of a painkiller addict

Look Who's Hooked

By Kalb From Newsweek

It all started innocently enough. Four years ago, when Brown got pregnant, her doctor wrote her a prescription for Lortab, a potentially addictive painkiller, for relief from migraine headaches. The Lortab made her life bearable, but it had a devastating side effect: "Slowly," says Brown, of Sanford, Maine, "I started to get addicted."

She became a "doctor shopper," hopping from one physician to the next to get multiple prescriptions. She discovered Percocet, and was soon mixing Lortab with OxyContin, a super-strength painkiller she got through a dealer. By early 2000, Brown, 26 and the mother of two, worked up the nerve to commit fraud. Pretending to be phoning from a doctor's office, she called her local pharmacy, read the physician's ID number off a prescription bottle and won, she says, "my key to the palace."

Realizing that for years doctors neglected to include pain management in patient care, the medical establishment has, over the past decade, taken a more aggressive approach to treating pain. A national accrediting body now requires hospitals and other facilities to treat pain as they would blood pressure or heart rate. In October 2000, Congress declared the next ten years the Decade of Pain Control and Research.

For the millions of Americans who suffer debilitating pain, these initiatives have been a godsend. Yet at the same time, the incidence of abuse of painkillers has surged. In 2000 an estimated 3.8 million Americans ages 12 and over were using prescription pain relievers, sedatives, tranquilizers and stimulants for "nonmedical" reasons.

The most abused prescription drugs, according to the Drug Enforcement Administration (DEA), include the oxycodone and hydrocodone painkillers, which contain potentially addictive opioids. And emergency-room data suggest that certain drugs have seen dramatic spikes in abuse in recent years. ER visits involving hydrocodone medications like Vicodin and Lortab jumped from an estimated 6100 in 1993 to more than 19,000 in 2000; oxycodone painkillers like Percodan and OxyContin rose from about 3400 to 10,825; and the anti anxiety drug Xanax (including the generic versions) increased from 16,800 to more than 22,000.

Reports of painkiller abuse from Hollywood catch the attention of the public more than any statistic ever will. In recent years, Griffith and each checked into rehab, publicly acknowledging their addiction to painkillers. TV shows fill scripts with the problem: On "ER," Dr. got hooked on painkillers after he was stabbed; even Homer Simpson battled a compulsion for the drugs.

Addiction tot prescription durgs is not a new problem. Remember "Valley of the Dolls"? The uppers, the downers, the sleeping pills? But some of todays drugs are far more sophisticated than anything n could have envisioned. OxyContin, which emerged in 1996, is one of the most powerful: It's a 12-hour time-release incarnation of the molecular compound oxycodone, the active ingredient in older drugs like Percodan and Percocet. OxyContin allows patients to swallow fewer pills, and offers pain relief three times longer than earlier versions. But when the drug is crushed and snorted, eliminating its time-release feature, it's a huge narcotic rush to the brain.

Abuse of OxyContin has gotten so bad that in some areas, users are robbing pharmacies to get the drug- recently, Hannaford Bros. Co., a major Notheastern chain, decided that "for the safety of our associates and customers," it would no longer stock the drug on its shelves.

When it comes to prescription painkillers, there is no typical abuser. Police departments say they've seen every variety, from teenagers to stay-at-home moms to executives who started taking drugs for their tennis elbow. Particularly at risk are chronic substance abuser who divert to prescription drugs when their preffered poisons, like heroin, run out. Health care professionals, with easy access to drugs, often succumb. Landon Gibbs, a former Virginia state police officer, recalls the arrest of a doctor who would "write a prescription, drive that person to the pharmacy and then split the pills."

Prescription painkillers are appealing in part because users think of t hem as "safe." They're FDA approved, easy to take on the sly and free of the stigma of illegal drugs. Mogil started taking Valium at age 20 to ease the emotional trauma after a car accident. Later as a manager in a health clinic, she had easy access to sample pills, then found her way to Vicodin and Percodan, visiting different doctors to get her supply. "I'd tell them I had a migraine; that's all I had to say," says Mogil, who lives in a suburban Atlanta. Her family never questioned the pills. "They think you're taking it for medical reasons." Finally, after two decades of abuse, Mogil collapsed-and checked into rehab. "I was no better than a street addict," she says of her dependence.

While any patient who takes an addictive drug over a long period will develop a physical dependence - meaning the body adjusts to the chemicals and thinks that's normal - that dependence can be managed. When it's time to off the drug, a good physician will taper the prescription so there's no withdrawl or rebound effect. But a genetic tendency to addiction, a history of substance abuse or a combination of factors may cause some patients to become compulsive about taking the drug, even when it threatennd their health or social and professional lives.

Once you're hooked, getting more becomes an obsession. Many abusers become doctor shoppers. Others buy their fix on the street: One Vicodin goes for about $6; Percocet and Percodan, $8 or more. Tales of desperation abound - the weekend visits to the ER claiming a toothache, the stolen prescription pads. Napier, head of a chemical-dependency program in Dallas, says she knows women who go to real estate open houses to "go through the medicine cabinets and steal the Lortab."

SO WHO'S TO BLAME for the misuse of these drugs? Many abusers point to doctors, who they say prescribe medications too quickly without warning patients that certain drugs can be highly addictive. But once patients begin deceiving pharmacists by phoning in fake scripts or seeking prescriptions from multiple doctors, the patients become the culprits. Sixteen states have prescription-monitoring programs, but many states don't have full-time oversight. Abusers who are caught are typically charged with fraud-a misdemeanor in some states and a felony in others.

With all the focus on abusers, pain specialists worry that legitimate patients will suffer. Too many doctors succumb to "opiophobia," fear of prescribing much-needed medications for patients who suffer moderate to severe pain. "Some patients and doctors are going to start looking at this stuff like it's nuclear material," says E. Joranson, director of the Pain & Policy Studies Group at the University of Wisconsin. "There is a real risk of losing recent gains made in pain management."

Pharmaceutical companies acknowledge that misuse is a problem. Pharmacia, which manufactures Xanax, says it educates people about the importance of taking the drug safely under a doctor's care. Abbott Labs, maker of Vicodin, offers symposiums to teach pharmacists about abuse potential. Last July, Purdue Pharma, which produces OxyContin, warned doctors that the drug should be prescribed only for moderate severe long-term pain.

ann Timmons, 51, of Concord Township, Ohio, took Vicodin to dull the pain of lifelong ear infections and a broken eardrum. Initially, she says, her doctor didn't want to prescribe the pills. When he finally did, he told Timmons to use them sparingly because of their addictive potential. "I felt like a crimminal," she says. "It shouldn't be a battle to get help with pain relief."

PAIN RELIEF and criminal activity. The new challenge for doctors and public-health officials is to provide one without advancing the other.

Last fall, in an unprecedented collaboration, the DEA and 21 leading health organizations agreed to help educate health professionals, law enforcement and the public about the appropriate use of pain medications. "We don't want to restrict doctors from providing these medications," said DEA Administrator Asa Hutchinson. "At the same time, We must take steps to ensure these powerful medications don't end up in the wrong hands and lead to abuse."

Taken out of Reader's Digest, January 2000 edition.Chat with friends online, try MSN Messenger: Click Here