A Prescription for Addiction

The Changing Face of Drug Abuse

Drug abuse has changed venues – trading seedy back alleys for medicine cabinets in master baths. Sparing no demographic, prescription painkillers, sedatives and stimulants are being abused at a level only surpassed by the illegal use of marijuana – leaving cocaine, heroin, and methamphetamine far behind.

By Gretchen Smith

“A Pill for Every Ill”

The National Institute on Drug Abuse estimates that one in five people use prescription drugs in ways inconsistent with their labeling or for reasons other than prescribed. In an estimated 20 percent of that group, these practices have led to addiction.

Prescription drug addiction is the lead story when it is a celebrity in trouble, but what about the housewife who hurts her back reaching for a can of soup. Fast forward one year and that same soccer mom is “doctor shopping” (going from doctor to doctor for the same drug without disclosing that she has a purse full), frequenting emergency rooms with phantom ailments, working multiple accounts with Internet e-pharmacies, and operating a small-time criminal career out of her kitchen, all to keep a full supply of Percocet.

With the advancement in new products to treat a greater range of medical conditions and with aggressive marketing campaigns, today’s society has increasingly become dependent on pharmaceuticals. Are you sleepy? Apidex. Sprained ankle? Vicodin. Dread the long lines at the airport? Valium. Closets wrecked? Ritalin. Many are running to the pharmacy to solve life’s problems – the sedated family doesn’t feud; the eight-year old making entirely too much noise pipes down after a pill.

Dangerous Addictions

The most commonly abused classes of prescription drugs are:

Opioids

Use: Prescribed to treat pain

Examples: OxyContin, Vicodin Central Nervous System (CNS)

Depressants

Use: Prescribed to treat anxiety and sleep disorders

Examples: Valium, Xanax

Stimulants

Use: Prescribed to treat certain sleep disorders and attention deficit hyperactivity disorder (ADHD)

Examples: Ritalin, Adderall

Where is the line? Psychiatrist and board-certified by the American Society of Addiction Medicine, Dr. Mark Peterson, M.D., with Focus Healthcare explains: “Drug dependence is a physical effect; your body needs the drug to function. Addiction is different. You continue to use the substance despite knowing it’s causing adverse consequences – physical, social and legal.”

What Is Responsible?

Availability, convenience, mindset, media and the lack of stigma associated with prescription drugs have all led to overuse and what has been described by some as a “social crisis.” Overuse turns into abuse. Abuse can lead to addiction, and addiction destroys lives.

Dr. Peterson sounds the alarm for the largest culprit, pain pills. “If you’ve taken an opioid and felt energized or ‘more normal,’ that’s an abnormal response, and you have a vulnerability to possible overuse and addiction.”

Control and Regulation

The need for legitimate access to controlled substance prescription drugs is very real, as any chronic pain, cancer or a post-op patient will attest to. Abuse prevention, recognizing and treating addiction, and keeping prescription drugs out of the hands of the abusers are the tests we’re failing.

The vast majority of physicians and pharmacists are on high alert when it comes to this growing epidemic. Tennessee’s Controlled Substance Monitoring Program collects prescription data from dispensers, thus creating a checks-and-balances system, whereby if a doctor prescribes to an abuser, addict or seller, it can be caught at the pharmaceutical counter. Unfortunately, from there, the industrious user often turns to one of the estimated 800,000 online “e-pharms” and web surfs until he or she finds a pill-friendly site that will gladly ignore the rules in exchange for a valid credit card number – any drug, any time, to anyone.

A study conducted in 2007 on behalf of the National Center on Addiction and Substance Abuse found 187 Internet sites selling prescription drugs without a required prescription. Of those, 52 clearly stated no prescription was needed, 83 offered “online consultation,” and 22 made no mention of a prescription at all.

In October of 2008, Congress enacted the Online Pharmacy Consumer Protection Act, requiring a valid prescription for controlled substances dispensed by means of the Internet. There again, however, cyber-smart “pill pharms” learned how to maintain a website for a week and then switch URLs to avoid detection, their fan base tagging along.

Doctors and pharmacists have stepped up the screening processes, and the courts are increasingly showing no distinction between prescription and illegal street-drug abusers. The Oxycodone offenders receive three mandatory (and up to 15) years behind bars. Possession of Oxycodone without a prescription is a Class C felony, and the courts are taking this matter seriously – 40,138 drug arrests were made in Tennessee in 2009.

Use with Caution

On the consumer level, follow these guidelines:

1. Just because the prescription comes from your doctor, don’t have a false sense of security that you will not or can’t fall victim to addiction.

2. Likewise, it can’t be said enough: use the medicine exactly as you’ve been instructed. Don’t share the drug, and don’t leave it lying around.

3. Don’t self-medicate. Ten minutes on the Internet reading about Demerol does not make you an expert. You are not your own doctor after an online questionnaire points you to a drug.

4. Ask this question: Do I really need to be medicated, or do I simply want to be medicated?

Seek Help

Seek help if you’ve tried to stop taking pills, only to find yourself taking them again. Has your doctor, spouse or anyone else brought your prescription drug use to your attention? Have you changed doctors or drug stores in order to protect your supply? Have you ever increased your own dosage? Do you keep pills hidden “just in case”? Have you ever taken medication in anticipation of a symptom? Do you find it difficult to stop taking your pills? If the answer to any of these questions is “yes” – get help.

“If abuse surfaces or addiction develops,” Dr. Peterson says, “treatment is available, and it works.” Talk to your healthcare professional. Don’t stop taking medication on your own. Your doctor may refer you to one of the more than 30 local treatment facilities. Recovery includes both medication and behavioral therapies, and in most cases the treatment is outpatient.

When involved with prescription drugs, Dr. Peterson cautions, “Be extremely careful.”

Gretchen Smith has lived in Chattanooga for 35 years. A resident of Lookout Mountain, she has three children and is married to Marvin Smith.

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