ADDICT'S VOW: NO MORE SECRETS

Banker Hopes To Help Others Get Off Drugs

Kristi Metzger had it all: a job she loved as a bank vice president,
loving family and friends, community activities, a house to shelter
her at the end of a productive day.

And a secret.

Metzger was addicted to the prescription pain reliever Vicodin.

After 10 surgeries in 15 years in a fruitless effort to relieve
chronic pain caused by endometriosis, Metzger had almost quadrupled
the maximum number of Vicodin she was allowed. And to keep her
secret, she had turned into a liar.

Now, after two stays in chemical dependency treatment centers,
Metzger, 31, has decided to keep that secret no longer. She has begun
talking to civic groups about her addiction to painkillers and the
resources available.

"My point is, addiction knows no boundaries," Metzger said. "It
doesn't matter what you do or where you come from or how smart you
are. It's a very real problem, people are struggling with it, and I
want to help."

An estimated 4.7 million Americans used prescription drugs
nonmedically for the first time in 2002, according to the 2003
National Survey on Drug Use and Health. The number who used pain
relievers was estimated at 2.5 million.

Studies also suggest that women are more likely than men to be
prescribed an abusable prescription drug, particularly narcotics and
anti-anxiety drugs.

"More women come to me for prescription drug use than men do, but I
think the drug of choice has changed," said Janell Christenson, a
registered nurse and a certified chemical dependency counselor with
Avera McKennan Hospital.

"I can remember when it was Demerol that was most abused, then
Percodan and Percocet. I don't know the top one now, probably
oxycodone or Vicodin."

First there's pain

Most addictions start out innocently, Christenson said. Generally
people have an accident, injury, surgery or medical problem that
causes pain and requires prescribed medication.

Three things are required for someone to become an addict, said Dr.
John Hansen, supervisor of Sioux Valley Hospital's Pain Clinic. First
is a psychological or biologic predisposition; second is a substance
that can produce addiction or chemical dependency, such as the
painkillers known as opiates, and third is an unrestricted access to the drug.

That is why his clinic provides a highly structured environment in
which the patient has no discretion in deciding to increase the
dosage of their drug, Hansen said. In addition, the clinic offers a
multidisciplinary approach providing physical therapy, psychology and
associated physician services.

Professionals can easily recognize the difference between a person
with chronic pain who is properly using opiates and one who is
abusing them, Hansen said.

"People who have chronic pain who get opiates look better, their mood
improves, they function more, and they look better when their pain is
controlled. People who are chemically dependent, when they have
unrestricted access to the meds they're dependent on, they look
worse, their behavior deteriorates, their mood can deteriorate."

That happened to Metzger, who cut herself off from family and friends
as her dependency worsened.

"My life was just constantly filled with, 'When am I going to take my
next pillUKP' It got so incredibly bad (but) I thought I was hiding
it well," she said.

At a high cost

No local physician would have prescribed the number of pills she
needed, but Metzger recalled something she had heard the first time
she entered a substance-abuse center: Pills could be purchased
online, after a quick chat with a physician.

She was amazed at how easy it was to get her Vicodin that way.

How costly was Metzger's addiction? She has never totaled it up, but
it easily cost her thousands of dollars to buy the pills online, she said.

For example, the Web site my247md.com offers 120 tablets of Vicodin
for $145. For Metzger, that was a four-day supply. That's $1,015 for
a four-week supply.

When she was taking eight painkillers a day, she ended up at Keystone
Treatment Center. On 30 pills a day, she frantically tried to hide her problem.

But her family, particularly her uncle Ken Ness, president of the
bank that employed her, knew something was wrong. He contacted
Metzger's parents and three brothers, and they staged an intervention
after Thanksgiving 2005.

"They had planned for me to go to Hazelden in Center City, Minn., and
I just started crying as soon as I saw them all sitting at this
table, and I knew that everybody knew and I had lied to them," she said.

After a sleepless night, Metzger's parents drove their daughter to Hazelden.

Metzger knew what was awaiting her, since she had been through
withdrawal once before. This time, with her body's greater reliance
on drugs, it was much worse.

"It was pure torture, the physical agony I went through," Metzger
said. "I was so sick, with flu-like symptoms. I was dry heaving;
eventually I threw up the pills I'd taken that hadn't gone into my
system. The anxiety was worse than anything, and they couldn't give
anything until the pills were out of my system."

Metzger lay in a bed at the clinic, her body convulsed with tremors.
Staff changed her sweat-soaked sheets several times. Doctors and
nurses closely monitored her that first week.

"I looked like 'dead girl walking,' " Metzger says. "I was pasty
white. I didn't look like I was alive."

Slowly, helped by a drug that reduced withdrawal symptoms, Metzger
began to feel better.

Just before Christmas, she returned home. But the battle wasn't over.

All in the attitude

Metzger's pain had started years earlier. As a 15-year-old student at
Hills-Beaver Creek High School, she was in a car accident. About the
same time, she learned she had endometriosis, a painful condition in
which the uterus' lining invades the abdominal cavity.

The condition worsened during college. Eventually, an ovary and part
of her fallopian tubes were removed. As the pain persisted, and it
became less likely Metzger would ever be able to become pregnant,
depression surfaced.

But she persisted in maintaining a positive front. She became a trust
officer and vice president at First National Dakota Bank. She played
piano, tennis and golf. She volunteered with Sioux Empire United Way,
the Sioux Falls Community Foundation's investment board and Kiwanis Club.

And she kept swallowing painkillers.

"I took these pills to get up, I took them during the day at work,
and I took them to go to sleep, so now my life revolved around these
drugs," Metzger says.

She realized she was addicted in July 2004, after undergoing surgery.
She entered the chemical dependency program at Keystone Treatment
Center in Canton in October 2004.

But her attitude was wrong.

"I went there very naive, not knowing anything about addiction,
thinking that this is really a fluke that happened to me, I'm not
really the addict type, I shouldn't be here, and when I was with
other alcoholics and drug addicts, there was really arrogance on my
part," she said.

That arrogance is gone. Metzger attends two Alcoholics Anonymous
meetings a week, and she volunteers at a halfway house.

Jane Pugh of Yankton serves as Metzger's AA sponsor.

"She has her ups and downs," said Pugh, who agreed to let her name be
used. "It's a new lifestyle she's learning. She's also discovering
who Kristi is."

To help in that discovery, Metzger has left the bank. She lives with
her parents, who now reside in Brandon. She can return to a career
when she knows she is healthy, Metzger says. It may be in law or
chemical dependency counseling.

Whatever it is, it won't involve secrets.

"I just don't want people to worry and be scared that this could be
the end for them," Metzger said. "There are treatment centers,
there's doctors willing to help you, there's pastors at your church.
There's resources."