DEPICTING DRUG ABUSE NOT A JOKING MATTER

In a heavily promoted live episode of Will & Grace earlier this
season, the title characters opened a linen closet in the palatial
bathroom belonging to their wealthy friend Karen Walker. Out gushed
hundreds and hundreds of pill bottles, a river of amber-colored plastic.

The studio audience went wild. Karen's fondness for booze and
prescription painkillers such as Vicodin, which she apparently goes
through like Tic Tacs, is one of the show's most reliable running
jokes, a laugh-getter as surefire as Kramer's entrances or Frasier
Crane's pomposity.

Dr. David Crausman thinks Karen's drug use is about as funny as food
poisoning, which is what he says her withdrawal symptoms would
resemble if they were ever shown forthrightly.

"It's not a joke at all," said Crausman, director of the Center for
Healthful Living, an outpatient counseling facility in Beverly Hills, Calif.

"It depicts a woman who's held hostage to her addiction. They're not
showing her when she doesn't get her pain pill, when she doesn't have
the alcohol. How she gets diarrhea, how she starts vomiting, how her
skin will crawl, her legs will cramp. They don't show that, because
that's not cute," he said.

This is a pretty heavy guilt load to lay on a popular, Emmy-winning
sitcom that aspires only to impertinent farce and an occasional
heartstring tug. In fairness, the show's comic references to Karen's
dependency on prescription painkillers are only an exaggerated
example of the concerns addiction specialists have about
entertainment TV in general when it comes to portraying the use of
such medications: minimizing the downside.

Prescription pain medications "are often discussed in a real casual
manner, almost as if there's real acceptance, whether it's prescribed
or not," said Dr. Marvin Seppala, a physician and chief medical
officer at the Hazelden Foundation, an alcohol and drug treatment
center near Minneapolis.

It's so casual at times, Crausman said, it's as if Vicodin and other
prescription painkillers were "glorified aspirin."

There are notable exceptions. While TV networks these days rarely
order "lesson" movies as they did in the 1970s with the likes of Go
Ask Alice (anti-LSD) or The Morning After (alcoholism), some episodic
dramas integrate social issues into their story lines. This approach
is probably wiser given how audiences have come to expect ambivalence
and imperfect heroes.

CBS's crime series Without a Trace, for instance, worked its way
through a subplot in which FBI agent Martin Fitzgerald (Eric Close)
wrestled with addiction to painkillers prescribed by a doctor after
Fitzgerald was shot in the line of duty.

In Fox's House, the addiction to painkillers of the title character
(played by Hugh Laurie), a brilliant medical diagnostician with a bum
leg, is, as executive producer David Shore put it, "a thread we pull
on occasionally." He said he and his staff feel an obligation to
depict Dr. House's drug problem honestly.

"It's not a show about addiction, but you can't throw something like
this into the mix and not expect it to be noticed and commented on,"
Shore said. "There have been references to the amount of his
consumption increasing over time. It's becoming less and less useful
a tool for dealing with his pain, and it's something we're going to
continue to deal with, continue to explore."

Seppala said patients who come to Hazelden for treatment for
addiction to prescription painkillers often "think it's OK, that
somehow it really isn't that serious. They think: 'It was prescribed
by my doctor. I'm using it for pain. How can that be bad?' I don't
think the media equate addiction to prescribed pain medication with
addiction to heroin. But they're the same class of medication, just
as powerful. In fact, some are more powerful."

According to a report by Columbia University's National Center on
Addiction and Substance Abuse, the number of Americans who abuse
controlled prescription drugs has nearly doubled -- from 7.8 million
to 15.1 million -- since 1992. Abuse of such medications among teens
has more than tripled over the period.

A study by the National Institute on Drug Abuse released in December
said 9.5 percent of 12th-graders reported using the painkiller
Vicodin and 5.5 percent reported using OxyContin.

You probably wouldn't guess that if entertainment TV were your
primary window on society. You would more likely believe there was an
epidemic of serial killers.

Still, in the case of prescription-drug abuse, television is
mirroring its audiences' ignorance.

Doctors interviewed for this article acknowledge that
prescription-drug abuse is a tricky problem for TV entertainment shows.

They point out that the medications have tremendous benefits as well
as frightening downsides, that most people who use them don't become
addicted and that even those who do may not exhibit behaviors that we
associate with heroin addicts and crackheads -- at least not for a while.

Bernstein noted, for instance, that the portrayal of Will & Grace's
Karen isn't necessarily unrealistic. "Karen is popping Vicodin all
the time, and she hasn't lost her wit," he said. "She hasn't lost her
edge. And that's the point. You're too functional on it. It's almost
too good of a drug."

Almost. If a user of a prescription painkiller gets into an addictive
cycle, tolerance develops rapidly, leaving the abuser to choose
between taking more and more pills or painful, debilitating withdrawal.