ADDICTION: WHEN PAINKILLERS HURT

With Doctors Reporting A Steep Increase In Abuse Of Prescription Drugs, More
People Are Struggling To Overcome Destruction Caused By The Very Pills Meant
To Bring Comfort

Chrissy's troubles began when she hurt her back shoveling snow.

That was eight years ago. To ease her pain, the Clarence native and single
mother was prescribed the synthetic opiate Lortab - a hydrocodone, and
cousin of codeine, mixed with Tylenol.

Over time, Chrissy became addicted to the painkiller, swallowing five in the
morning just to get out of bed. Her daily pill intake grew from six to 25.

Eventually, when her prescribed amount wasn't enough, Chrissy would cop the
white, unmarked pills from drug dealers on the Lower West Side to keep her
back pain at bay.

"I would take every penny I made as a waitress - $100, sometimes $120 a
night in tips - and after work I would go right to my spot and come home
with no money, just so I could have the pills in the morning," said Chrissy,
who asked that her last name not be used. "Just so I could feel good."

Last month, Chrissy re-entered detox for a second time at Erie County
Medical Center, where she is currently going through rehab and is determined
to make a permanent recovery.

But the problem is far from hers alone.

She is one of an increasing number of people who have become hooked on
prescription pain medication - in Western New York and across the nation.

It's a growing problem that was highlighted recently by the admission that
conservative talk show host Rush Limbaugh is addicted to the popular
painkiller Oxycontin.

A 2002 federal survey found nearly 1 million people ages 12 and up used
Oxycontin at least once for nonmedical reasons in 2001. That was four times
the number found just two years earlier, according to the Substance Abuse
and Mental Health Services Administration's National Survey on Drug Use and
Health.

Dr. Paul Updike, a medical director of chemical dependence at Sisters
Hospital, has observed a steep increase.

"I'm seeing a significant percentage of people who are prescription opiate
abusers. It's clearly on the rise. More and more people we're seeing are
using prescription opiates," Updike said.

That's also the case among young people, according to the annual federal
survey.

Over the past 15 years, the number of teens and young adults using
prescription painkillers skyrocketed - from 400,000 users in the mid-1980s
to 2 million in 2000.

"Unfortunately, it seems to be something more and more kids are
experimenting with," Updike said. "It's not uncommon for me to see someone
in their early 20s with a five-or six-year history of opiate use. It's a
disturbing trend."

Ernest Blackman, an addiction counselor at CAO/DART, which treats people
with dependencies, has noticed a change in the type of people who become
trapped in painkiller abuse.

"We have seen an increase in patients who are addicted to opiate pain
medications," said Blackman. "These are working people never involved in the
drug culture."

The addiction often is formed through a gradual process that takes place
over a number of years. And unlike most drugs that people get into trouble
with, prescription pain medications are at least as common among women as
among men, according to Dr. Robert Whitney, clinical director of addiction
services at ECMC.

Whitney said prescription painkillers have an important medical role and
help many people. But some patients can't regulate the medication the way
doctors prescribe it, because a tolerance is built up. Others become
behaviorally dependent.

"The vast majority of people seem to be able to take these kinds of
medicines for short periods of time and then they forget about it or for
longer periods of time but don't increase the amount they're taking,"
Whitney said.

"But the whole behavioral piece is a different thing altogether," Whitney
said. "That's the kind of problem Limbaugh and others seem to have, where
it's being taken for reasons other than for pain management."

Abuse of Oxycontin, Limbaugh's apparent drug of choice, isn't as common in
Western New York as other parts of the country, Whitney believes. The
prescription painkiller he sees most often is Lortab. Other brand name
hydrocodones include Vicodin and Lorcet.

Lortabs are more readily abused because, unlike Oxycontin, an oxycodone,
they aren't time-released and have a relatively rapid onset.

Frequently, doctors find themselves in the position of having to determine
when a patient genuinely needs painkillers, and when they don't.

Jayne Haley, program director of BryLin Hospitals, which operates addiction
clinics in Buffalo, Williamsville and Alden, agreed that determining the
honesty of a patient is fraught with problems.

"Pain is subjective, and everyone has a different tolerance for it," Haley
said. "We have our medical staff use pain assessment tools to work with the
patients so they can take a realistic look at their use. But it can still be
hard to sort out."

Connie, a married mother of two who lives in a small rural town in Western
New York, admits to having "played the system" to get three doctors at one
time prescribing her Lortab. That lasted until her health insurance company
caught on.

The married mother of two, who also asked that her full name not be used,
started taking the painkillers in 1991 because of a degenerative lower back
problem exacerbated by years of physical labor.

At one time, her daily intake was 30 to 40 pills a day. Without them, she
contended, she would have been unable to go to work. They were also readily
available.

"There's always somebody somewhere who can get you some, whether on the West
End in Buffalo or in the suburbs," Connie said. "There's so much out there,
and there are so many people out there who (sell) them."

A turning point arrived when Connie's supply ran out one week, and she
couldn't find pills anywhere. Her pill supplier suggested she try a bag of
heroin. Needing to get through work that day, she did.

"I snorted it. It was politically correct to snort but not shoot," she said.
"But I put my seat belt on when I drove, you know? Go figure - this is your
white-collar worker. Let's snort some heroin but put your seat belt on."

Her heroin use began four years ago, and eventually grew to as much as six
to eight bags a day. It came to a halt when she checked into ECMC earlier
this month.

"It's taken a toll in the house. I've drained everything, all my stocks,"
Connie said, although she said she retained enough willpower never to touch
money set aside for groceries or utility bills.

This is Connie's fourth time in detox, where during a five-day period she
was helped with the physical torment of withdrawal. But it's her first time
going through rehab, a four-week program that emphasizes changes in habit.

One reason Connie never did rehab before is that her health insurance policy
- - like most that serve Western New York - doesn't cover it.

Knowing what she knows now, Connie said she hopes patients will ask doctors
questions about prescription painkillers before they get hooked. She said
the pain of withdrawal from prescription drugs was just as hard as heroin
withdrawal.

"If a doctor said I'm writing you a scrip for 120 bags of heroin, people
might say, "Maybe I don't hurt that bad,' " Connie said. "I would have
thought twice if I was told that."

Updike said it's always important to remember that most addicts of
prescription painkillers started with a pain problem. None of them wanted to
become an addict.

He is hopeful news of Limbaugh's drug addiction will raise public awareness
of the problem.

"You always hope that these kinds of things will bring attention to a larger
problem," he said. "Because this can happen to anybody."