PRESCRIPTION FOR ADDICTION?

Abuse Of Pain Killers, Sedatives On The Rise

An attractive go-getter with a six-figure income and a plush 5,600-square
foot house. A teetotaling mother of two. A recovering heroin addict.

Three Boulder County women. Three different lives. One common problem: a
life-altering addiction to prescription medication.

"I was just a mom with two young kids who had an accident at work," says
Meg, 51, a recovering addict who traces her descent into drug abuse to the
day 15 years ago that her doctor sent her home with a bottle of Vicodin.

She soon discovered the painkillers not only numbed the pain but also
fended off depression. When she saw another doctor for anxiety, he gave her
tranquilizers. Before long, she was downing 20 various pills a day.

"Before I even had a chance to recover on my own, I was put on all kinds of
medications and I got dependent on them," she says.

According to national studies, local therapists and users themselves,
stories like this are growing more common.

A survey released by the U.S. Department of Health and Human Services last
month found that an estimated 6.2 million Americans abused pain killers,
sedatives, tranquilizers and stimulants in 2002, making non-medical use of
prescription drugs second only to marijuana use in popularity.

Abuse of pain killers is by far the most common, researchers say, with 1.5
million people -- more than the number of cocaine addicts nationwide --
believed to have a "serious problematic dependence" on them. The numbers
are growing steadily.

Opinions vary on the root cause.

Some blame doctors, eager to please a pill-happy society and too busy to
ask questions that may tip them off to brewing addictions. Others point to
an increased emphasis on pain management, which has led to better pain
control for those who truly need it, and also has opened the door to more
liberal prescribing practices.

Regardless of the cause, activists say, the problem needs to be addressed.

"Prescription drug addiction is one of our most serious drug problems, but
it is also the least understood and most underreported," says Rod Colvin,
author of "Prescription Drug Addiction: The Hidden Epidemic," (Addicus
Books) and founder of the Internet support group prescriptiondrugaddiction.com.

"These are often unwitting addicts who start taking a drug for a legitimate
reason, no one realizes they have underlying emotional problems, they start
self-medicating, and it escalates from there."

Killing The Pain

Earlier this month, conservative radio talk show host Rush Limbaugh stunned
listeners with his admission that he was addicted to pain killers and was
checking himself into a rehabilitation center. He says he developed his
habit after a failed back surgery.

In 2001, Cindy McCain, U.S. Sen. John McCain's wife, wrote a column in
Newsweek detailing her abuse of the drugs she originally got for pain relief.

Such celebrity confessions may leave one wondering: Just how common is it
for a person to grow addicted to their pain medication?

Statistics vary widely, ranging anywhere from 6 percent to 30 percent of
those prescribed pain pills.

"The reality is, it is a relatively small percentage of the time, probably
in the 10 percent range," says Dr. Timothy Justice, chief medical officer
at Centennial Peaks Hospital, a mental health and addictions facility in
Louisville. "The flip side is, when it happens, it is extremely destructive
.. and this is a disease that is caused by treatment. That is what makes
it so important."

Jasmine Aranda, chemical dependency coordinator for Centennial Peaks, says
that at one point this spring, more than 40 percent of her patients were
addicted to prescription drugs. The vast majority, she says, were
introduced to their pills by a doctor.

"Very few just sought the drug out on their own," she says.

In the beginning, that is.

She and other area addiction specialists say they have seen pill-seekers
take desperate measures to feed their growing addictions.

They "doctor shop," having several different care givers supplying them
with pills for conditions they may or may not have. They steal prescription
pads. They steal from friends and relatives.

"I have had clients who will injure themselves rather severely so they can
go to the emergency room and get a prescription for pain medications," says
Mike Lewis, a therapist in the recovery program at Boulder Community
Hospital's Mapleton Center.

Debra, a 45-year-old management consultant from Louisville, got turned on
to OxyContin -- a high-powered, time-released pain killer -- when a
relative brought home a few pills after back surgery. (Like the other women
interviewed for this story, she asked that -- for the sake of her children
and career -- her last name not be used.)

At the height of her problem, she was paying a chronic pain patient $1,800
per month for the bulk of his back pain prescription. When that supply ran
out after a few weeks, she'd spend the rest of the month "chasing pills,"
sometimes faking an injury at the local emergency room.

"You could do anything on Oxy. You would feel like you controlled the
world," says Debra, who has been clean for six months since her stay at
Centennial Peaks.

For Meg, her doctors caught on after a year or two and cut her off. Rather
than doctor shop, she turned to illicit drugs. She's now been sober for 10
years thanks to a local 12-step group.

"I was never a drinker. I didn't smoke pot. It all started with
prescription drugs.'"

Calming Anxiety

Anti-anxiety medications such as Valium and Xanax also are part of the
problem, experts say. Nearly 2 million people used tranquilizers for
non-medical purposes last year. While newer, less addictive
anti-depressants and anti-psychotics are available, many family practice
physicians with little training in addiction still prescribe tranquilizers
more often than necessary, Centennial Peaks' Justice says.

Ann Noonan is clinical coordinator for Boulder County Public Health's
substance abuse programs.

She says she often sees women with alcohol problems visit their doctor for
help with stress and anxiety, then walk out with a prescription.

"They go to the doctor, describe their symptoms, the doctor doesn't assess
how much alcohol they are using, and they prescribe them benzodiazepines
(depressants)," she says, noting that when tranquilizers and pills are
combined, the effects of both are amplified.

"Then they are stuck with both."

Terry, a 44-year-old Boulder woman, says she had been off heroin for a
little more than one year when her therapist urged her to take anti-anxiety
medication to help her sleep and calm her nerves.

She was resistant.

"I had just gotten clean and I didn't want to be taking any pills, but the
system pretty much insists upon it," she says.

Now she fears she might get addicted to her anti-anxiety pills.

"They are just as addictive as any other drug. If I miss a day, I have
horrible reactions," she says.

Hard To Treat

Because prescription drugs linger in the system and rewire the brain,
treatment for addiction is particularly tough, experts say.

"They can die from withdrawal if they are not careful," says Centennial
Peaks' Aranda, who recommends an in-patient detoxification program.

While it takes roughly 72 hours to detox after quitting alcohol, it can
take five to seven days to get through the withdrawal symptoms of a
tranquilizer addiction. Some people have seizures.

Those weaning themselves off painkillers often experience extreme pain, and
have to be given other non-addictive drugs to help them through it.

"The challenge that a big chunk of these folks are going to face is, they
have legitimate pain," she says. "How do they address that pain and not
engage in the addiction?"

That's where Bonnie Wilensky, a pain resource nurse for Boulder Community
Hospital, often comes in.

Until recently, she says, pain was largely undertreated by the medical
field. Now, new federal mandates require that doctors be more attentive in
assessing and treating pain. Newer, more effective drugs, such as OxyContin
have emerged.

But with the new emphasis on pain management has come a great
responsibility, says Wilensky.

"The balance is, how do you be humane and ethical, and not create more
problems for people?"

Boulder Community's in-patients are sent home with a booklet on how to
safely wean themselves off pain medications and are seen frequently by a
practitioner who keeps track of their dosage. All patients are encouraged
to try complementary therapies such as massage or acupuncture.

When someone appears to be growing addicted to a particular drug, Wilensky
may try to wean them off it, trying other less-addictive medications, and
refer them to counseling.

She says that out of the hundreds of people she has seen this year, only
seven or eight got addicted.

"It doesn't take us very long to figure out if they are manipulating us,"
she says.

Educate Yourself

Jack Lavino, a certified addictions counselor in Boulder, points out that
millions of people use prescription drugs all the time without getting
addicted to them.

"It isn't just that the drug does it to the person," he says. "They bring
either genetics or environmental factors along with them."

But Aranda and Colvin believe doctors should be doing more to learn what
those factors are, screening patients for emotional problems and addictive
tendencies and insisting that patients take a greater role in their care.

"We, as patients, have an expectation to leave a doctor's office feeling
better and doctors are trying to meet our expectations. Yet they lack the
education on addiction," Aranda says.

Adds Colvin, who runs his addiction support Web site from Omaha, Neb.:

"We consumers need to educate ourselves about the pills we are putting into
our bodies."

His brother, Randy, was in his mid-20s when he went to a psychiatrist to
seek help with his chronic anxiety. He was given a prescription for
tranquilizers. He liked them, and he began taking more.

On his 35th birthday, Randy was rushed to a hospital emergency room
suffering from complications from long-term tranquilizer abuse.

He died in his sleep.