LIMBAUGH'S ADDICTION WON'T BE EASY TO END

BOSTON -- Rush Limbaugh is not alone. Addiction to prescription painkillers
has boomed in recent years, and they can be as tough to kick as heroin. The
number of Americans who begin misusing painkillers each year has almost
quadrupled from 1990 to 2001, according to government figures. And many
abusers don't recognize the insidious slide into addiction.

"It's just so much more acceptable in society for people to be taking
prescription drugs," said Sean Evans, 31, of Everett, Mass., a construction
worker who became addicted to the pain reliever OxyContin, then moved on to
heroin. "You can always rationalize the reason to take it."

Limbaugh, the conservative radio commentator, told his audience Friday he
is addicted to prescription painkillers that he began taking after spinal
surgery "some years ago."

He said he had checked himself in for treatment twice before, without
success. This time, he said he was headed to a rehab center for a month "to
once and for all break the hold this highly addictive medication has on me."

Limbaugh may be overly optimistic about the time frame, said Alice Young, a
psychology professor and a drug researcher at Wayne State University in
Detroit.

"He had said he was going into treatment and lick it within 30 days. I
think that's probably an unrealistic expectation," she said.

Limbaugh didn't name the medication, but the National Enquirer, which first
reported his abuse, said Limbaugh's drug connection said he used OxyContin
and other painkillers.

Most patients who become addicted have taken more medication than their
doctors prescribed. However, addiction can take hold quickly - within weeks
- - for some drugs. The addicts often buy their drugs on the street when
their prescriptions run out.

Doctors say the biology and treatment of addiction are similar in many ways
for both legal and illegal drugs - from tobacco, alcohol and prescription
painkillers to cocaine and heroin. Addiction sets in when users become
dependent on the intense feelings evoked as the drug works on primitive
pleasure points within the brain.

"In our field, a drug is a drug is a drug," said Bill Carrick, program
manager at the CAB Boston Treatment Center. Evans, the construction worker,
was undergoing detoxification there.

Initial treatment often entails detox, sometimes with a substitute drug
such as methadone. Long-term therapy may aim to substitute healthy rewards
in family or work life for drug-induced euphoria.

Some abusers of painkillers are no longer in pain and take the drug purely
for pleasure. Others, as Limbaugh said of himself, are also getting relief
from pain. During their treatment, nonaddictive pain relievers can be used.
Such patients may also receive electrical stimulation, acupuncture,
counseling and other treatments to help cope with their pain.

Even with all the techniques, however, patients and therapists agree that
it is difficult to overcome the addiction to many prescription drugs.

"Honestly, I think OxyContin is a lot harder to come off than heroin," said
Evans, who has been treated for both.

The maker of OxyContin, Purdue Pharma, disputes the notion that the
painkiller is stronger than heroin, saying there is "absolutely no
scientific basis" for such a contention.

While Limbaugh joins a long list of celebrities who became hooked on
prescription drugs - actress Marilyn Monroe, pop entertainer Michael
Jackson, country singer Tammy Wynette and football player Brett Favre among
them - many more ordinary Americans succumb to this kind of addiction.
Evans, for example, started taking painkillers when he had his wisdom teeth
pulled.

The rate of abuse has risen dramatically for such drugs. About 2.4 million
Americans began misusing prescription pain relievers in 2001, almost
quadrupling from 628,000 in 1990, according to the federal government's
Survey on Drug Use and Health.

An estimated 6.2 million Americans, or 2.6 percent of adults, misuse
prescription drugs of all kinds. About 4.4 million of them misuse pain
relievers, taking more than their prescribed amount. The rate of full-blown
addiction is about 0.3 percent, but patients who don't follow their
prescriptions are considered at risk.

Other abused prescription drugs include sedatives for anxiety and
stimulants prescribed for attention deficit disorder and obesity.

It isn't clear why more Americans appear to be misusing prescription drugs.
Howard Chilcoat, a drug-use researcher at Johns Hopkins University, said
more may be available through illegal channels, more abusers of illegal
drugs may be switching, and people may be more aware of the power of
prescription drugs through news stories.