Q&A ON DRUG ABUSE

Today's answers are from Dr. Erik van Ginkel, director of South Miami
Hospital's addiction treatment program.

Q. When it comes to prescription drugs, is there a difference between
physical dependence and addiction?

A. Yes, and it's really an important difference. It's so easy to
become physically dependent. Every patient who takes opiates,
tranquilizers or stimulants for longer than two weeks becomes
physically dependent to varying degrees, which means if they stop
taking them abruptly, they may suffer withdrawal. Addiction is when
people have a psychological as well as physical dependence. They use
the drugs compulsively, are obsessed with using and will use in spite
of negative consequences.

Q. What are the commonly abused prescription drugs?

A. Pain medication such as Percocet, Vicodin, Tylenol III, OxyContin,
Morphine and Duragesic. Central nervous system depressants for anxiety
and insomnia include Valium, Xanax, Ativan, Ambien. Stimulants for
narcolepsy, obesity and Attention Deficit Hyperactivity Disorder such
as Ritalin and Provigil.

Q. What are the consequences of prescription drug abuse?

A. Chronic use may result in tolerance -- requiring a higher dose for
the desired effects. Physical dependence means your body cannot
function without the drug and stopping it can result in life-
threatening withdrawal manifested by symptoms including nausea,
vomiting, diarrhea, heart palpitations, high blood pressure, even seizures.

Q. How can people physically dependent on drugs get off
them?

A. It is tricky. They need to be weaned off the drugs to prevent
withdrawal. If it's opiates, the drug needs to be decreased by 25
percent a day. It could take seven days to get off the drug. If you
have been taking benzodiazepines, like Valium or Ativan, for months or
years, you gradually taper the dose for one or two months. The process
is guided by signs of withdrawal.

Q. What is the treatment for prescription drug addicts?

A. An addict taking drugs for the wrong reasons needs an inpatient
addiction treatment program followed by outpatient treatment.

Q. How successful is this treatment?

A. You can reduce drug use by 40 percent to 60 percent if it's
treated, and that's significant because addiction is a chronically
relapsing disease. So are diabetes, cardiovascular disease and asthma.
But addictive disease has such a bad connotation. It is genetically
determined. About one in 10 people have addictive disease. It may not
be manifest because they have never had mood-altering drugs.