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Substance Abuse and Addiction Health Center

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It's Hip to Be High


While doctors know that certain subgroups of people are more vulnerable to addiction than others, they still don't have a good handle on how to spot that vulnerability. There also is growing suspicion that your chemical makeup may be the biggest factor in determining if you are at risk for addiction following short-term use.

At least one government agency has drawn attention to the rising use of prescription painkillers. Late last year, the National Institute on Drug Abuse (NIDA) listed hydrocodone (Vicodin, Lortab) as an "emerging" recreational drug, saying that emergency room visits in which use of the drug was noted rose almost 140% since 1993.

NIDA is set to introduce a major public-health initiative next week to address the problem of prescription drug abuse.

One reason painkillers like Vicodin, Percodan, and Percocet are attractive to some is because they provide a considerable feeling of well-being, but users can still function relatively normally in their jobs and personal life and often get away with it for years, says Miotto, medical director of the VA Los Angeles Ambulatory Clinic.

As long as you have a prescription, painkillers are perfectly legal. But news reports suggest the black market for Vicodin, Percocet, Percodan, and another powerful painkiller called OxyContin (the "poor man's heroin"), is growing rapidly.

Miotto says serious abusers become "doctor shoppers" -- going from doctors to dentists on an almost daily basis picking up one prescription after another.

One celebrity female patient of hers actually kept a computerized spreadsheet to track her prescription-collecting rounds. The woman ended up in full-blown liver failure and required a transplant due to her long-standing Vicodin habit.

One of the main ingredients in Vicodin is acetaminophen, also the main ingredient in Tylenol. Over time, acetaminophen "doesn't just cause a problem, it destroys your liver and you die," Miotto says. Alcohol makes the situation even worse and hastens the destruction of the liver.

While Vicodin and other prescription painkillers may seem cool, they can destroy more than your health, says William George, a professor of pharmacology at Tulane University School of Medicine in New Orleans.

"When you go out and get a job and you're using these drugs that you have become dependent on, you're going to lose your job. Then where does that put you?" says George, who runs a nationally certified drug-testing laboratory. He says while celebrities may be able to get away with long-term addiction, most people in the real world can't because the decrease in mental alertness will become evident.

"People may want to tell you that [recreational use] isn't so bad," he says. "They're wrong for a variety of reasons, and young people need to hear that."

Miotto says she worries about the pro-drug message that a high-profile celebrity like Eminem sends to young people with his Vicodin tattoo.

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