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This article is from the WebMD News Archive
Getting Past Painkiller Abuse
Dec. 8, 2003 -- First Rush Limbaugh, now Ozzy Osbourne. Prescription painkiller abuse is a problem for the rich and famous -- and for plenty of average people.
Painkiller abuse develops very subtly. Very often, no one's trying to get high. Prescription medication abusers many times do not equate themselves with other drug addictions, they often do not recognize that they have a problem.
"A person can be developing depression, but they don't get treatment for depression -- they take their pain pills instead," Karen Miotto, MD, an addiction psychiatrist with the UCLA Neuropsychiatric Institute, tells WebMD.
The problem escalates: Instead of taking pills three times a day, it's four or five or six times. Soon, the painkillers are combined with something else -- valium, alcohol -- to increase the effect.
The abuse then leads to dependency which can be a physical dependency or a psychological one.
"Then, life begins to revolve around getting the medication," says Miotto. 'Physician shopping' occurs in an effort to obtain their medications. "You call your ob-gyn, tell her your family practice doctor is out of town, and ask for a prescription. Or your husband had dental surgery, and there's some leftover pain pills in the medicine cabinet."
By getting more prescriptions through 'shopping' the person can obtain enough drugs to continue their dependency and dosage. Eventually the drugs no longer produce the same effect and the body will start to crave larger doses, this is also known as tolerance and leads to withdrawal symptoms.
Many people are initially in denial about painkiller abuse, she adds. "Their denial is more profound than that of people shooting up heroin. They can fall over the Christmas tree and not even realize it. They also don't realize it's related to their medications."
"Even when people have hit rock bottom, they don't see it that way," says John O'Neill, LCSW, an addiction counselor and program director at The Menninger Clinic, affiliated with Baylor College of Medicine in Houston.
"It's amazing," he tells WebMD. They argue and argue: "It's not because of my addiction, it's because of XYZ. It's my boss. They're not being flexible about my hours."
O'Neill has worked with addiction treatment for 16 years, and agrees with Miotto -- hospitalization is the way to go. "Detox just isn't enough," he tells WebMD. Even if they are hospitalized, getting patients to fully participate in treatment isn't always easy.
"The patient's motivation, or lack of it, dramatically affects whether they're willing to do to stay sober and what they are willing to do," O'Neill says. "A lot of people think, 'If I check myself in for 30 days, I'll be over it.' No, this is just the start."
"The people who come here are at the top of the top in terms of success," he tells WebMD, they're used to the 70- or 80-hour-plus work week."
In fact, often it's career stress, and inability to deal with down time, that pushes them to painkiller abuse. "We pull them into therapy, then we also help them deal with leisure."
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