It's Hip to Be High

From the WebMD Archives

April 6, 2001 -- Friends star Matthew Perry went for help to get over it and controversial rap star Eminem apparently feels so strongly about it that he has an image of it tattooed on his biceps.

The "it" that has celebrities, and apparently plenty of others across the country, in a firm embrace is the prescription painkiller Vicodin. Experts say it -- and several other painkillers -- are fast replacing cocaine and heroin as drugs of choice among recreational users. The problem has become so serious that Newsweek even put Vicodin on the cover of its April 9 edition.

Although celebrities stand out as the most obvious examples, addiction to common narcotics prescribed for pain or illness isn't restricted to the rich and famous.

On her personal web site, actress Melanie Griffith describes how she sought treatment last year for what she says was a 20-year addiction to the prescription painkiller Norco. In journal entries written by Griffith, she says, "I feel it is important that I share this with you, because an addiction to prescribed pain pills can happen to anyone, and you have to be careful. Please if you are on any kind of medication, ask your doctor to explain the side effects and the possible addictive qualities of the drug."

Griffith says she initially was prescribed the painkiller after being injured in an automobile accident but didn't know it was addictive. Media reports say Perry became addicted to Vicodin after having a wisdom tooth pulled.

For most of us, short-term use of these drugs after a dental procedure or for relief of pain after injury doesn't lead to abuse. In fact, some who must take them for pain wonder why anyone would want to abuse them.

After an accident to her hand left her with a painful condition called reflex sympathetic dystrophy and severe carpal tunnel syndrome, 43-year-old Francesca (last name omitted) was prescribed Vicodin to control the pain and allow her to work. That was in January. But she soon found herself feeling moody, angry, and verbally abusive to her husband and family.


"Now I only take it once a day in the morning when I get to work," she says. "For the most part, I prefer to deal with the pain than deal with the Vicodin." She says she actually avoids taking it whenever possible because although it calms the pain, "I don't like what it does to me."

But others, such as those with existing anxiety or depression, people abusing alcohol or other medications, and people who have trouble coping with problems in their life, "get well-being from it and pretty soon the drug has a life of its own," explains Karen Miotto, MD. People who take the drugs over a long period of time develop a physical dependency -- their bodies adjust to the chemicals and become accustomed to them, needing them -- and that's when the dependency develops.

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.

"It lends an air of being chic and acceptable," she says. "It's sad really."