Pubdate: Mon, 03 Nov 2003 Source: Buffalo News (NY) Copyright: 2003 The Buffalo News Contact: http://www.buffalonews.com/ Details: http://www.mapinc.org/media/61 Author: Mark Sommer Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) Bookmarks: http://www.mapinc.org/people/Rush+Limbaugh (Limbaugh, Rush) Bookmark: http://www.mapinc.org/rehab.htm (Treatment) ADDICTION: WHEN PAINKILLERS HURT With Doctors Reporting A Steep Increase In Abuse Of Prescription Drugs, More People Are Struggling To Overcome Destruction Caused By The Very Pills Meant To Bring Comfort Chrissy's troubles began when she hurt her back shoveling snow. That was eight years ago. To ease her pain, the Clarence native and single mother was prescribed the synthetic opiate Lortab - a hydrocodone, and cousin of codeine, mixed with Tylenol. Over time, Chrissy became addicted to the painkiller, swallowing five in the morning just to get out of bed. Her daily pill intake grew from six to 25. Eventually, when her prescribed amount wasn't enough, Chrissy would cop the white, unmarked pills from drug dealers on the Lower West Side to keep her back pain at bay. "I would take every penny I made as a waitress - $100, sometimes $120 a night in tips - and after work I would go right to my spot and come home with no money, just so I could have the pills in the morning," said Chrissy, who asked that her last name not be used. "Just so I could feel good." Last month, Chrissy re-entered detox for a second time at Erie County Medical Center, where she is currently going through rehab and is determined to make a permanent recovery. But the problem is far from hers alone. She is one of an increasing number of people who have become hooked on prescription pain medication - in Western New York and across the nation. It's a growing problem that was highlighted recently by the admission that conservative talk show host Rush Limbaugh is addicted to the popular painkiller Oxycontin. A 2002 federal survey found nearly 1 million people ages 12 and up used Oxycontin at least once for nonmedical reasons in 2001. That was four times the number found just two years earlier, according to the Substance Abuse and Mental Health Services Administration's National Survey on Drug Use and Health. Dr. Paul Updike, a medical director of chemical dependence at Sisters Hospital, has observed a steep increase. "I'm seeing a significant percentage of people who are prescription opiate abusers. It's clearly on the rise. More and more people we're seeing are using prescription opiates," Updike said. That's also the case among young people, according to the annual federal survey. Over the past 15 years, the number of teens and young adults using prescription painkillers skyrocketed - from 400,000 users in the mid-1980s to 2 million in 2000. "Unfortunately, it seems to be something more and more kids are experimenting with," Updike said. "It's not uncommon for me to see someone in their early 20s with a five-or six-year history of opiate use. It's a disturbing trend." Ernest Blackman, an addiction counselor at CAO/DART, which treats people with dependencies, has noticed a change in the type of people who become trapped in painkiller abuse. "We have seen an increase in patients who are addicted to opiate pain medications," said Blackman. "These are working people never involved in the drug culture." The addiction often is formed through a gradual process that takes place over a number of years. And unlike most drugs that people get into trouble with, prescription pain medications are at least as common among women as among men, according to Dr. Robert Whitney, clinical director of addiction services at ECMC. Whitney said prescription painkillers have an important medical role and help many people. But some patients can't regulate the medication the way doctors prescribe it, because a tolerance is built up. Others become behaviorally dependent. "The vast majority of people seem to be able to take these kinds of medicines for short periods of time and then they forget about it or for longer periods of time but don't increase the amount they're taking," Whitney said. "But the whole behavioral piece is a different thing altogether," Whitney said. "That's the kind of problem Limbaugh and others seem to have, where it's being taken for reasons other than for pain management." Abuse of Oxycontin, Limbaugh's apparent drug of choice, isn't as common in Western New York as other parts of the country, Whitney believes. The prescription painkiller he sees most often is Lortab. Other brand name hydrocodones include Vicodin and Lorcet. Lortabs are more readily abused because, unlike Oxycontin, an oxycodone, they aren't time-released and have a relatively rapid onset. Frequently, doctors find themselves in the position of having to determine when a patient genuinely needs painkillers, and when they don't. Jayne Haley, program director of BryLin Hospitals, which operates addiction clinics in Buffalo, Williamsville and Alden, agreed that determining the honesty of a patient is fraught with problems. "Pain is subjective, and everyone has a different tolerance for it," Haley said. "We have our medical staff use pain assessment tools to work with the patients so they can take a realistic look at their use. But it can still be hard to sort out." Connie, a married mother of two who lives in a small rural town in Western New York, admits to having "played the system" to get three doctors at one time prescribing her Lortab. That lasted until her health insurance company caught on. The married mother of two, who also asked that her full name not be used, started taking the painkillers in 1991 because of a degenerative lower back problem exacerbated by years of physical labor. At one time, her daily intake was 30 to 40 pills a day. Without them, she contended, she would have been unable to go to work. They were also readily available. "There's always somebody somewhere who can get you some, whether on the West End in Buffalo or in the suburbs," Connie said. "There's so much out there, and there are so many people out there who (sell) them." A turning point arrived when Connie's supply ran out one week, and she couldn't find pills anywhere. Her pill supplier suggested she try a bag of heroin. Needing to get through work that day, she did. "I snorted it. It was politically correct to snort but not shoot," she said. "But I put my seat belt on when I drove, you know? Go figure - this is your white-collar worker. Let's snort some heroin but put your seat belt on." Her heroin use began four years ago, and eventually grew to as much as six to eight bags a day. It came to a halt when she checked into ECMC earlier this month. "It's taken a toll in the house. I've drained everything, all my stocks," Connie said, although she said she retained enough willpower never to touch money set aside for groceries or utility bills. This is Connie's fourth time in detox, where during a five-day period she was helped with the physical torment of withdrawal. But it's her first time going through rehab, a four-week program that emphasizes changes in habit. One reason Connie never did rehab before is that her health insurance policy - - like most that serve Western New York - doesn't cover it. Knowing what she knows now, Connie said she hopes patients will ask doctors questions about prescription painkillers before they get hooked. She said the pain of withdrawal from prescription drugs was just as hard as heroin withdrawal. "If a doctor said I'm writing you a scrip for 120 bags of heroin, people might say, "Maybe I don't hurt that bad,' " Connie said. "I would have thought twice if I was told that." Updike said it's always important to remember that most addicts of prescription painkillers started with a pain problem. None of them wanted to become an addict. He is hopeful news of Limbaugh's drug addiction will raise public awareness of the problem. "You always hope that these kinds of things will bring attention to a larger problem," he said. "Because this can happen to anybody." - --- MAP posted-by: Doc-Hawk