Pubdate: Sun, 04 Mar 2007
Source: Mail Tribune, The (Medford, OR)
Copyright: 2007 The Mail Tribune
Contact:  http://www.mailtribune.com/
Details: http://www.mapinc.org/media/642
Note: Only prints LTEs from within it's circulation area
Author: Sarah Lemon, Mail Tribune

ABUSING PILLS:

Prescription for Trouble Legal Drugs Become a Popular Fix; Experts 
Say Rush to Treat Pain Opens Door to Addiction

A brush with methamphetamine addiction couldn't begin to prepare 
Nathan Wick for the crushing grip of prescription-opiate dependency.

"Cocaine and meth and all those are nothing compared to the 
addictions your body goes through with pain medication," the Medford 
resident said.

Off meth for seven years, Wick, 32, started taking Vicodin to 
alleviate the pain of a 2002 back injury. As his tolerance for the 
prescribed drug increased, he turned to Percocet, an opiate-derived 
painkiller. Soon Wick was downing more than his prescribed dosage and 
looked to emergency rooms, urgent-care centers and, finally, 
street-level dealers for his next fix.

"Pills are so accessible ... it's easy to play the system," Wick said.

Wick is among a growing number of Americans addicted to prescription 
drugs, particularly opiates. These painkillers now rank second -- 
only behind marijuana -- in the country's most commonly abused drugs, 
according to statements released last month by the White House Office 
of National Drug Control Policy.

The trend prompted President Bush to develop a nationwide strategy 
targeting the non-medical use of prescription drugs, a problem that 
affects a reported 6.4 million people, including an alarming number 
of teens, the president's director of drug-control policy announced 
in February in Portland.

Teens between 12 and 17 constituted one-third of all new abusers of 
prescription drugs in 2005, according to statistics released by the 
Office of National Drug Control Policy. The majority said they 
received the drugs from a friend or relative. A third said they 
believed prescription drugs are much safer than illegal drugs because 
they're prescribed by a doctor, the White House office reported.

Locally, younger addicts of opiate-derived painkillers are replacing 
the typically older heroin addicts at Jackson County's methadone 
clinic, said Clinic Manager Steve Brummett. Although the stigma 
associated with heroin and the lifestyle of an intravenous drug user 
have led to the narcotic's decline, the rising popularity of legal 
opiates has led to an increase of local methadone patients, Brummett said.

Last year, 160 clinic clients in Jackson County cited "other opiates" 
- -- largely prescription painkillers -- and non-prescribed methadone 
as their primary drug of addiction, representing 54 percent of 
clients, according to statistics compiled by Oregon Department of 
Human Services. During the same period, 137 clinic patients were 
treated for heroin addiction.

The numbers stand in contrast to heroin's prominence in other Oregon 
counties. Heroin addicts accounted for 79 percent of methadone-clinic 
patients last year in Marion County, 81 percent in Multnomah and 91 
percent in Lane, DHS reported.

Local prevalence of legal opiates comes as no surprise to Jim Shames, 
a physician employed by Jackson County Health and Human Services. 
Small metro areas such as Medford, Shames said, have higher instances 
per population of prescription-drug abuse. A demographic similar to 
meth's, the addiction is also more common among Caucasians.

Because Oregon doctors prescribe more opiates than those in other 
states, Shames said, he has spearheaded a local project to raise his 
peers' awareness of prescription-opiate addiction. His effort entails 
showing videotaped interviews with methadone patients who may have 
stepped onto the path of addiction in a local doctor's office.

"We have been at the forefront of wanting to treat chronic pain," Shames said.

Improving patients' lives while guarding against addiction poses a 
dilemma for many physicians, said Randy Nelson, chief of medicine at 
Southern Oregon Rehabilitation Center and Clinics in White City.

"There's a fair amount of pressure to treat pain and to treat it 
aggressively," Nelson said.

Physicians at SORCC recognize a certain number of patients -- all 
military veterans -- may already have histories of addiction to 
alcohol or illegal drugs and, thus, aim to handle those cases without 
prescribing more narcotics, Nelson said. Restoring a patient's 
ability to function is the goal, rather than erasing all pain, Nelson added.

"It's very, very difficult to have someone pain-free," he said.

Physicians at Pain Specialists of Southern Oregon reserve opiates as 
a last resort, said Dr. Joseph Savino. Unfortunately, a number of 
patients referred to his office arrive already in the grip of high 
doses and at risk for developing tolerance and dependency, he said.

"It's still controversial to use opiates for chronic, non-malignant 
pain," Savino said.

In an attempt to forestall abuse of prescription drugs, his clinic 
counts patients' pills and conducts random urine screening to detect 
medication levels that are either too high or too low, as well as the 
presence of other legal or illegal substances.

Among all patients in chronic pain, however, those who suffer 
addiction are relatively few, Savino said. While dependence is 
characterized by physical symptoms such as tremors and cravings, 
addiction is marked by "mal-adaptive" behavior such as forging or 
stealing medication, he added.

Theft of prescription drugs is on the rise locally. And the crime 
doesn't just threaten businesses, police said.

On Monday, burglars of Franck's Compounding Pharmacy in Medford made 
off with fentanyl, a powerful opiate painkiller that can be lethal 
even in small doses. The thieves also grabbed hydrocodone, oxycodone 
and methadone in amounts worth several hundred thousand dollars on 
the street, Medford police said.

The heist was the third pharmacy break-in reported this year in the 
county. Burglars also targeted Rogue River Pharmacy on the same day 
as Franck's. Rogue Valley Medical Center's Asante Health System 
pharmacy was raided for pain pills in early January.

In lieu of outright theft, more prescription-drug addicts have 
resorted to forging prescriptions when their doctor won't fill the 
bill, police said. Suspects arrested on charges of tampering with 
drug records more than doubled between 2003 and 2006. Local police 
booked 14 such suspects at the Jackson County Jail in 2003, 19 in 
2004, 23 in 2005 and 29 last year, according to statistics compiled 
by Medford Police Department.

"It can become a significant drain on the community," Savino said, 
adding that his clinic immediately reports anyone suspected of 
forging a prescription to police.

Kristin Kinsey, 33, never went so far as to forge a prescription for 
OxyContin. But the Central Point resident did steal pills from her 
own father, who needed them for a severe back injury.

"I felt desperate. I was sick ... physically," Kinsey said.

She started buying doses of methadone from a friend whose doctor had 
prescribed it. Realizing that nothing had worked so well for her pain 
or addiction, Kinsey used methadone exclusively for about six months.

"I didn't feel like I was Jonesing for pills," she said.

Kinsey knew about the county's methadone clinic but assumed it was 
only for heroin addicts. Running low on her own supply, Kinsey's 
friend and methadone connection encouraged her to visit the clinic. 
Kinsey's been a patient for three years.

Government-supported programs such as the county's have garnered 
criticism for substituting methadone dependency for illegal drug 
addiction. But proponents say the clinic contributes to public health 
and safety because patients are under the care of a doctor and don't 
engage in risky behavior to feed their habit.

"I've had people say, 'I can buy it cheaper,' but the problem is, 
it's not a steady supply," Brummett said.

Since becoming a clinic patient more than a year ago, Wick said he 
has never relied on another prescription painkiller. Despite feeling 
"more healthy" on his replacement drug, Wick said he hopes a regimen 
of physical therapy can soon give him the strength to pry the monkey 
of methadone off his back.

"I just want to be able to say I'm clean." 
- ---
MAP posted-by: Richard Lake