Pubdate: Wed, 13 Mar 2013
Source: Pottstown Mercury (PA)
Copyright: 2013 The Mercury, a Journal Register Property
Contact:  http://www.pottstownmercury.com/
Details: http://www.mapinc.org/media/2287
Author: Frank Otto
Page: A3

GATEWAY TO HEROIN IS OFTEN LEGALLY PRESCRIBED DRUGS

By many accounts, the gateway to heroin addiction is not through 
other illicit drugs like cocaine or marijuana, but through 
prescription opiates like Oxycontin or Percocet. As such, one of the 
biggest ways to combat heroin addiction is to monitor or curtail the 
prescription of such powerful painkillers.

"The problem here in Pennsylvania is that there is nothing a 
physician can tap into to see if (addicts are) shopping. Legally, we 
do not have access to that information," said Dr. Greg Pierce, a 
doctor at the methadone clinic, Habit OPCO in Pottstown. "That would 
be huge to helping this war against opiate use."

Douglas Albertson, the clinic's director, said a system like the one 
Pierce references exists in Ohio and other states in the Midwest.

Habit OPCO has all of its patients dual-enroll with other methadone 
clinics so that they can track whether their patients have been 
seeking treatment elsewhere and attempting to "double-dip."

But Albertson and Pierce are unable to check up with physicians 
unless their patients give permission.

"I don't know where you've been," Pierce said. "You could have seen 
10 physicians that have prescribed opiates."

"We'd have to get a release from every physician within a 50-mile 
radius of this building," Albertson said. "That's how determined 
addicts can be."

The director of Temple University School of Medicine's Center for 
Substance Abuse Research said addiction to prescribed pain medication 
has grown markedly in recent years.

"Prescription opiate abuse has skyrocketed mainly due to 
availability," Dr. Ellen Unterwald said.

Addicts manipulate

Special law enforcement units have helped educate and cut down on 
overprescription of opiates in recent years, according to Lower 
Frederick Police Chief Paul Maxey, but issues do persist.

"The majority of doctors are ethical, legitimate doctors," Maxey 
said. "But there are doctors that will write these scripts for profit."

Albertson and Pierce said they have dealt with certain unscrupulous doctors.

"One of our patients said they went into the doctor's office and had 
a prescription written out for them (for a painkiller) before they 
even told them what was wrong," Albertson said.

Ethical doctors that are not pushing prescriptions for their own 
financial benefit can also be duped into feeding an addict's 
problems, according to Albertson and Pierce.

"Addicts are some of the smartest people I know," Albertson said.

"Once you let them know that you have the power to get them what they 
want, they know they've got you," Pierce said. "It's not hard for a 
patient to go into a doctor's office and recite the symptomology (of 
something requiring a painkiller) and present them and the doctor 
would go, 'Oh my gosh, OK, fine.'"

Coleen Watchorn, whose son Stephen died in August of an overdose 
after moving from prescription pills to heroin, says parents don't 
question doctors enough about the number of presriptions they give 
out. As a parent, you tell your child to take his medicine, and you 
don't know it may be too much, she said.

Then there's the manipulation once a person becomes addicted. "How 
many times can an addict say to a doctor, 'I lost my prescription,' 
before the doctor says, 'No you can't have any more,'?" she said.

Guarding against overprescription

The education of doctors into the manipulation by addicts could be 
paramount to cutting down on opiate addiction that could later lead to heroin.

Although only a small number of people get addicted to painkillers 
when they're properly prescribed and used, many of the problems arise 
when those prescriptions are shared with family or friends.

"They don't think that they're doing anything wrong," Pierce said. 
"They don't think they're committing a felony."

Pierce said workers could end up abusing painkillers and sharing them 
with colleagues just to get themselves through a physically taxing 
day. He said he's heard of Percocet being nicknamed "Work-ocet."

Some pharmacists are now using online databases with the 
encouragement of police to track prescriptions, a system that is 
helping, said Limerick Detective Matt Daywalt.

Area police have participated in the annual National Drug Take Back 
Program, sponsored by the U.S. Drug Enforcement Administration, which 
provides residents the opportunity to safely rid their homes of 
expired and unused prescription painkillers before they get in the 
hands of abusers.

Unterwald said research is also being done into the effects 
painkillers have when prescribed to younger children for issues like 
broken bones or other injuries.

To date, she said, there hasn't been much proof of a link between 
childhood prescription of opiates and later-life addiction to 
painkillers or heroin.

However, some of the behaviors that may have led to the injuries that 
require the painkillers might be indicators of a personality prone to 
such an addiction.

"Maybe you have a kid who is a risk taker," Unterwald said. "It's 
very well documented that kids who are risk-takers are more likely to 
be involved in substance abuse."

Albertson said he and the clinic he manages are doing everything they 
can to keep on the lookout for prescription abuse, striving to keep 
lines of communication open with local law enforcement and pharmacies.

"We are very accountable," he said. "This is very serious."
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