A prescription for drug abuse

Published 9:00 pm Saturday, May 19, 2001

By Angie Wagner

Associated Press

LAS VEGAS — Thanksgiving and Christmas came and went, and Jan hardly noticed. She slept a lot, trying to get off the prescription painkillers that consumed her days. She crashed her car for the third time, and once passed out at work for three hours.

"I knew I was in trouble," she said. "I didn’t see how I was going to survive."

At 48, Jan now has a good job as a bookkeeper at a beauty salon and has been married 14 years. She’s also a recovering prescription drug addict, one of an estimated 4 million in the United States and part of what the head of the National Institute on Drug Abuse calls "a dangerous new drug abuse trend."

Patients take drugs to relieve pain, calm stress or get to sleep — then sometimes can’t stop. So they turn to a network of suppliers, from friends to co-workers to underground sellers. Or they visit multiple doctors to get the same prescription. Some even break into drugstores or forge prescriptions on stolen prescription pads.

The newest concern is OxyContin, a synthetic morphine used to treat severe cancer pain that has become the illicit drug of choice in some parts of the country. State law enforcement chiefs are so worried that they announced a national task force last week to fight Oxy abuse.

For Jan, who spoke on condition that her last name not be used, the problems started 12 years ago when a psychiatrist prescribed the sedative Xanax for her severe panic attacks. She liked the way they made her feel — calm, in control, self-confident.

"I absolutely loved them. They solved everything," she said.

Soon she built up a tolerance and needed more. So she got Xanax prescriptions from four doctors and took the prescriptions to different pharmacies. No one ever questioned her, she said: "It was easy."

Taking up to 20 pills a day, she tried to give them up but turned to alcohol to combat the withdrawal. When she couldn’t get out of bed, her husband, Peter, figured she had the flu.

"I didn’t know at all. I’m not a particularly suspicious type," he said.

Finally, after five years, she knew it had to stop.

She told her psychiatrist and checked into a detoxification center for 14 days. She continued with outpatient treatment, but fighting her addiction took her away from her construction company payroll job, and the company replaced her. Though she could have returned in a different position, "I was too embarrassed to go back."

So she took college classes and got a new job doing payroll at a casino. After three years, she stopped treatment, thinking she was cured.

She wasn’t.

"You sit back and go, ‘How did this happen to me? How did I do this again?’ she said. "It just escalated."

State attorneys general said last week they will study several state efforts to fight prescription drug abuse and make recommendations to their legislatures.

A potential model includes a Kentucky database that doctors, pharmacists, police, prosecutors and others can use to figure out whether a person is filling multiple prescriptions for the same drug at different locations.

A similar system used in Nevada since 1997 scans prescriptions and flags the names of patients who "doctor shop" to get multiple prescriptions for controlled substances. The information is given to the patients’ doctors and pharmacies, and they can decide whether to ask the patients if they need help, said Keith Macdonald, executive secretary for the Nevada State Board of Pharmacy.

Only the program administrator and another worker have direct access to the Nevada database, because it’s used to prevent drug abuse, not for enforcement, Macdonald said. Authorities investigating patients who may be illegally selling drugs are given information only by request.

A computer scans 2 million controlled-substance prescriptions each year. In 1998, 162 patients were flagged and half of them decreased the number of prescriptions they were getting in the next year.

A year later, with an additional worker, the system identified 475 patients and the system tracked a 41 percent decrease in those patients’ prescriptions.

"We have calls from patients who say, ‘I never realized how bad I was,’ " Macdonald said.

In the summer of 1998, Jan’s nightmare returned. She pulled a muscle in her back and didn’t hesitate when a friend offered her the painkiller Loritab.

Then, prescribed Percocet for pain after dental work, she took three pills when she was told to take just one. Soon she was paying $500 a week for her pills, taking by her count 30 to 40 Percocets a day and skipping mortgage payments. When she tried to go without, she stayed in bed for days.

Three times, she got into minor car accidents while driving to get more pills. Her house was in foreclosure, her job in jeopardy, and by the time she passed out at work, she knew she needed help. She checked into a drug treatment hospital again.

A year and a half later, "I’m still trying to clean up all the wreckage."

At the Pills Anonymous meetings she attends, the addicts tell their stories one by one. Several got hooked on pain pills after surgery; others can’t really say how it happened.

"It’s been the absolute hardest thing I’ve ever done in my life," one says of his recovery.

Looking back, Jan said she should have known she was at risk. Her older brother had been addicted to sleeping pills and alcohol when he committed suicide eight years ago. Her uncle and grandfather were alcoholics.

Her husband says his own father was addicted to prescription drugs and alcohol before dying in 1983.

"This stuff is so powerful. The consequences are just devastating," he said.

Peter attends every Pills Anonymous meeting with his wife, offering support and telling his father’s story.

Still, for Jan, there is always the temptation. Once she picked up a Loritab prescription for her mother. "I had it in my hand, and it was like it was glued to my hand."

She resisted.

"Does this obsession ever go away? she asks. "There’s times when I think — I’d like to have six pain pills right now."

On the Net:

Substance Abuse and Mental Health Services Administration: www.samhsa.gov

National Institute on Drug Abuse: www.drugabuse.gov

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