After a suicide, I stood in the room where Alice (name is changed) chose to overdose herself. I held a half-dozen pill bottles and shook my head as I looked at the labels and wondered if the cocktail of medications and a glass of wine had created the perfect storm, a way to leave her young children, family and friends behind, wishing for one more chance to love her tender heart. Who had prescribed them, how had they made her feel and why did medication for relieving pain caused by illness become a weapon for ending her life?
The CDC reports that, "Drug overdose was the leading cause of injury death in 2011," more than traffic crashes, with 55 percent of deaths related to prescription drugs.
Christopher, a pharmacist with a Pharm. D. degree recently shared his perspective on the prescription drug abuse epidemic. He acknowledged that patients are often experiencing serious pain and in need of pain medication. He said, "Not everybody that is on pain medication is addicted...pain is so subjective."
As a pharmacist, Christopher has observed that there are a number of alternate ways for physicians to treat pain. He noted that often physicians simply write a prescription for a pain medication when the patient might benefit from physical therapy, diet changes, anti-inflammatory medication, mental health help or other alternate treatments.
Webster's Dictionary defines addiction as, "persistent compulsive use of a substance known by the user to be harmful." In other words, knowing it hurts you and doing it anyway.
Christopher said, "... prescription use becomes prescription abuse when you are using it more often than what your doctor prescribed. Or, if you are taking someone else's medication that was not prescribed for you." He also pointed out that there is a difference between dependence on a medication, whether it is mental or physical, and addiction.
I asked Christopher to share his experience with prescription drug addiction. He offered, "Sometimes children will steal medications from their parents including pain medications, anti-anxiety medications and weight-loss medications. I have even seen where parents have taken ADHD medications from their own children. I have seen patients abuse the emergency room, urgent care and multiple specialty doctors and primary care doctors in an attempt to get pain medications. I have seen patients drive as far as two to three hours away when they have 'used up' all of their doctors in their local community."
Why do we do it?
As a sexual and domestic assault advocate who provided trauma recovery groups and met with hundreds of victims, I learned that the need to numb psychological or physical pain is very real. If survivors don't have healthy coping skills for pain or trauma like exercise, spiritual guidance or counseling, they may turn to costly methods for coping like addiction, eating disorders and other self-destructive behaviors.
Helpguide.org lists symptoms people with post-traumatic stress disorder may experience, including very real physical aches and pains. Sexual assault survivors may feel very real and unexplainable abdominal pain. Veterans initially treated for very real physical pain may later develop a psychological dependence on pain medication which can develop into an addiction. Tired mothers who live stressful lives may experience real physical pain and misuse prescriptions to escape emotional pain.
No one is immune to addiction. Lisa Ling explored a young woman's addiction for CNN.
How do you know if someone you love is addicted to pain meds and what can you do about it?
Physical symptoms might include
-
Physical changes.
-
Bloodshot eyes.
-
Pupils that are bigger or smaller than usual.
-
Changes in appetite or weight.
-
Changes in sleep patterns.
-
Slurred speech.
Behavioral signs might include
-
Changes including new or different friends.
-
Stealing medication from parents, friends or family members.
-
Asking for more money than usual.
-
Doctor shopping or going to multiple doctors for multiple prescriptions.
Additional information on addiction can be found at
NA Links for all 50 states providing free 12-step programs in your local area
States like Oregon are now creating prescription drug monitoring programs which will allow physicians and pharmacists to monitor prescription drug use. Christopher explained that soon, "... It will require an original prescription, rather than a fax or phone call."
As it gets harder to get prescription drugs, addicts will go to increasingly difficult lengths, including turning to street drugs like heroin, which is cheap.
Some ways addicts obtain the medications they are addicted to include
-
Forging or altering prescriptions.
-
Taking other people's medication.
-
Buying or stealing medication. Some medications go for a dollar a milligram or for $20 for a 20 mg pill.
-
Doctor shopping or going to several different doctors to get the desired medication.
-
Teens may use dextromethorphan or cough medications. This can lead to hallucinations and, on rare occasions if mixed with alcohol, can lead to coma or death.
Alice's life had become the perfect storm. Serious illness caused family doctors and specialists to prescribe a cocktail of medication. Life stressors existed that would cause anyone to feel depressed, anxious and overwhelmed. Therapy was conducted in a contained office. And then when her life felt like it was imploding, a new prescription was added without enough monitoring. Throw one more family stress on the fire, add alcohol and Alice's life ended in a painful and heartbreaking way.
Are you or someone you love taking one more pill than you should, showing signs of prescription drug abuse or seeking out cheaper street drugs after starting with prescription drugs? Ask Alice's children. There is a better answer for your pain.