Prescription Painkillers Are Gaining Addicts -- An

Pain Pills
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Prescription painkillers are gaining addicts -- and casualties

By Ken Raymond and Jim Killackey
The Oklahoman
Dec. 12, 2005

A 30-something Oklahoma City addict craved painkillers so much, he shoved a hat pin into his urethra, hoping blood in his urine would convince doctors to prescribe narcotics.
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Another Oklahoma City man intentionally burned himself and broke his thumb with a hammer -- on multiple occasions -- so doctors would give him more pills.

And a Tulsa man crushed his teeth, one by one, to obtain prescription pain relievers.

Those are among the horror stories doctors and addicts told The Oklahoman during a months-long investigation into prescription drug abuse.

In Oklahoma, controlled painkillers aren't just growing in popularity. They're also killing more people than any other drugs.

Three of the drugs -- methadone, oxycodone and hydrocodone -- accounted for nearly half of the state's 526 drug deaths in 2004, according to the state medical examiner's office.

Of the top 10 drugs identified during testing by the medical examiner, four (the three above, plus acetaminophen) were drugs most often used as pain relievers.

Four more -- commonly known as Valium, Xanax, Soma and Elavil -- are generally prescribed for anxiety or depression, but also are used as pain treatments for chronic pain patients.

"Unfortunately, we're a drug-addicted society," said Kevin Rowland, chief investigator for the state medical examiner's office. "And increasingly, we're getting addicted to prescription painkillers."

According to the U.S. Department of Health and Human Services, an estimated 180,000 Oklahomans, or about 5 percent of the state's population, have some chemical addiction or dependency related to prescription pain medications, illegal drugs or alcohol.

And a recent report by the National Center on Addiction and Substance Abuse found more Americans are abusing controlled prescription drugs than cocaine, hallucinogens, inhalants and heroin combined.

From 1992 to 2003, teenage abuse of prescription drugs rose 212 percent, while adult abuse rose 81 percent, according to the report. Also, the number of Americans abusing prescription drugs rose seven times faster than the increase in the country's population.

"It's definitely increased," said Steve Deutsch, an Oklahoma County assistant district attorney who prosecutes drug cases. "Not exponentially, but it's on the way up."

A different type of abuser
Prescription drug abusers often have little in common with other addicts, said Jeff Dismukes, spokesman for the state Department of Mental Health and Substance Abuse Services.

"A lot of them are older folks," Dismukes said. "They're professionals. They're people who have stumbled into it innocently."

No one knows this better than Dr. Lanny Anderson, who is responsible for steering state doctors into treatment for legal and illegal drug abuse.

He's never been busier.

"This isn't a just a bad habit or something that shows you're immoral or you're not a good enough Christian.

"It's truly a disease, which means you don't have power over it. You need help," said Anderson, head of the Oklahoma Health Professionals Recovery Program.

"Opiates take you to trouble-free places of less pain, less anxiety. They're terrific elixirs."

For those prone to addiction, though, painkillers can destroy relationships, careers and lives -- even for those who should know better.
For example, in 1998, Oklahoma City doctor Jeffrey H. Schimandle was accused of switching a patient's dose of Demerol with water so he could use the drug himself, according to the Oklahoma Board of Medical Licensure and Supervision.

His license to practice medicine was revoked.

That same year, Dr. Robert Ricketson issued medical orders while under the influence of Lortab, board records show. An anesthesiologist refused those orders because they could have worsened a patient's heart problem.

Ricketson's license also was revoked.

Pharmacists fall prey to temptation, too. Tandi Reheis, executive director of Oklahoma Pharmacists Helping Pharmacists, said 12 percent to 19 percent of the state's 3,000 pharmacists are thought to be addicted to alcohol or drugs.

"When they've got the key to the candy store ... they think they can medicate themselves," said John Duncan, chief agent for diversion for the Oklahoma Bureau of Narcotics and Dangerous Drugs Control. "Then it all gets out of hand."

Medical professionals aren't the only offenders, of course. Addicted patients break the law and even maim themselves in order to get their next fix.

"We had a guy with a pair of pliers up in Tulsa," Duncan said, "and he'd use them to crush a tooth and then go around to all the different doctors and dentists.

"Finally, he got to where he didn't have any more teeth left, so what he did is he got a razor blade and would cut himself and get an abscess, so he'd ... get more drugs. He finally died of a heart valve infection."

In another memorable case, Duncan said, a doctor received a phone call from a pharmacist trying to confirm a suspicious prescription for morphine.

"The doctor said, 'Well, I'm a pediatrician. I don't prescribe morphine. How did you know it was a fake?'" Duncan said.

"And the pharmacist said, 'It's for M-O-F-E-E-N, and it says: One kilo. Use as needed.'"

Stemming the tide
Determining who needs painkillers, what dosage they should receive and who is exhibiting addictive behavior is often a guessing game.

"The American Medical Association reports doctors feel underprepared in treating chronic pain versus acute pain," said Duncan, who teaches physicians about pain management. "Doctors also report being underprepared" in understanding how pain medications work.

Adding to the confusion is that people have different levels of pain and different reactions to medications, he said. A dosage that barely makes a dent in one person's pain might kill another, and not everyone who takes pain relievers, even in large doses over a prolonged period, will become addicted.

According to a 2001 report by three leading pain management organizations, patients using certain prescription painkillers "usually" develop a dependence on the drugs and "sometimes" build up a tolerance -- but don't usually become addicts.

So what are doctors to do?

A program under development by Duncan's agency may provide a partial solution. In 1990, the state narcotics bureau began a prescription monitoring system, called OSTAR, for Schedule II drugs, which include pain relievers such as codeine and morphine.

Hydrocodone, called the "most abused pharmaceutical drug in Oklahoma" by bureau Director Lonnie Wright, is among a number of Schedule III drugs. Their distribution has not been tracked with OSTAR.

That's about to change.

Wright's agency has received approval and $350,000 in federal money to expand OSTAR to include all schedules of drugs and make the information more easily available to medical professionals.

The database will be available to individual doctors for their patients, Duncan said.

"When they enter a registration number, they'll be able to pull up information on their patients and what they're taking," he said. It will also prompt spontaneous notification if a particular patient is going to multiple doctors to get the same drug."

OSTAR is expected to be fully operational in about a year, he said. He hopes it will enable doctors to intervene before their patients become addicted. At the least, it will identify people engaged in illegal "doctor shopping."

Anderson's group, which helps assure that drug-abusing doctors get treatment, offers physicians their own chance for rehabilitation. Reheis' program aids pharmacists in similar straits.

Those who continue to abuse or provide drugs to addicts illegally run the risk of facing Deutsch and other prosecutors across the state.

"You're sad for the people who are really addicted," Deutsch said. "The people who should burn in hell are the ones who prey on people who are addicted."
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Thanks for this thread. Atlas
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Cynical, just look at how many post on the pain pills topic versus all the other topics there. It is astounding how many more of us there are than all the other topics comined. These facts you state are certainly justified
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Here more, I just happened upon this.....
Click the links on the page to articles about perscription drug abuse....
http://arthritis.about.com/b/a/184967.htm
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Thanks Kath for sharing that. The part about the "MORFEEN", kilo? Cracked me up. I know it's not really funny, but I could totally see someone I know doing that.

Cowgirl
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This always touches something in me. I go to AA and the rooms are often packed. Then I look at this board and see the alcohol forum has the fewest posts. Must not be very many alcoholics, right? Somehow, I would not put any money on that.

Why the alcohol forum has the fewest posts is beyond me. As far as numbers of addicts are concerned, I think alcohol might win this "race" (oh, great). And why not? Its relatively cheap and its aquisition it totally legal. Its usage as a recreational drug is totally socially sanctioned. Powerful reasons for it to be the front runner.

From what I learned in my outpatient therapy, there are more alcohol overdoses (alcohol only in system), then ALL OTHER DRUGS combined. Hmmm, and why the fewest posts? Got me.
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My dear Uncle died from alcoholism. he was the most intelligent man in our family. He was charismatic, easy to be with, and often refered to as too smart for his own good. He died when I was very young. His neighbor found him face down on the floor of his house dead and alone. He had lost his marriage and his life because of this disease. The last thing I could imagine him doing would be posting on the internet. What I have found is that people who are drinking could care less about turning on a computer. They are drinking. my drug of choice allows me the energy to be socialable...(sp?).

I think there are as many if not more people suffering from alcoholism as there are rx pain med addicts. The effect of these diseases seems to differ in everyone... but I think that being under the influence of alcohol would make me less apt to get on the computer. I have maybe 2 glasses of wine a year, and I have no interest in the feeling of overindulgence of alcohol, but I do know how it feels to be drunk (I was a hellion in high school)....
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Tired is correct. People who are drinking could care less about a computer, and if they are detoxing, typing would be out of the question. Pill addicts can usually still function somewhat normally.
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I have found on this board that many had problems with alcohol as well as the pills. Some had some good clean time and found painpills, because of an injury, the dentist, whatever....And it tripped hell all over again. And some were using both as a means to get there, wherever thier where was.......
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Using whatever there was available...that can apply to many of us. Believe me, if I was totally out of my oxys, I would take vics, darvocet, methadone, tylenol #3, cough medicine w/ codiene, alcohol...anything to help.
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That thing about alcohol being socially acceptable...so true.

I came to this site because of my addiction to pills. I never really questioned my daily use of alcohol before. The pills...I knew I was over the top with them. Now I realize that I have nothing in common with social drinkers. Just because I don't have the same withdrawals from alcohol as the pills, I am still stuck in hell with both of them.

It was easy to rationalize my drinking. It's legal. Many people do it. What's the problem with having a "couple" of drinks to unwind before bed? Then I had to ask myself, if I don't have a problem with alcohol, then why, at 34 years old, do I try to hide it from my own mother? That sounds ridiculous, doesn't it?
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It is so easy to rationalize alcohol. But yes, if you are hiding the use of any substance, that is a red flag. Even if mom is a pain in the butt. Not saying yours is, Jodi, just that all moms can be.