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While
Berry would like to enroll in an inpatient or outpatient drug rehabilitation
program, neither is covered by her health insurance - a common predicament
with prescription-drug abuse, says Steven Juergens, M.D., an addiction expert
at Virginia Mason Medical Center in Seattle. "Prescription-drug
withdrawal can take up to three weeks, while withdrawal from alcohol
and cocaine can happen in a few days," says Juergens. "That
time difference amounts to a lot of money, and many health-insurance
companies won't pay for it." According to Colvin, the cost
of 28-day inpatient treatment programs ranges from a whopping $14,000
to $30,000, and partial-day hospital programs cost between $250
and $400 a day.
On her own, Berry's
gone from taking six Ativan to half a pill a day. Still, every
day is a struggle, and she and her husband are contemplating
divorce because of the drug's impact on her life. "Now my kids take care of me instead
of the other was around," she says. "On my really bad
days, I feel like I've gone insane and beg ny husband to put me
in a mental institution. He tells me it's the medication's fault,
not mine. I try to keep believing him."
Health Care in Crisis
At first glance, stories of prescription-drug
abuse just don't add up. How can FDA-approved drugs be ruining
so many women's lives? The main problem, says Miller, is that doctors
increasingly use pills to solve an array of complex medical problems.
"There's little education for physicians on how to respond
to patient discomfort other than by writing a prescription,"
he says. "Patients, inundated with ads of "miracle"
drugs on TV, are increasingly demanding pills too. Why se a psychologist
or physical therapist for months or years when you can pop a pill
and feel fine? "We're in a society that expects a quick fix
to everything," says Gitlow. "Doctors are undoubtedly
feeling this pressure. When they see a patient suffering, their
first reaction is often to make them comfortable as quickly as
possible."
But why aren't doctors sufficiently
addressing the potential for addiction by screening, educating,
and checking up on patients? Largely because the majority of doctors
have little or no training in diagnosing or treating addiction.
According to a survey conducted by the Journal of Addictive
Diseases, 56 percent of doctors have only a small amount of
training in addiction; 20 percent reported having none at all.
Combine this with physicians' increasingly tight schedules, and
you've got an accident waiting to happen. "Many doctors lack the time
or training to make sure patients don't get addicted to prescription
drugs," says Jamie Court, executive director of the nonprofit
Foundation for Taxpayer and Consumer Rights in Santa Monica, California,
and an author of Making a Killing: HMOs and the Threat to Your
Health.
In an ideal world,
says Cynthia Romero, a family physician in Virginia beach, Virginia, "I'd like to
see 15 patients a day. But since reimbursements from health insurance
companies haven't risen to meet the costs of running my business,"
she continues," I have to see 20 to 30 patients a day to make
my overhead." And in the 15 minutes she has per patient, there
often isn't time to educate patients about all the dangers of addictive
drugs or to fully assess their backgrounds. "I do what I can,
but it's impossible to do everything," she says. "Sometimes
I'm forced to cut visits short."
Plus, Romero adds, patients often
don't appreciate when she does take the time to discuss
a medication's potential for addiction. "When I start to explain
how a drug works, they roll their eyes and say, 'Come on, doc, I've
been on this medication for years; no one else has ever asked me
these questions,'" she says. She fears that these time-pressed
patients won't return and will choose instead to go to doctors who
offer faster service without thoroughly reviewing their symptoms
and the potential side effects of medications they prescribe. "It's
a tough situation," she says. |
But
busy doctors are only part of the problem; Colvin emphasizes
that pharmacies could also do more to stop prescription drug
abuse. "Most pharmacies
have now way of knowing if a patient is doctor-shopping in order
to fill numerous prescriptions for the same drug," says Colvin.
Some states are making progress on this front, however: Currently
17 states have centralized electronic monitoring systems that can
track whether someone's filling excessive prescriptions in various
pharmacies; names of people who do so can be turned over to law
enforcement. "But until these monitoring programs are in place nationwide,
many people will continue to get away with fooling pharmacies -
and stay addicted," says Colvin.
How To Get Healthy - Not Hooked
"While we'll
probably never stop all prescription drug addiction,
we can do something about the 'unwitting' addicts - people who
innocently end up hooked," says Colvin.
To avoid this fate, patients must take a more active role in their
health care, and broach subjects their doctors may be too busy
to bring up themselves:
-
When prescribed any drug, ask your
doctor if it's addictive. 'Many people get hooked on prescription
drugs merely because the don't realize the drug they're on
is habit-forming," explains
Colvin. "By knowing this from the outset, patients can
avoid becoming addicts through sheer ignorance."
-
If ay any point you feel your doctor is not taking the time
to fully understand your problems or explain your treatment and
its side effects, insist on seeing a physician who will - if possible,
someone who specializes in pain management, anxiety disorders,
or addiction.
- If the drug you're being prescribed
is habit forming, ask your doctor, "How quickly could I develop a dependence?"
With opioids and sedatives, dependence can occur in two to four
weeks; with stimulants, in one to three weeks, says Fleming.
If you're on these drugs for this amount of time or longer, discuss
with your doctor how you should taper off the drug to prevent
withdrawal symptoms.
-
While you're taking these drugs,
monitor yourself for signs of addiction. Colvin suggests
keeping these questions in mind: Have you ever felt that
the amount of the drug you're prescribed isn't working as
well as it used to? Do you experience more than just symptom
relief on the drug, such as a feeling of excitement, or a "high"?
Do you feel that you can perform certain tasks or activities
(like driving in traffic or socializing at parties ) only with the medication? If you answer yes
to any of these questions, this may be a sign that you should
broach the subject of addiction with your doctor.
-
While on these drugs, ask three
friends or family members to keep an eye on you as well.
Say to them, "I'm on a medication
that's potentially addictive. Can you tell me if you notice my
personality changing over time - say, if I'm acting too happy,
or more remote or irritable than usual?" The less secrecy
and shame you have about using these drugs, the more likely you
are to get help if you need it, says Colvin. "Most people
understand alcoholism," he says. "But when an addict's
drug of choice comes from a doctor, there's a lot more confusion.
People think, Maybe she's supposed to be taking these. The
more people who know that prescription
drugs can be a problem,
the faster we can stop this epidemic of addiction.
For more information, please  call (310) 205-0808 or (888) 987-HOPE or  send us a confidential email.
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