A growing number of women are becoming addicted to the prescriptions their M.D.’s insist will heal them. Here’s why – and how to tell if you could get in trouble with your next Rx.
After having back surgery in May 2001, Vicky, 34, was prescribed OxyContin, a powerful pain reliever. But the drug did more than merely alleviate her discomfort. The Tennessee native was out of bed within a few days and in a state of euphoria that made it seem as if she would never sleep again. Bursting with energy, she began cooking more elaborate meals, kept the house spotless, lavished attention on her husband and 6-year old daughter, “I felt like Superwife,” recalls Vicky. Deep down she knew that all the energy was coming from her OxyContin and that maybe she was beginning to love it a little too much. But was she an addict? No way. A former high school valedictorian and homecoming queen, Vicky didn’t smoke or drink. And she’d been prescribed painkillers before and had been just fine. “I knew I wasn’t taking OxyContin for the back pain anymore,” she says, “but I figured I’d just stop once the month-long prescription ran out.”
But after four days without the drug, Vicky (who doesn’t want her last name used) was bedridden with fatigue and flu-like symptoms. “At this point, I pretty much knew I was addicted to OxyContin,” she says, “I wish my doctor had told me from the beginning that this would happen. But I was too into the drug to bring up this concern with him.” Instead, she asked for a refill, saying she was still in pain from her surgery. Her physician gladly obliged, not bothering to ask Vicky if she was experiencing any signs of dependence or any side effects from the drug.
Three refills later, Vicky caller her physician to make an appointment to get a fourth – but found out he was booked for three weeks. Desperate for her fix, she turned to a street dealer, referred by a relative who occasionally popped pills for kicks. For months, after church on Sundays, Vicky would make excuses to drive alone – and once even with her daughter – to a run-down drug shack to get the medication. And since her tolerance for OxyContin had gown so much that taking the pills orally couldn’t keep her pain-free and energized, Vicky started crushing and snorting the drug.
To get the cash, Vicky secretly drained the money her family had saved for a down payment on a new house and sold some of her jewelry, spending $75,000 in total on her addiction. Her husband, who suspected she was abusing OxyContin but trusted her when she said no, put two and two together when one noticed that the down payment had disappeared – and threatened to divorce her. “I compromised everything,” says Vicky, who finally managed to kick her habit in August 2002 at the Waismann Institute, a detox facility in Beverly Hills, California. Since then she’s worked on undoing the damage she wreaked on her family. “I feel terrible that I lied to my daughter and husband,” she says. “I could have lost them, and even my life.”
Vicky isn’t the only woman who’s gotten in trouble with drugs she first got from her doctor. In 2001 nearly 5 million Americans said they’d used prescription pain relievers, sedatives, or stimulants for “non-medical”reasons (meaning for something other than their intended purpose, such as for the “high”), according to the Substance Abuse and Mental Health Services Administration (SAMHSA), a public health agency within the Department of Health and Human Services. And while people who pop pills once or twice for kicks don’t always end up addicted (which is defined as having an uncontrollable craving for the drug), others aren’t so lucky. According to SAMHSA, emergency rooms across the country are seeing more and more people who’ve overdosed on these pills or taken them in life-threatening combinations with other substances, such as alcohol; and ER visits involving the abuse of pain relievers – OxyContin, for example – more than doubled, to nearly 100,000, from 1994 to 2001.
Prescription addicts aren’t your stereotypical junkies. “Many are ‘unwitting’ addicts,” says Rod Colvin, author of Prescription Drug Addiction: The Hidden Epidemic. “They have no history of drug abuse but begin taking a drug for legitimate reasons, as directed by their doctor.” And since these drugs are FDA-approved, many patients assume they’re safe. But sometimes they aren’t – and many doctors, nurses, and pharmacies aren’t doing enough to protect patients, says Colvin.
Women are especially at risk for prescription-drug abuse, largely because they’re more likely to be exposed to these medications. Why? Because in general, women are more comfortable seeking medical attention for discomfort, depression, and anxiety than men are, says Michael M. Miller, M.D., chairman of the public policy committee of the American Society of Addiction Medicine (ASAM) and medical director of NewStart alcohol and drug treatment program at Meriter Hospital in Madison, Wisconsin. The result: Women, while they make up the minority of abusers of alcohol, constitute approximately half of prescription-drug addicts, estimates Miller.
What makes these drugs so quietly addictive for women? And why aren’t doctors, hospitals, and pharmacies doing more to protect patients?
Powerful – But Dangerous – New Prescriptions
While prescription addiction is hardly new, it’s become way more widespread than the “sleeping pill” habit Marilyn Monroe and other stars had in the past. Today dozens of brands of potentially addictive pills are prescribed for a range of ailments. According to Colvin, there are three main types: pain relievers, also called narcotics or opioids because they’re derived from opium (OxyContin, codeine, and Lortab); sedatives (Valium, Xanax, and Ativan), which are usually prescribed for anxiety, panic attacks, and insomnia; and stimulants (Ritalin, Dexedrine), which are used to treat attention-deficit hyperactivity disorder, and sometimes to help women lost weight. What makes these drugs addictive is their ability to mimic the body’s own natural feel-good chemicals (like endorphins and dopamine) and this makes the user feel calmer or more energized, depending on the drug. The problem is, when the body gets these chemicals from an outside source, it gradually makes fewer of its own. So when you try to stop taking these drugs after a few weeks on them, the sudden drop in endorphin and dopamine levels can trigger symptoms of withdrawal, such as depression, anxiety, chills, and insomnia. In rare cases, withdrawal can initiate brain seizures, which can result in death, says Michael Fleming, a family physician in Shreveport, Louisiana, and president-elect of the American Academy of Family Physicians.
That’s not to say that these drugs should just be taken off the market. “The FDA approved these drugs for a reason: They allow people in pain or with anxiety or other disorders to lead normal lives,” points out Colvin. But Stuart Gitlow, a psychiatrist and a delegate from the American Society of Addiction Medicine to the American Medical Association (AMA), believes that for most patients these drugs should be used only for short periods (no more than a few weeks). “If you’re having a root canal, three days of pain reliever is fine; or if you get anxious every time you fly in an airplane, taking one sedative is fine,” he says. “But unless a patient isn’t responding to other medications, habit-forming drugs aren’t good solutions for long-term problems, like if you’re in chronic pain or constantly anxious. That’s because the longer you’re on these drugs, the more difficult it is to stop taking them.”
Before prescribing addictive medications, doctors should carefully screen patients to see if they’re good candidates for them – a task many physicians fail at, says Gitlow. “Given that 10 to 20 percent of Americans will develop a substance abuse disorder, including alcoholism, at some point in their lives, I think any doctor prescribing addictive drugs should do so carefully,” he says. Background checks are especially important because a predisposition for addiction is often genetic. “People who have a first-degree relative with a substance-abuse disorder, like alcoholism, have a seven-to-eightfold-increased likelihood of having substance-abuse disorder themselves,” says Gitlow. “That family history is important info for doctors to know, and unfortunately not enough are asking for it.”
Once doctors prescribe these medications, many don’t even tell patients they’re habit-forming, says Colvin. “I’ve spoken with many recovering addicts who had no idea they were taking an addictive drug until they were really in trouble.” Why aren’t doctors warning patients? “They’re too busy and they assume it won’t be a problem,” Colvin explains. “In most cases they’re right. But when they’re wrong, the results can be catastrophic.”