Reprinted from the Health District's quarterly publication mailed to district residents (Spring 2010)

Troy (not his real name) wasn’t looking for a high when he started taking prescription painkillers — he was looking for relief.

The 50-something Fort Collins resident got a prescription for OxyContin, an opioid painkiller, after injuring his back at work. He quickly found himself needing more and more of the prescription pills to function. When his doctor would no longer renew his prescription, he realized he had a new problem: drug addiction.

Troy is one of a growing number of people who abuse prescription drugs. Some come to the habit through legitimate means. Others seek out the high of prescription drugs outright. In all, the National Drug Abuse Institute estimates that 48 million people (ages 12 and older), about 20 percent of the U.S. population, have used prescription drugs for non-medical reasons in their lifetimes.

“During my 13 years in psychiatry, I’ve seen a real increase in the use of prescription drugs for their mind-altering purposes,” says Richard Oddy, M.D., a psychiatrist with a private practice in Fort Collins. “Certainly after marijuana, prescription medications are now the most prevalent.”

Getting hooked

Although many prescription drugs can be abused, opioids are the most addictive and therefore the most often abused. They are also the most dangerous in terms of the completely disastrous U-turn they can cause in the lives of otherwise healthy, law-abiding people.

“Opioids help some people with depression, acting as a mood elevator,” Oddy says. “For others, they relieve anxiety and help with drive and motivation.”

Even as the pain for which the opioid was prescribed decreases, the patient finds himself seeking out the drug for these newly discovered benefits.

“People build up a resistance, so they increase their dosage seeking to continue the positive effects of the drug,” Oddy explains. “But what they don’t realize is that they are developing a physical dependence on [the drug], and within about six months they are stuck.”

The two other most commonly abused types of prescription drugs are central-nervous-system depressants, which are used to treat anxiety and sleep disorders, and stimulants, which are prescribed to treat attention-deficit hyperactivity disorder (ADHD).

The two other most commonly abused types of prescription drugs are central-nervous-system depressants, which are used to treat anxiety and sleep disorders, and stimulants, which are prescribed to treat attention-deficit hyperactivity disorder (ADHD).

“A student might take Adderall to be able to study all through the night and then they find that they have trouble maintaining focus without it,” Oddy says. “Instead of solving the problem they had before, such as the inability to focus, they are worse off in the end because they have the original problem and the new problem of being addicted.”

Seeking a high

“It’s hard to lump all people who abuse themselves with prescription drugs into one pile,” says David Jones, supervisor for the substance abuse program at the Larimer Center for Mental Health. “Most of the time, folks have no idea what they’re getting into; they get injured at work, they’re prescribed pain meds and they wind up dependent on those drugs. But then there are a lot of teens and people in their early 20s who are seeking out the high they can get from prescription drugs.”

In the 2004 National Survey on Drug Use and Health, 4 percent of youth (ages 12 to 17) reported non-medical use of prescription medications in the past month.

“There’s just too many pain meds out there that create an alternative state,” Jones says. “Kids hear about them from their friends or on the Internet, and then maybe they see a bottle of the stuff in their parents’ medicine cabinet. Maybe you’re supposed to take one every four hours, and they take three all at once.”

On the streets and online

Medical and law enforcement officials say the biggest factor in the growing abuse of prescription drugs is their increasing availability.

“There was increasing pressure on the medical community to do a better job of medicating pain disorders, and so doctors got more comfortable prescribing painkillers,” Oddy says. “As a result, more people become addicted and the drugs are getting on the street more easily.”

Jo Ellen Isaly has run an addiction support group through the Larimer County courts for the past five years.
“I would have to say availability is playing a big role,” she says. “I ask the people in my group where they even get the stuff, and they say, ‘Just ask any one of us and we can tell you where to get it in a hurry.’”

Sgt. Paul Wood is head of the Fort Collins police department’s criminal impact unit, which enforces the laws regarding illegal use of prescription drugs.

“Over the last two years, we’ve seen a notable increase of either theft or robbery of drugs along the OxyContin line,” he says. “Prescriptions fraud is a good portion of that. People start out with a legitimate prescription, but as their addiction grows they go to four or five doctors to get the same prescription, steal a prescription pad or find a way to get it illegally on the Internet.”

Controlling it

Recognizing a growing problem, the medical community is taking measures to stop the increasing abuse of prescription drugs.

“Professional organizations of doctors that prescribe medicine for pain have swung from one end to the other,” Oddy says. “Doctors recognized the dangers of not recognizing and treating pain and began prescribing it more readily. Now there’s a fairly clear message that any patient prescribed medications for pain needs to be monitored for addiction.”

An increasing number of doctors require patients to sign a pain contract that delineates safe behavior in regard to taking pain meds. In addition, the state has set up a central database for pharmacists to monitor patients’ prescription medication use.

For those who have already developed a habit, there is new hope in the form of new addiction treatment drugs, such as Suboxone, which allows a patient to gradually break away from an addiction to prescription drugs.
“There is light at the end of the tunnel for people who have formed an addiction to prescription drugs,” Oddy says. “They can get back to their lives and leave the addiction behind them.”
 

For help with a prescription drug problem, talk to your doctor. You can also call Narcotics Anonymous at 282-8079. To speak with a counselor and for assistance finding treatment for an addiction, call Connections (a program of the Health District of Northern Larimer County in partnership with Larimer Center for Mental Health) at 221-5551.