Prescription drugs present a unique challenge to those of us who treat chemical dependency. Our culture demands immediate relief of discomfort, so when something ails us, taking a pill is one way we cope. This is often effective, and when appropriate, even long-term use of certain drugs keeps many of us healthy and functioning. Even treatment programs often turn to medications like Antabuse, Methadone or Naltrexone to help patients overcome addiction to alcohol and other drugs.
Still, we find addiction to prescription products in many of the people we treat at Serenity Lane. Given that drugs are effective in so many healthcare situations, how do we know when ongoing use is helpful and when it may be a problem? Here are some of the warning signs:
Focus on strong painkillers. Many painkillers are based on natural or synthetic opium derivatives – among the most addictive substances on earth. While very effective, these drugs can create powerful withdrawal symptoms, including depression or craving, even after occasional use. That can increase the likelihood of dependency. Common examples are Vicodin, Tylox, Demerol and Darvocet.
Ongoing use of tranquilizers. At Serenity Lane, we sometimes encounter patients dependent on tranquilizers, including Xanax and Clonopin. A number of these chemicals are fat-soluble, so they can build up in the brain, liver and other fatty tissues. People who stop taking the drug experience significant changes in body chemistry, changes that can be extremely uncomfortable and discourage them from addressing the underlying problems that caused the anxiety or depression in the first place. This psychological/physical combination is an important component of addiction.
Increased use over time. One of the first indicators of addiction is the need to take increasing amounts of a drug to get the same "relief." If you're taking more than you used to, your risk of developing dependency is increased.
Behavior changes and other problems. A combination of personality changes, mood swings, increased conflict at home, problems at work, financial difficulties, hidden drug use and certainly, problems with the law may well indicate a drug problem.
Drug-seeking behavior. Treatment professionals and medical staffers now consider a number of behaviors to be "drug-seeking." These generally include some combination of the following: frequent complaints of pain that is hard to substantiate; frequent visits to an emergency room (where there are few or no long-term patient records kept); manipulation of the physician by subtly steering him or her to the drug desired; or multiple prescriptions for the same drug from different doctors who don't work together. Of course, by themselves, these behaviors may well indicate a legitimate medical condition. Taken together, however, they can indicate an emerging or existing pattern of chemical dependency.
There are a number of ways that we can get the health benefits of prescription products while minimizing the chance of becoming addicted in the full sense of the word. First, of course, we have to become aware of the signs of addiction the same way we would learn about the symptoms of an unhealthy drug interaction.
Second, we need to take charge of the drugs our family members use, particularly older people who tend to take medications for a variety of conditions. If you're concerned about the number and type of drugs in the medicine cabinet, behavior changes or other problems, call your doctor's office (before you make any changes!). Medical professionals now receive more training in addiction than they used to and they certainly want to know if the product they're prescribing seems to be causing problems beyond expected side effects. And educate yourself. The Physician's Desk Reference is available in most bookstores, as are other reference materials, and the Internet can be a good source of information. Hospital information lines like Ask-A-Nurse can be helpful, too, and treatment centers can provide assessments when symptoms of addiction are apparent.
Third, don't assume that just because a drug is prescribed it can't hurt you. A recent news report detailed tens of thousands of people who died last year from taking drugs prescribed for them. Interactions can be harmful or fatal. Don't be afraid to ask your doctor and pharmacist questions about drug interactions and dependency. And if you can, buy all of your drugs from the same pharmacy, especially if it has one of the new computer systems that track interaction dangers.
Today, more medications are available than ever before to ease physical and emotional pain and suffering. When used properly, these products can have a dramatic impact on the quality of our lives. But make no mistake about it: certain kinds of drugs, prescribed legally every day, can be very addictive. Knowing the warning signs, looking out for each other, taking charge of our health and asking questions of our medical professionals are the best ways to make sure we're keeping risks at a minimum while getting the benefits we want.
The previous article, written by Jerry Gjesvold, was first published in the Register Guard newspaper, Eugene, Oregon as part of "Straight Stuff" a monthly newspaper column about substance abuse and related topics. © Serenity Lane, Inc. 1997
The opinions expressed in this column are those of the writer