For a number of years the abuse of prescription drugs has been making headlines as the general public learns of the consequences of taking these powerful medications. When we hear of people driving under the influence or committing domestic violence, we have assumed that alcohol was the problem, but now a growing list of celebrities admitting presciption drug abuse highlight this increasing social problem. Almost 50 million people, approximately 20% of the US population, have used prescription drugs for non-medical reasons during their lifetimes.
We see several classes of drugs more commonly abused by the patients who come to Residence XII. Opiates, originally derived from opium, are a powerful class of drug used for pain relief and include Darvon, Demerol, Dilaudid, MS Contin, OxyContin, Vicodin, and Percocet to name a few. In therapeutic doses these drugs relieve pain effectively. Abuse of opiates, however, leads to physical addiction with mild to severe withdrawal symptoms that mimic the flu. Opiate abuse can affect breathing/respiration and create a number of other serious health issues. Opiates are the most commonly abused prescription drugs in the United States.
Another commonly abused class of drug is tranquilizers and sedatives. Benzodiazepines were developed in the sixties and seventies to treat anxiety, sleep disorders and panic attacks by decreasing brain activity. We see patients who become reliant on Valium, Librium, Xanax, Ativan and Klonopin. When used in therapeutic dosages, these medications are a short-term answer for acute episodes of emotional and physical distress but were not intended for long-term use. Benzodiazepines can be highly addictive because over time the body requires higher doses to achieve the same initial effect. Withdrawal from this class of drug calls for close monitoring as the brain’s activity can rebound and race out of control leading to seizures or other harmful results.
We find that many of the women who come to Residence XII have abused medications given to them by their physician or psychiatrist. As the addiction progresses, we see women using multiple doctors, emergency rooms and walk-in clinics as sources for their drugs. Sometimes these drugs are purchased on the street from the same dealers who provide heroin, marijuana and other street drugs. We have seen a significant rise in the number of women who access the internet to buy drugs from multiple drug sites in virtual anonymity. The majority of these women started using opiates in response to specific health issues such as chronic pain, multiple surgeries and accidents but physicians and psychiatrists also prescribe benzodiazepines for major life changes that bring a degree of anxiety and worry such as divorce, job loss, death of a loved one, and trauma.
Research studies indicate that women are more likely than men to be prescribed abusable prescription drugs, especially opiates/prescription narcotics and benzodiazepines, the anti-anxiety drugs. In some cases, women are 55% more likely to be prescribed these drugs. In addition research has shown that women have an increased risk for abuse of these narcotics and tranquilizers. Residence XII sees younger women using opiates and benzos that are stolen from parents, friends or family, although some younger women are put on high risk medications for sports-related injuries, menstrual problems and panic attacks. Women age 65 or older are more likely to unintentionally misuse drugs due to long-term use and multiple prescriptions but are also at risk for taking drugs that are not medically necessary. High rates of multiple illnesses, changes in drug metabolism with age, and the potential for drug interactions can have more adverse health consequences with this group than a younger population.
Treatment for prescription drug use may start with a medical detoxification. There are several hospitals in the Puget Sound area that provide medical monitoring for withdrawal. If medical detox is necessary it usually lasts three to seven days, depending on the drug being used, the amounts and frequency, and the combinations of alcohol and drugs used. After detoxification, women are admitted to either a residential or intensive outpatient setting where they participate in education about the disease of addiction and behavioral counseling to identify problem areas that may trigger use.
With women who use opiates, significant time is spent on pain management and learning alternative tools to deal with pain. Those who have depended on benzodiazepines identify triggers to anxiety, panic and depression and learn tools to deal with the emotions before they escalate out of control. Behavioral treatments can help women improve their relationships and ability to function at work and elsewhere. Ongoing support is crucial for all substance abusers. The 12-step program of Narcotics Anonymous is seeing more prescription drug addicts and Dual Recovery Anonymous supports women dealing with depression and anxiety, as well as addiction.
Residence XII provides a support group for women who are addicted to prescribed medications. The Rx group meets on Wednesday evenings from 7 to 8:30 pm. This group is structured in much the same way as a 12 step meeting but also provides the opportunity to give each other feedback. The Rx meeting is facilitated by a Residence XII Counselor. Women in recovery from the abuse of prescription medications must be up front with their health care providers, tell them about their addiction history and be active in their treatment planning, especially around medications.
Source for information provided: NIDA, Research Report Series, Prescription Drugs, Abuse and Addiction Rev. 2005