By Samina Khan
Drug addiction: the term carries with it many social prejudices and stereotypes - images of needles, homelessness and utter desperation and whilst this image may be true for a small percentage of drug addicts what is not so well known and in many ways hidden are the vast numbers of people who are addicted to prescription medications. These addicts may well hold down well paid jobs, be actively involved in their families and communities and yet their need for their prescription drugs whether oxycontin, tramadol, adderal, or xanax is just as desperate as with any other addict. Yes, these may be prescribed by a doctor but in terms of the impacts upon an individuals health and well-being, over the long term prescription drugs can be seen just as harmful as the more illicit drugs. This is the hidden side of addiction that for every “illegal” addict there will be someone suffering in a similar way but with their addiction being legally sanctioned.
52,000 Americans died of overdoses in 2015
At Hope many of the clients who come to us for treatment also come with a prescription drug dependence. It is not surprising that a majority of these clients come from the United States- America leads the world in terms of opioid addiction. Some sobering statistics bear testament to this fact- whilst the States makes up less than 5% of the world's total population it contributes to 75% of the world's opioid prescription drugs and even more shocking is the fact that drug overdoses are the most common cause of unintentional death within the United States - fifty two thousand Americans died of overdoses in 2015 - four times as many as died from gun deaths. Of the 20.5 million Americans that had a substance use disorder in 2015, 2 million had a substance use disorder involving prescription pain relievers.
So why is this? Why do the United States lead the way in the over prescription and the resulting dependence upon these prescription medications? According to Dr Sanjay Gupta there are a number a factors creating this “perfect storm” of dependency and overdose. Firstly is the power of insurance companies within the States to dictate the medical approach- on the surface pills are much cheaper option than a multidisciplinary approach and cost savings are the holy grail for these companies.
Pharmaceutical companies make enormous profits with opioids
What is also true is that the perceived cost savings for insurance companies also equate with enormous profits for the pharmaceutical companies that can provide the pills that appear to be the most effective. And appearance is the key word. For whilst most opioids do provide temporary relief for their users they also come with the almost certain risk of dependency and addictions. These risks were so well known that in 1914 Congress passed the Harrison Narcotics Tax Act threatening jail for doctors who prescribed opiates to addicts, however in the intervening years much has changed.
According to Gupta one paper written in 1986 by Dr Russell Portenoy (the so called “King of Pain”) was the turning point. Before the launch of his paper- which was based on just 38 patients- opioids had not been widely prescribed because of the concern over their addictive qualities; however Dr. Portenoy basing his claims on the small group he had studied, claimed that opioids could be used for literally years on end, they were easy to quit and overdoses were rare. With the benefit of hindsight these statements are not only shockingly untrue they can also be seen to contribute towards the deaths of hundreds of thousands of opioid overdoses since their publication.
Gupta believes that the medical profession itself that needs to shoulder the largest responsibility
What has also come to light is that certain pharmaceutical companies misled the FDA about the risks of opioid dependence in an effort to sell more of their drugs; the prosecution in 2007 of three of Purdue Pharmaceuticals executives, the company who brought OxyContin to the market, shows that monetary greed was finally being brought to account for the untold misery of their clients opioid addiction. However, what also remains true is that in 2015, the Sackler family who own Purdue Pharmaceuticals appeared at number 16 on the Forbes list of America's richest families. The stark reality of the economic and monetary forces that drive the pharmaceutical industry remains.
Dr Gupta however believes that it is the medical profession itself that needs to shoulder the largest responsibility for the current situation.“The fact is, we have accepted the tall tales and Pollyannaish promises of what these medications could do for too long. As a community, we weren't skeptical enough. We didn't ask enough questions. We accepted flimsy scientific data as gospel and preached it to our patients in a chamber that echoed loudly for decades.”
80% of new heroin users start off using pain pills
As interesting as it is to understand some of the roots of the history of the opioid prescription epidemic within the States it does little to offer relief to the many hundreds of thousands of people currently battling with their own prescription addictions. It has also been recently shown that 80% of new heroin users start off using pain pills. So what solace can be offered?
Firstly to recognise that prescription addiction is not fundamentally different to other addictions - just because a doctor has enabled it does not change the body's reaction to the medication and the cravings that will ensue following withdrawal. Prescription addiction needs the same help as all other addictions - and this is where Hope rehab and other rehabs can help.
Prescription drug addiction treatment at Hope Rehab
We address the underlying problems that can contribute to the need to get high, escape and avoid the challenges that life can present. We can work with individuals to find some of their root causes that created some of the initial dependencies and then find other more effective ways to deal with the problems. We use a holistic combination of mindfulness, CBT, body based therapies, integrative therapies and fitness to deliver tailor made individual treatment plans for our clients.
Prescription addiction needs to be seen for what it is - an addiction to a drug which creates dependency and withdrawal within its users. It is time for the divide between legal and illegal drug dependencies to be removed and treated in the same way: both effect the bodies and minds of their users in a similar fashion - it's just that one has been found illicitly and the other has been wrapped up in pharmaceutical sheeps clothing - but make no mistake its still a wolf inside.
 America's Addiction to Opioids: Heroin and Prescription Drug Abuse” National Institute on Drug Abuse 2014