Doctors Alerted to Prescription Narcotics Abuse
The number of people abusing prescription narcotics is increasing. As a result, a physician's oversight group in Washington State has issued new guidelines. The panel wants doctors to be more aware of the signs of abuse. It also urges particular caution when treating chronic pain with addictive meds like Oxycontin, Percocet, and morphine. KUOW's Patricia Murphy reports.
When people who suffer chronic pain end up addicted to pain killers it's likely they had prior addictions to other drugs or alcohol.
Take the case of Glenn Terrell. He splits his time between Seattle and Portland selling large scale print graphics...the big banners you see at sporting events. But after a series of debilitating back sprains Terrell began to abuse prescription narcotics.
Terrell: "In retrospect I had drug seeking behavior probably going back four or five years when the back started to get worse, that's when I started to... I went from Vicoden to Percoset. Once I saw that I was having back surgery it almost in my mind legitimized that I could have access to opiates really on an ongoing basis."
Terrell was getting multiple prescriptions in two states. Sometimes he would pay cash instead of putting the charge through his insurance. He says his abuse was wrecking his life. He was selling his possessions to pay for the drugs and lying to his family. Terrell was certain he'd end up on the street shooting dope. Then one night his son found him in a heap on the bathroom floor. Terrell says he decided to stop lying to himself and everyone else. He called his doctor.
Terrell: "You know I said I need you to give me enough to get me into detox and then never write for me again...He acted a little surprised but then he said he really appreciated it."
A simple urine test would have alerted Terrell's doctors to his addiction.
Caleb Banta green is a research scientist at the University of Washington's alcohol and drug abuse institute. Banta green says since 1999 the number of people being admitted for drug treatment of prescription narcotics is up four fold. While the rate is still relatively low at four percent, consider this number.
Green: "From 97 to 03 in Washington state the amount of prescription opiates getting prescribed increased two thirds. We don't know how much of that's more people getting medications or people getting more medicine... it's probably some of both."
More prescriptions... More potential for abuse. The new guidelines from the state agency medical directors group advise doctors to be conservative with dosing levels and to look for warning signs of abuse. Things like lost prescriptions and exaggeration of pain.
Dr Joseph Merrill treats a lot of chronic pain patients at Seattle's Harborview medical center. He welcomes the guidelines. He says doctors need better education about treating pain with opiates.
Merrill says opiates are tricky. Drug tolerance is common... So recognizing the sometimes the difference between tolerance and addiction can be a challenge.
Merrill: "There's a very wide range of what someone may encounter in a physicians office. Some might say opiates are good because they treat pain and I'm going to treat your pain and I don't really pay attention to whether you have an addiction or a mental health problem... all the way to the other side where if you mention opiates for the treatment of pain I'm very likely to arrange it so you'll leave the office."
Glenn Terrell is well into his recovery. But he's had to learn to alleviate his back pain in other ways.
Terrell: "You know when you deal with chronic pain in an appropriate fashion you know you stretch more, you walk more, you swim more, you do what normal people do. You don't rip off your family."
Terrell still spends many of his working hours driving between Portland and Seattle. For recovering addicts such long stretches of time are difficult because the mind can revert back to old thought patterns. Terrell says he avoids that trap by using the phone. He talks to clients and when he needs support, he calls his kids or his friends in recovery. Patricia murphy, kuow news.