Author: Stuart Birnbaum/Tuesday, August 23, 2011/Categories: Other Addictions
Today’s addict has an ally. The new drug pushers aren’t pimps hanging out in schoolyards or villains in an episode of Law & Order. They are our pharmaceutical companies. They are the pharmacies that distribute their wares. They are the doctors that prescribe these medications to their patients without a true understanding of addiction and prescribe them without exit strategies, without a sound plan for how a patient should stop taking them once dependency is created. And there is one new factor in the addiction equation: the Internet. Procuring drugs on the Internet makes it quick, easy and anonymous. The medical/pharmaceutical delivery system liberally supplies high-grade drugs and the state allows their delivery without any means of tracking them. The result: an addiction crisis of epidemic proportion.
Of course, the drug companies have developed and distribute medications that are helpful, even life-saving if properly administered to patients. But abuse runs rampant in the system, especially in pain clinics. This abuse is especially prevalent in Pain Management where “Pill Mills” have popped up around the country. Doctors treat patients for pain. Most of the doctors and complaints are legitimate; people suffer maladies and injuries that only opiates can temper. The problem is that most doctors are not savvy about addiction. How often we have heard stories from drug-dependent patients who were advised by their primary physician that when they had finished running the course of Vicodin or Oxycontin or Percocet, the patient would be able to simply wean off these narcotics? But more often than not they cannot do this. Patients become dependent on these meds very quickly (often between three and four days) and stopping is simply not easy.
Many doctors, never having experienced withdrawal, are ill-informed, so patients are treated without an exit strategy. It’s a bit like our troops in Afghanistan: Once in, how do we get them out? Once in the patient’s system, once the brain’s chemistry has been changed, how do we get them out? How do we deal with the cravings for these drugs once addicted? Patients will commonly experience profound urges to take these medications for weeks or months after they have stopped taking them. The drugs will call to them, consume their thoughts. The urge becomes obsessive.
Common, too, is the patient abusing the quantities of the medication. They start at a given dosage level, but soon become dependent on the euphoric sensation. They take at first one pill more than ordered…then two, three, four at a time. The continued ability to reach the same euphoric levels become more difficult and it becomes necessary to take more and more. This is physical dependence in the making. Often, the doctor is forced to stop prescribing these medications. Then, typically, the patient goes doctor shopping until he finds another physician, unfamiliar with the patient’s treatment history, who will provide him with another prescription. The new doctor has no way of determining a patient’s real pain level. She can look at an MRI or X-ray and see the damage, but it gives the doctor no indication of how much it hurts. Some patients are treatment-savvy and build medical histories, knowing full well that their charts will enable doctors to readily supply them with the drugs they need to get high.
Any doctor who has her own practice is familiar with the “Drug Rep.” The Drug Rep (Representative) is a drop-dead gorgeous 22-year-old female decked out in a sharply cut, smart-looking pin-striped business suit. Two years ago, she was a popular sorority sister at the local university. She was recruited for her first job by a major pharmaceutical company to represent their “product” by carrying the message to doctors from office to office. The message is contained in a satchel filled with drug “samples.” Thirty years ago, she would have been snapped up out of Phi Delta Kappa to American Airlines or Pan Am. She would have worn a similar smart suit, but with wings on her collar instead of a “Phizer” name card. If the drug rep was wheeling her sample bag through an airport waiting room rather than a doctor’s waiting room, she would be virtually indistinguishable from yesteryear’s “Stew.”
Naturally, the drug rep has her counterpart in good-looking, hunky guys in pin-striped suits, GQ profiles, sporting pearl-white, Cheshire-Cat grins. They, too, carry drugs in their briefcases — samples of new product — for sleeplessness, anxiety, depression or pain. They will leave these gifts for the doctor to dispense freely to the patients. The thinking is that patients will try their wares and come back for more. First one’s free! Sound familiar?
Is this payola? You’re damn right it is. Pharmaceuticals are big business in the United States and around the world. They lobby Congress as they grease healthcare providers up and down the food chain.
And then we have the Internet — the revolution in technology that has changed the face of health care. Because the government does not require it and the drug companies and pharmacies do not insist on it, there is no way to track or enforce the sale of drugs on the Web. The benefits of the Internet are obvious: The flow and access to any kind of information imaginable is so vast and so immediate, it boggles the finite human mind. Travelers in cyberspace are privy not only to any and every kind of medical knowledge and direction to healthcare, but to the dark side of The Force as well. By simply filling out a brief medical history which, more importantly than anything else includes a credit card number, and pressing the send button, any man, woman or child can be prescribed sleeping medication, erectile dysfunction drugs or opiates (most commonly Vicodin) “legally” by an unseen “doctor.” This doctor (who does not ask to see his patients and may reside in South Africa or Sri Lanka) has all the information he needs to Fed-Ex the applicant a month’s supply of his or her drug of choice. Often these drugs are resold to others in need at inflated prices.
Why isn’t our government regulating the flow of these drugs into our homes, our communities? Drug lobbyists see that Congress makes cheap prescription medications from Canada difficult, if not impossible to get. The barrier is set up to protect our home-grown pharmaceutical companies who have a financial strangle-hold on Americans in need (especially the elderly) of legitimate drugs. Much is made today of the illegal alien problem. But our borders are porous in many ways. What comes and goes is always dictated by the almighty dollar rather than the needs of the individual. Free trade is neither free nor trade as we understood it, but rather a cyber black market in goods and services that shock the imagination.
The greatest attraction for online drug shoppers is anonymity: no one knows. A prominent attorney will steal upstairs to his home office while his wife and children are sleeping and order a month’s supply of Hydrocodone. The wife is surprised to find her husband home early the following day. When the doorbell rings, he races to intercept the Fed-Ex or UPS package before disappearing with it behind locked doors. Yes, no one knows…or so he thinks. True, his wife and neighbors, children and business colleagues do not see him consume 12 pills throughout the course of the day. But they do notice when he slurs his words in the office. His wife notices when he smokes endless packs of cigarettes and has trouble keeping his eyes open at 9 p.m. He may hang around the house over the weekend, but when his kids need him, Daddy just isn’t there anymore. Yes, he’s anonymous, but he’s also a zombie. To learn more, visit www.recoveryadvocatesusa.com for more information.
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