Addiction to painkillers is a growing problem: How to kick it

By Cynthia Billhartz Gregorian
Sunday, December 5, 2010

ST. LOUIS - Nichole Marie Case unwittingly became dependent on opioid pain drugs. She's not alone.

The National Institute on Drug Abuse estimated in 2008 that 1.85 million people in the United States were dependent on or abusing prescription opioids, also known as Schedule II painkillers.

Americans make up 4.6 percent of the world's population, but they use 80 percent of the global supply of opioids and 99 percent of the global supply of hydrocodone.

Deaths from prescription drug overdoses have become the second-leading cause of accidental deaths nationwide, behind car accidents, and the leading cause in some states, says the Centers for Disease Control and Prevention. They now take more lives than heroin and cocaine combined.

Such statistics have lawmakers, federal agencies and even health-care providers taking a closer look at the way doctors prescribe Schedule II pain drugs.

Even pharmaceutical companies are taking notice.

Recently, Highland Pharmaceuticals introduced a technology that allows opioids to be manufactured in a solid-dose oral tablet that cannot be crushed for inhalation or extracted for injection, methods drug abusers often use to consume them.

In November, the Food and Drug Administration approved monthly injections of Vivitrol, a drug used to treat alcoholism, to treat addiction to heroin and Schedule II painkillers.

Case, 48, of St. Peters, Mo., began taking hydrocodone, oxymorphone and tramadol in March 2009 when bulging discs pinched a nerve in her spine, causing excruciating pain in her back and numbness in her legs.

All three are opioids, which bind to receptors in the nervous system, decreasing perception of pain while increasing tolerance to it. In drug addicts, they can produce a high similar to their sister drugs, morphine and heroin.

Case took the drugs as her doctor prescribed and didn't experience a high.

"But I didn't like taking them, because I couldn't drive or do much of anything," she said. "I think I was pretty much in a state of screwed-up most of the time."

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