Prescription drug abuse growing despite efforts to curb problem

07/21/2014 6:42 PM

07/21/2014 6:49 PM

No two painkiller addiction stories are ever the same.

For Brylee Mayo, 21, it started with some easily-accessible Percocets to give her an extra boost. Now pregnant with her second child, Mayo is going through methadone treatment.

“I was scared to tell my doctor about it,” she said. “It was hard – I wanted to get an abortion.”

For Jessica Wornkey-Immediato, 23, it started when she was hit by a drunk driver when she was 18. The OxyContin and Lortabs she was prescribed made her bulging discs and scoliosis bearable.

“They don’t tell you that you’re going to be dependent on it and you’re going to be sick if you don’t have it. It doesn’t say that,” she said. “I didn’t know at 18 years old that I was going to go through the stuff that I went through.”

The two young women are not alone.

The state of Kansas has seen an uptick in prescription drug abuse since 1999, and though measures have been implemented to help curb abuse, doctors say it is still a growing problem.

Kansas recently was invited to participate in a national prescription drug abuse academy sponsored by the Substance Abuse and Mental Health Services Administration. State officials say they hope going to the academy will help shape public policy to combat a statewide problem.

“We have to be able to better serve this group of people who we’re trying to help,” said Angela de Rocha, Kansas Department for Aging and Disability Services spokeswoman. “We want to get better ideas on how to reach them, how to communicate with them and provide them the services they need to get better.”

With abuse becoming more prevalent, doctors and recovering addicts are speaking out to help educate people and remove some of the stigmas associated with addiction.

“It’s hell, actually,” 62-year-old patient John Galvan said. “More people need to talk about it.”

Methadone treatment aids recovery

“Everything was just in place to steer wrong” for Galvan when he was growing up, he said. His family had a history of alcoholism, and he said he started shooting amphetamines when he was 14, “before I even smoked pot,” he said.

He said he was a lucky addict because he had money to pay for the drugs – a lot of addicts don’t, he said.

“When I did drugs I was just high all the time,” Galvan said. “It was on account of the crowd I hung around with, I think.”

He started going to treatment in 1984, and generally has been clean since, he said. He has relapsed a few times, he said, but his most recent stint with methadone treatment at the Center for Change is intended to get him permanently off drugs.

Methadone treatment involves coming to the center multiple times a week for the liquid drug and therapy. The treatment cuts all cravings for narcotics, patients say, but relapse is dangerous. Methadone combined with painkillers can be fatal.

Wornkey-Immediato started methadone treatment when she was pregnant, because it is generally considered safer for a developing child, she said. Though typically the placenta absorbs a large portion of methadone, her 50-milligram-a-day treatment left her baby daughter addicted at birth. The girl was born with gastroschisis.

“Her bowels were on the outside – she had a hole in her tummy,” she said. “She was withdrawing from the methadone and had to get weaned off of it. She was in there for a month to get over it. It was horrible.”

‘Taking some pills is always the answer’

Dr. Greg Lakin, medical director and founder of the Center for Change, has been practicing drug abuse rehabilitation in Wichita for the last 15 years, he said. As a former police officer in Colorado and a prosecuting attorney, Lakin said he has seen the issue from both a legal and a medical perspective.

He said most times addictions start with everyday painkillers, but if left untreated, an addiction can rapidly progress to harder drugs. It is not uncommon for addicts to spend $200 to $300 a day on pills, he said, which can lead to family and work issues.

“It’s not a poor man’s addiction,” Lakin said. “The scenario often is they start off with just some Lortabs from a friend or a well-meaning doctor for a temporary injury or pain … next thing you know, they start to like them. Next thing you know they could be taking 20, 30, 40 a day. I see that quite often.”

Once their bodies become accustomed to the drugs, they build up a tolerance, he said. In order to maintain that “rush,” he said, they resort to OxyContin, MS Contin or a Fentanyl patch.

“Sometime along the way they have to start snorting them to get a buzz or, heaven forbid, they have to start shooting them to get a buzz,” Lakin said. “Then if their source dries up along the way, they’ll go out and find heroin because heroin is around. It’s always around.”

The clinic has been seeing more young women in recent years than it ever has before, Lakin said, which corresponds with a national trend. He said he believes this younger generation does not see all of the risks involved with opiate addiction, especially when it comes to snorting drugs.

“It used to be we had a bunch of old guys out there and we don’t see that as much anymore,” he said.

Lakin said while some prescriptions come from “well-meaning doctors” in the area, a lot of painkillers in Kansas come from southern states such as Florida and Oklahoma. They are then sold on the streets for a profit, he said.

“They can get a prescription, take half of the pills, sell the rest and do quite well,” Lakin said. “It’s big business for some of them.”

Doctors have an “ethical as well as a legal duty” to treat pain patients may be experiencing, but there is no perfect way to tell whether a patient truly is in pain or not, which catches them “in a bad place,” he said.

“They can read the book and recite the symptoms,” Lakin said. “They see doctor after doctor and they’ve fine-tuned their presentation skills. There’s all kinds of diseases they could say they have, and we can’t say they don’t.”

About eight years ago, a volunteer group of physicians, pharmacists and law enforcement units convened to discuss solutions to the problem, which yielded – what they thought at the time – would be the solution: K-TRACS.

K-TRACS, or Kansas Tracking and Reporting of Controlled Substances, was implemented in 2011 to unify databases between pharmacies and doctors across the state, Lakin said. The program prevents people from “doctor shopping,” or going to a different doctor and pharmacy every time they need a new prescription.

“K-TRACS made our committee obsolete – the problem was solved for a while,” Lakin said. “Now maybe it’s time to reformulate, now that they’ve adapted.”

Agencies work to solve problem

Earlier this month, officials with the Obama administration outlined a 2014 plan to curb opioid abuse.

According to the Centers for Disease Control and Prevention, 41,300 Americans died of drug overdoses in 2011, with prescription drugs accounting for more than half of those deaths. More people died of overdoses than gunshot wounds or motor vehicle crashes that year, according to the organization.

The president outlined a four-step plan to curb abuse: prevent drug use before it begins, expand access to treatment, reform the criminal justice system while protecting public safety and support Americans in recovery.

The 2012 National Survey on Drug Use and Health indicated 23.1 million Americans 12 and older needed treatment for an illicit drug or alcohol problem that year; however, only 2.5 million received treatment at a specialty facility.

Data from the CDC indicate Kansas is on par with the nationwide average for opioid prescriptions, with 94 prescriptions per 100 people in the state. Ten of the highest-prescribing states are in the south, according to the data.

Officials with the Center for Change say they have seen a marked increase in patients in recent years.

“It’s become an epidemic in Wichita,” said Heidi Brown, a supervisor at the Center for Change. “We see a lot of kids, people in their 20s.”

Larry Smith, a counselor at the Center for Change for the past two years, said changing habits is one of the prerequisites to success.

“They’ve got the tools to success; they just need to find the path to those tools,” Smith said. “You can’t hang around with dope addicts. You can’t have them on speed dial on your phone. Replace those with people who are going through recovery with you.”

Smith, a former alcohol and drug addict himself, said addiction is not a choice. It affects people of all walks of life – from lawyers to veterans, he said.

“In second grade on career day, I don’t think I remember anybody holding up their hands and saying, ‘Hey, I want to be a heroin addict,’ ” Smith said. “It wasn’t planned. It happened.”

After about four years of sitting in the group therapy room at the Center for Change, Galvan says he is ready to be drug-free – methadone and all.

“I would say I’m working on it,” Galvan said. “I’m getting close to seeing the end of the rainbow, seeing the light at the end of the tunnel. I’m ready to be off of it, actually.”

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