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In the Grip of Heroin Part 5: Painkillers Often are “Gateway” to Heroin Addiction

Sharyn Morrow, Flickr

Experts say many heroin addicts first get hooked on opiate-based prescription painkillers.

They have a similar effect on the body as the illegal drug.

Some remain addicted to the pills, and don’t switch over to heroin. That’s the case of a 26-year-old yoga teacher and grad student at UW-Milwaukee. The lean, graceful woman appears the picture of health, walking on campus. Yet, she’s struggled with a crippling addiction to prescription painkillers.

“I crushed them and snorted them,” she says.

She says she began taking the drugs in her teens.

“A good friend asked me if I had ever heard about painkillers, and then my dad happened to have a surgery and didn’t like his, so I took them from home and, you know, we started doing them, then I kind of just took off from there,” she says.

She says the pills somehow seemed “safe,” because a doctor had prescribed them -- although she took them in large doses. She says they made her feel mellow, something she craved, during a stressful time attending Marquette University. Before she knew it, she needed the drugs.

“I started having the physical withdrawal symptoms, which I wasn’t expecting, I didn’t know that my body was dependent on it. And I started just getting really emotional if I wouldn’t have it, crying, depressed, and then more physical symptoms, like just being achy, and flu-like sort of things,” She says.

A 45-year-old Milwaukee man says when his body craved the painkillers, he learned to “play the system” to obtain them. He says he’s embarrassed now, by what he did.

“I could generate any symptom, whether it was true or made up. I asked the doctor, I said, ‘how do you know when somebody’s faking?’ (the doctor answered) ‘when they’re yelling and screaming and crying and being a pain.’ So I’d always be the quietest guy,” he says.

Credit Ann-Elise Henzl
Some medical offices have signs helping patients identify their pain level. The medical community began a push in the 1990s to better identify and treat pain. Some say that’s led to a proliferation of prescription painkillers

He doesn’t look like a “stereotypical” drug addict, when we meet at a Starbucks in Wauwatosa. He’s dressed in a suit and tie, sipping coffee and reading a newspaper. He works in finance, and golfs in his spare time. What you don’t see is that he spent time in jail because of his drug use. And his liver failed. He says it all started when a doctor prescribed Percocet following an accident.

“(I was) 18 years old, I got thrown off a horse and shattered my tailbone, and just hurt my back pretty bad,” he says.

Both he and the yoga instructor we talked with are sober today. But they’ve struggled for years to get off opiate-based painkillers and stay clean.

Some lose the fight. Dr. David Gummin has seen patients in grave condition after they’ve overdosed. Gummin is medical director of the Wisconsin Poison Center, professor of emergency medicine, and section chief of medical toxicology at the Medical College of Wisconsin.

“They’ll often come in extremely sleepy, in fact so sleepy that they're not able to support their own breathing. Tiny pinpoint pupils are often part of it, reduced body temperature, reduced respiratory rate, and coma ultimately, with low blood pressure and respiratory arrest,” Gummin says.

Gummin says more people have been using -- and dying from – prescription painkillers, because they’re highly addictive, and readily available. He points to the late 1990s, when he says there was a push in the medical community to ease pain.

Dr. Tim Bartholow says those good intentions prompted some doctors to prescribe opiate-based painkillers liberally. Bartholow is chief medical officer at the Wisconsin Medical Society.

“Sometimes we will be more aggressive in pain management or use a stronger pain medication than we might actually need, or we will write for more pills actually than might be necessary,” Bartholow says.

The unintended result is that potent drugs have flowed into patients’ hands.

Credit Ann-Elise Henzl
A sign in the lobby of one of the AIDS Resource Center of Wisconsin's offices alerts guests to the painkillers that may be addictive – and lead to heroin abuse. The office hands out a drug that can reverse overdoses from both opiate-based painkillers and heroin

“I think we’ve done that to try to make sure that the patient isn’t inconvenienced, but unfortunately, I think some of those medications then end up sort of unattended,” Bartholow says.

Bartholow says some doctors need to do a better job choosing medications for their patients. He says someone with a sprained ankle probably doesn’t need an opiate-based painkiller.

The Milwaukee man who works in finance – and once went from doctor to doctor to get drugs – also offers a solution. He says very few of the prescriptions should be written in the first place.

“Maybe just for like, surgical procedures or cancer or HIV/AIDS or something like that? That’s really got to be really limited,” He says.

And he suggests adults warn children never to begin experimenting with the drugs. Experience has taught him what can happen.

“Just get ready for jail, get ready for just chaos and sleeping outside and just feeling so low and so bad about yourself and commit some crimes, and prison maybe, that’s what’s out there,” he says.

Ann-Elise is WUWM's news director.
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