Overdose Lifeline — “From prescription to problem, how legal opioids create substance abusers”

Ben Lashar, Indianapolis Recorder, April 5 2019

Despite stereotypes of tempting drug dealers and substance abusers seeking highs, many who suffer from opioid abuse never intended to take drugs recreationally. Instead, a legitimate prescription from a doctor got out of hand.

“I never thought that the one bottle of pain pills from my surgery would change my life,” Laura Nowling, who is in recovery from opioids, said.

Doctors prescribed her morphine pills after a breast implant surgery, and she loved the motivation and energy the pills provided. Nowling sought out that feeling after she finished her prescription, beginning a 10-year battle with opioids that would cost Nowling her job, her home and her children. She began attending Indianapolis Comprehensive Treatment Center in July 2018. Now Nowling has a new job, reconnected with her children and works on her recovery every day.

Stories like Nowling’s prove opioids how dangerous opioids are — even when prescribed. If used unwisely or prescribed too vigorously, prescription opioids can lead to addiction. Now both medical professionals and patients try to approach prescription opioids with caution.

“Your basic story is from prescription medication,” Tony Toomer, manager of Indiana’s Opioid Treatment Program, said. “You get a 30-day script for a tooth extraction. You only need it for three days, but after three to five days you can actually become hooked on the medication. If you continue to take it, that’s when you start to have the problems.”

Justin Phillips, founder and executive director of Overdose Lifeline, agreed that opioid abuse often stems from medical needs. For example, doctors sometimes prescribe opioids to children after oral surgery, even though children exposed to addictive substances before 15 are five times more likely to develop a substance use disorder. Phillips’ son, Aaron, developed an opioid use disorder when taking opioids to address sports injuries.

Some experts worry doctors over prescribe opioids. Jim McClelland, Indiana’s executive director for Drug Prevention, Treatment and Enforcement, noted America consumes 80 percent of the world’s OxyContin. In 2012, Indiana’s opioid prescription rate was 110.5 prescriptions per 100 people.

Since then the number of prescriptions dropped, reaching 74.2 prescriptions per 100 people in 2017. That rate was the 10th highest of all the states and 26 percent higher than the national average. To address the high rate, legislators passed a law in 2017 requiring prescribers to check INSPECT, Indiana’s prescription drug monitoring program, before providing opioids.

Dr. Tim Kelly, an addiction psychologist at Fairbanks Alcohol and Drug Addiction Treatment Center, blamed high prescription rates on doctors both prescribing too many pills and prescribing them for pain levels that don’t justify opioids.

“I call it ‘just-in-case prescribing,’ where they don’t really want the person to call them back or feel like the doctor was mean or undertreated their pain,” Kelly said. “They err on the side of overtreating it, so the person won’t call them back, and the person won’t complain.”

Kelly said most patients take only 40 percent of opioid pills doctors prescribe for short-term pain. Not only does this pose the risk of patients taking more pills than they need, but it also leads to easy to access and unaccounted for pills. Either, patients don’t dispose of the pills or dispose of them in ways that allow others to find and use them.

Jennifer Pferrer, executive director of the Wellness Council of Indiana, said health care professionals changed their philosophy on pain because of the harm pain killers can do. Initially, professionals viewed pain as something to eliminate. Now they see pain as a natural part of healing.

“We now know that it’s OK to be in pain,” Pferrer said. “Pain is a natural healing process. Not all pain, if you are a cancer patient and you are having a stem cell transplant you need pain medication to manage that. But for an acute sprained ankle or a wisdom tooth, you can eliminate the pain medication that you need based on your pain level based on with some simple ibuprofen and acetaminophen.”

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