What It's Really Like To Be Addicted To Painkillers

Photographed by: Jessica Nash
Erica, a high-level manager and mother of three, kept an all-consuming secret for more than three years: She was addicted to prescription painkillers. At her lowest point, she would swallow a full month’s supply in a week — 90 pills in seven days.

“I thought about those pills 24/7,” she says.

Erica is among an ever-growing number of Americans who are hooked on prescription painkillers: Nearly 10 million adults in America misused the drugs in 2012, according to a study released in June from the National Institute on Alcohol Abuse and Alcoholism. Misuse of prescription painkillers, or opioids, more than doubled among adults from 2001 to 2012, jumping to 4.1% from 1.8%, the study found. The Centers for Disease Control calls the situation an “epidemic.”

The crisis has snowballed to such an extent that the House and Senate came together in July to pass a bipartisan bill to combat it. The landmark bill, the Comprehensive Addiction and Recovery Act, authorizes health officials to award grants to tackle prescription-painkiller abuse and heroin use, to launch a task force to review practices for prescribing painkillers, and to expand the availability of naloxone, a medication that can counter the effects of an overdose. Republican Senator Rob Portman of Ohio, a proponent of the bill, has called it “historic,” noting that it marks “the first time in decades that Congress has passed comprehensive addiction legislation.” President Obama has said the bill falls far short on funding, for which he blames Republicans, but signed it nonetheless, saying, “Some action is better than none.”

For Erica, the problem began with a knee surgery in 2012, when she was in her thirties. After the procedure, which was performed to relieve chronic pain from a childhood injury, her doctors prescribed the potent painkiller fentanyl — the drug known for Prince’s deadly overdose. The doctors recommended that Erica take the drug via patch, allowing her body to absorb the medication more efficiently, as she had undergone a recent stomach surgery that could make it difficult to absorb pills.

Erica (who asked that her last name be withheld for fear of hurting her career) didn’t fully grasp the power of the medication until one day when she forgot to put on the patch. She suffered immediate and intense withdrawal symptoms: “I thought I was having a mental breakdown,” she says. “I got paranoid. I started worrying that my parents were going to die. I drove for four hours to go see them.” After that, she went back to her doctors and said, “This drug is too strong.” They prescribed a different painkiller, hydrocodone, in liquid form. She took the drug as prescribed, but gradually found herself becoming reliant on it, feeling she needed it all the time to function.
Photographed by: Jessica Nash
“The drug produces a sense of euphoria, well-being,” says Joseph Garbely, the medical director of Caron Treatment Centers, a nonprofit provider of addiction treatment with centers across the country. “For some, it acts as a soothing mechanism. Many experience it as an escape. They reach back for more. The more you take it, the more you need the desired effect.” (Research is under way on a promising new class of pain relievers targeting chronic pain, but for now opioids remain the go-to treatment.)

Soon Erica was taking the full month’s supply long before the month was up. For the rest of the month, she “self-medicated,” she says, with alcohol. (She notes that while she did drink before painkillers entered her life, sometimes going overboard, she didn’t consider it to be a problem.) Her pain-management clinic conducted random drug tests and noticed that she didn’t have the drug in her system at all times, which raised a red flag. “I think they thought I was selling it,” she says. Erica lied, saying that she was taking the medication as prescribed, but that her body absorbed it differently due to her stomach surgery, skewing the test results. The clinic accepted that excuse, and started prescribing hydrocodone pills instead of liquid.

Erica could not see her way out: All she could think about was getting that next prescription. “I felt like I was on my own,” she says. “I never thought I would get addicted — I had never taken an illegal drug in my life.” Her brain had been “hijacked,” she says, to a degree that “the drug becomes more important than anything else in your life — more than your family, job, hygiene.” Erica began downing the full month’s supply of pills in a week, and continued to do so for more than a year.

Addiction carries serious risks: More than 28,000 people in America died from overdosing on opioids, including prescription painkillers and heroin, in 2014 — more than any year on record, according to the CDC. Deaths from prescription-painkiller overdose among women rose more than 400% from 1999 to 2010, compared with a 265% rise in men, the CDC says. Women are more likely to have chronic pain, to be prescribed prescription painkillers, to be given higher doses, and to use the drugs for longer periods than men, according to the CDC.

“The numbers are staggering,” says Garbely. High demand and ready availability of the drugs have spurred the problem, he says, but so have doctors who are not vigilant in prescribing the drugs. Health-care providers wrote 259 million prescriptions for opioids in 2012, enough for every adult in America to have a bottle of pills, according to the CDC.

More than 28,000 people in America died from overdosing on opioids in 2014.

Erica hit rock bottom when she showed up drunk to a breakfast with friends. A concerned friend drove her to a counselor, who called the Hazelden Betty Ford Foundation, a nonprofit addiction treatment provider with centers throughout the country. Erica made plans to check in. “My family thought I was addicted to alcohol,” she says. They had noticed that her drinking was escalating, and her son told her, “I’m afraid you’re going to get in a car wreck and die.”

When Erica went to the treatment center, she finally told her family about the painkillers, saying, “I have a much bigger problem.” Her family was shocked. “My husband was furious when he found out I had been lying,” she says, and her marriage unraveled, eventually ending in divorce. She spent around three months at the center and another month in an outpatient program. Her insurance paid for only a month’s worth of care, and it was a battle to get it. The insurer had initially planned to cover only 13 days, she says, but she filed four appeals over the course of a year to get a month paid. “Insurance companies still don’t treat addiction like a disease, the same as other diseases,” she says. (Costs for drug rehabilitation vary, but can add up to tens of thousands of dollars.)

Erica marked a year of sobriety in May of this year. But recovery is a process that can go on long past rehab.

One woman who knows that from experience is a former nonprofit worker and mother of four who goes by the nickname CB. (She has asked to keep her full name private, citing the stigma of addiction.) CB has been in recovery for five years, and says it is a daily battle. She keeps count of every single day of sobriety. “It’s 1,814 days today,” she says. The tally helps her ward off temptation: “I don’t want to start over, back at day one.”

CB’s problem began when she was in her thirties, after she fell and smacked the back of her head on a marble floor. She suffered a traumatic brain injury that left her with no sense of smell or taste, along with chronic migraines. “I had a headache the size of Texas,” she says.

Doctors prescribed painkillers, and she quickly got hooked, she says, sparking “four years of hell.” Like Erica, she was on a “constant quest for the pills,” sometimes downing the entire month’s supply in a week or less. “I justified it, telling myself, I’m using medication, not doing drugs.” She went to several different doctors, manipulating them to keep the prescriptions flowing. “I would fill my hand with pills and swallow them — I didn’t care how many pills were in my hand,” she says. “It felt nefarious and disgusting.” She saw no end to her addiction. Her husband stepped in, driving her to a Caron treatment center and saying, “I can’t take this. I don’t want to have to worry about whether you’re dead under the deck.”

At first, she says, she felt like the center was jail. “I was ranting and raving about the stupidity of the place and the people,” she recounts. “I said, ‘Rehab is for people who live under bridges.’ A doctor said, ‘Well, that hasn’t happened to you — yet.’” The warning became a turning point, and she started cooperating with the program.
Photographed by: Jessica Nash
A common misconception about prescription painkillers, which include hydrocodone (Vicodin) and oxycodone (OxyContin, Percocet), is that they cannot cause the same kind of harm as illegal drugs such as heroin, says Garbely. “People think it’s legal, it’s prescribed, it’s endorsed by a medical professional.” But in fact, the drugs are so addictive, many of his patients had escalated from painkillers to heroin, he explains, noting that heroin is cheaper and more euphoria-inducing. He adds that doctors themselves are getting addicted to opioids.

The CDC took action in March, issuing a milestone set of guidelines for physicians, directing them to take more care in prescribing the medication. The guidelines urge doctors to prescribe opioids only if the benefits outweigh the risks, to talk to patients about the risks, to start patients on a low dose, and to monitor the situation closely, among other recommendations.

Today, both Erica and CB work with support groups, doctors, and sponsors to manage their pain and avoid a relapse.

Erica is back at work. She keeps her past addiction to herself at the office due to the stigma, but she wants to help other people who struggle with the problem. She recently gave a talk at her treatment center, and she is thinking about going back to school for addiction studies.

CB also gives talks to people in recovery, and keeps lists of things she is thankful for, to keep her focused and on track. “I make a list every day, even on days when I hate the world,” she says. She also does a daily worksheet, as she did at the treatment center, rating her actions during the day — whether she was rude to someone, whether she needs to apologize — to help her stay balanced. Some of the people she met at the center relapsed and are now dead. “That keeps me clean,” she says. “I know that could be me.”

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