October 17, 2011

Addiction: It doesn't discriminate

There is no such thing as a typical drug abuser. But some are more likely to become hooked.

By John Richardson jrichardson@pressherald.com
Staff Writer

Second of six parts

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PAINKILLERS IN MAINE: Stories, video interviews and links to resources.

Prescription painkillers are known as an equal opportunity drug.

Widely available and highly addictive, the pills can ensnare people who might never be exposed to illicit drugs, such as cocaine or heroin.

"We've had a 70-year-old grandmother whose doctor prescribed it for chronic pain. The Yarmouth soccer mom. The 20-year-old. I have to laugh when people say the typical drug abuser. What's that?" said Shannon Trainor, clinical director for Crossroads for Women, a Portland-based substance abuse treatment agency.

At the same time, experts say, there are definite risk factors that make some people more vulnerable to the changes in brain chemistry that lead to addiction. While access to the drugs and social factors fuel abuse, these risk factors can determine how fast a user gets hooked:

Youth -- Not only are teenagers more likely to experiment with the pills, their developing brains are much more susceptible to addiction.

Past abuse or trauma -- Sexual abuse as a child is a common experience among a surprisingly high number of addicts.

Mood or anxiety disorders -- Many people drawn to the numbness of an opiate high are drowning the symptoms of some underlying medical problem.

Family history -- Someone with alcoholic or drug-addicted relatives may have what is called the "addiction gene."

Addiction is a disease of the brain, a change in chemical pathways caused by the highs and lows of repeated drug use.

The human brain is built to pursue pleasure and avoid pain, and opiates are especially potent hijackers of the pleasure and pain signals in the brain.

The drugs, especially when abused and taken in intense doses, shift the brain's ability to experience pleasure beyond its natural range. Soon, the brain craves the drug to feel normal.

Opiate withdrawal, meanwhile, is intensely painful. Opiate receptors in the brain and different parts of the body go into a kind of shock. It doesn't kill you, addicts say, but you may wish it would.

"There is nothing as traumatic as unmedicated opiate withdrawal," said Mark Publicker, an addiction specialist at Mercy Recovery Center in Westbrook. "You're in hell."

Once an addict gets a taste of withdrawal, avoiding it becomes the brain's top priority, sometimes at the expense of virtually everything else in an addict's life.

It's no accident that Mainers in their 20s have the highest rates of painkiller abuse. OxyContin and other prescription painkillers first hit Maine's middle schools and high schools 10 years ago. The second-highest rate of abuse is among people now in their teens.

"Kids don't even realize it's an opiate. They don't know what they are taking," said Eric Heintz, a substance abuse counselor at Day One in South Portland.

Nearly one-quarter of Maine high school seniors in 2009 -- 23.9 percent -- said they had taken the drugs at least once, according to state data. Eleven percent of Maine's eighth-graders -- mostly 13-year-olds -- had used prescription drugs in their lifetimes, according to the survey.

"Opiate addiction is a pediatric onset disease in Maine," Publicker said. "Vicodin is more of a gateway drug than marijuana at this point."

Vicodin, which is a commonly prescribed painkiller for broken bones and wisdom tooth extraction, is often most available to teenagers.

The teenage years, when brains are still developing, are an especially bad time to take the pills, experts say.

Teenagers are more likely to become addicted, and heavy use at that age can have more long-lasting effects on the brain.

Teenagers or others who have family histories of alcoholism or drug addiction are well known to be at higher risk. It's effectively the same reason heart disease, depression and some cancers can run in families, doctors say.

(Continued on page 2)

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