Prescription pill addicts hide in plain sight

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Donna says the public perception of a drug addict is someone like Paul (not their real names), a biker who literally grew up on the streets of Toronto with scars from knives and bullets to prove it.

She said the growing number of addicts on P.E.I. are harder to spot, except by former addicts like herself.

They're professionals, "functioning" and addicted to prescriptions drugs they've either obtained legally or illegally.

Donna said she was addicted to prescription drugs for a year and a half.

After a major surgery, she was prescribed 1 mg of Dilaudid a day for her pain.

She said she continued to increase the dosage until 1 mg a day became 75 mg a day.

"Mentally, I was so impaired I didn't realize how much I was taking," she said. "It got to the point where I wouldn't remember the last time I took the drug."

Donna said she always went to the same doctor for her prescription and did everything by the book.

Donna's day started with an injection of Dilaudid. She went to work, and functioned. Without it, she said she couldn't get out of bed.

It was while returning home from vacation that she realized she had an addiction problem.

She took a supply of Dilaudid with her, which ran out the day she returned home.

"I was coming back on a certain day and on that day I knew the physician was on holidays and I almost panicked. That's when I realized I had an addiction."

She asked her doctor for help and was told to just ween herself off the medication.

"You can't tell an addict to do that. You have to have close guidance."

She entered detox programs including one at Mount Herbert which she called "a waste of time". She said at the time, addiction services in Mount Herbert were geared towards alcohol addiction. She said they didn't know how to treat her addiction.

She said she's been told that services at Mount Herbert have improved considerably since her time there.

Still, she believes there is room for improvement.

"Public education and changes have got to come. There's no education out there for the whole public to be on alert and to help one another and understand it. Addicts now just aren't the ones on the back streets, sitting on benches. That's the public portrayal."

The public perception of an addict might look a lot like Paul, back when he was an addict. Clean, Paul comes across as a kind grandfather in a leather jacket. On drugs, he said he could be a monster, with little regard for his own life or others.

Paul says he started abusing drugs at 13 to bury the pain of sexual and physical abuse.

He ran away from home soon after and kept on running for 40 years.

"I never felt the same as other people," he said. "It was like I was a different species. I couldn't relate to anyone it seemed.

"But once I had the drugs and alcohol, I could be funny and look cool."

When Paul was functioning, he could work as a truck driver, making good money to feed his addictions. He used whatever he could get his hands on. When he eventually got fired he would steal to pay for his habit or break into doctors' offices.

He moved to P.E.I. 20 years ago, hoping to find a final solution.

The solution he eventually came up with was suicide.

He attempt was nearly successful.

When he came to, one of the nurses, a former addict herself, pleaded with Paul to get help before it was too late.

He said he was touched by her kindness but it wasn't enough to keep him from using after he was released.

It wasn't long before his addiction put him in serious trouble in court.

The charges were attempted murder, assault with a deadly weapon and assault causing bodily harm.

"I was looking at seven years. A couple of cops went to bat for me. I did some time, but I didn't do seven years."

Seeing so many people have faith in him made Paul want to turn his life around.

With the support of Narcotics Anonymous, he got clean and has stayed clean for five years.

He remembers during the first few weeks of detox, sitting in his house with the window blinds down, sweating, shaking, jumping at anything that moved.

There was a small knock at the door. He crept to the front of his home and lifted the blind by a hair to reveal two girl scouts trafficking cookies.

"Here I am, a 50 year old man, who's been shot and stabbed, cringing in fear at two girl scouts. On drugs, I would have bit their heads clean off and taken their cookies."

Paul now helps others get clean. Many of them have lives and experiences similar to Donna's.

"There's so many functioning prescription addicts, never mind the people in the back alleys."

Paul recounts one time he got a call late at night from the wife of a man he was sponsoring.

He was using again.

Paul arrived at the home and saw a man he used to be years ago.

"He was there pounding the table like I used to. Whoever pounds the table the loudest wins. Drool was coming out of his mouth and he wasn't making any sense."

The man's daughter was crying and screaming at her father

"I hate you daddy!"

"That tore my heart because I never got my family back. I said no you don't hate him. You hate him on drugs. That's not your daddy. Try to remember that."

Paul eventually got the man clean. He watched father and daughter fly a kite together and cried for their joy and his loss.

For all the physical and emotion scars Paul carries, he said the loss of his family cuts him the deepest.

He recently received a letter from one of his daughters, the first time he's had contact with her in 17 years.

He said he gets to experience what he lost to drugs through helping other addicts overcome their addictions and keeping their families together.

"It's like nothing I ever felt in my life."

Although they come from different worlds, Paul and Donna say they share a bond as former addicts.

Donna said services for drug addiction are improving, but many are still not getting the help they need.

She would like there to be some place where addicts can go for 28 day detox. She would like there to be a counselling group to be there to take over when they get out of detox. She would also like to see additional services offered in West Prince.

"It's too bad West Prince couldn't have a physician to deal with people with addiction problems. I think it would go a long way."

For some doctors, not all the prescriptions they write are for patients - some are for themselves, says a leading North American addiction expert.

Doctors are just as vulnerable as anyone else to alcohol and drug addiction, Dr. William Farley, director of a Virginia treatment program, told the annual meeting of the Ontario Medical Association.

"It's a disease," said Farley."The title MD does not render us immune to addiction any more than it renders us immune to cancer."

In fact, addiction experts say about 10 per cent of Canadian doctors will experience drug or alcohol dependence at some point in their professional careers.

The prevalence of alcohol addiction in physicians is about the same as in the general population, said Farley, who has treated about 1,600 doctors in the last 10 years. However, prescription drug abuse is much higher among doctors.

A 1989 national survey suggested between five and 10 per cent of Canadian adults abuse alcohol. About five per cent abuse prescription narcotics such as morphine.

There are many factors that lead to substance abuse among doctors, including job stress, a sense of invincibility, and for many, surprisingly, feelings of insecurity and low self-esteem, he said.

In the case of prescription drug abuse, a major factor is availability - "We're the keepers of the candy store."

Besides alcohol, doctors abuse opiates such as morphine, sedatives, and even nitrous oxide, or laughing gas, he said. They obtain them through drug company samples or write prescriptions in other people's names, most commonly for their mother-in-law or spouse.

Some have even filled prescriptions for deceased patients, said Farley, recalling one New York physician who had treated a cancer patient with high daily doses of morphine. After the man died, the doctor continued filling the prescription and taking the drug for four months.

Diverting drugs is another method. Anesthesiologists, for instance, will sign out narcotics for patients, then use other drugs to keep them unconscious, he said. The chart will show they gave the narcotic every 15 minutes, "which they did - to themselves."

Specialists in other high-stress jobs, such as emergency medicine, psychiatry and neurosurgery, are among the top substance abusers, Farley said.

Surprisingly perhaps, there have been few instances of alcohol and drug abuse affecting patients' welfare, said Farley. "And that's because the last place their addiction shows up is on the job."

The addiction is kept going because most deny they have a problem, he said. They fear they will lose their licence to practise and gain the contempt of their colleagues and families.

"They can't reach out for help. This disease is one of loneliness and isolation."

Farley knows this from first-hand experience. A Canadian, he lost his job as an anesthesiologist at an Alberta hospital and his licence to practise after abusing prescription drugs for 17 years.

He got treatment in the United States and had his medical licence reinstated, but could only get a job in the North. It was then he decided to dedicate himself to helping other doctors recover from addictions.

He said his centre's program has a 77 per cent success rate in keeping doctors drug- or alcohol-free for two years.

Farley believes organized addiction programs, such as those operated by medical societies in all 50 states, are the best means of helping to identify and treat physicians who are substance abusers.

The Ontario Medical Association has no similar program for its members, although it is trying to develop one, said spokesman Dr. Ted Boadway.

Dr. Peter Mezciems, a staff physician at the Homewood treatment centre in Guelph said about 30 physicians went through the centre's program last year.

About 100 of Ontario's 26,000 doctors are treated for alcohol or drug addiction each year, he said.