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A prescription for pain

David Rosenker, executive vice president of treatment services at Caron Foundation in Pennsylvania, sheds some light on the prevalence of prescription drug abuse and what can be done about it.
/ Source: msnbc.com

More than nine million Americans use prescription painkillers for non-medical reasons, and according to government figures, the number of Americans who begin misusing painkillers each year has almost quadrupled from 1990 to 2001. Why is this number on the rise and why are white collar, high profile people particularly at risk? David Rosenker, executive vice president of treatment services at Caron Foundation in Pennsylvania, sheds some light on the prevalence of prescription drug abuse and what can be done about it on “Today.” Read some of his thoughts below.

IS WHITE COLLAR ADDICTION A PROBLEM?

I think addiction is a problem — white collar, high profile, kids — for everyone. Addiction in general is rampant. It hasn’t declined at all. Adults who are high profile, celebrities or executives are able to get drugs and alcohol easily. Also, people around them are less likely to report them. Supervisors, bosses or board members are not likely to confront someone who is high profile or in a powerful position.

WHY IS ADDICTION MORE PREVALENT IN WHITE COLLAR AND HIGH PROFILE PEOPLE?

They have different stressers. I know we all have stressers, but their stressers are different. It’s tough for them to come out of treatment services and be successful. For their jobs, they go to parties, galas, lunches, dinners, etc... It’s tough because alcohol and other triggers are there. And it’s tough for them to remain chemical free at these functions. These addicts are usually type A. They also have assistants and spouses, and other people around them who are paid very much to keep their addiction a secret.

MORE THAN NINE MILLION AMERICANS USE PRESCRIPTION PAINKILLERS FOR NON-MEDICAL REASONS. WHY DOES THAT NUMBER KEEP RISING?

It is definitely on the rise. Basically it’s because of the ease of getting the drugs. At Caron, we did a survey to find out how prevalent getting a prescription over the Internet is. Forty-five percent of our patients who took the survey say they can get it over the Internet. We knew it would be high, but not that high. People are able to get the prescription with out a Rx. The black market is also high and very easy to find. The demand is easy to find. They say the controls are tighter on the black market, but it only increased the Internet purchase of it.

ARE THESE CELEBRITIES AND WHITE COLLAR PEOPLE WHAT YOU CALL “ACCIDENTAL ADDICTS” OR ARE THEY DELIBERATE?

It depends. For Rush Limbaugh, he started taking the pills for pain — like most. Then then they continue, and continue and then they become dependent. Then they cross the line and start becoming addicted. When you start having behaviors that you wouldn’t have when you are sober, there is a problem. When the chemical begins to be a primary relationship and motivating factor in your life, then you know you have a huge problem. This is when addicts use with harmful circumstances.

HOW QUICKLY CAN SOMEONE BECOME ADDICTED?

For adolescents it’s quite quick. It’s very rapid because of their youth. It really just depends from person to person. Sometimes it’s months. For adults, it can take a longer period of time.

WHAT DOES TREATMENT FOR AN ADDICT ENTAIL?

We treat it as a disease. We replace the drug and alcohol with a relationship. We use the 12-step approach. It closes the door on people enabling us to use. And then it’s support, and more support. The addict has to surround her/himself with people who care and are going to help them.

WHY DO YOUR PATIENTS COME TO CARON? IS THERE USUALLY AN EVENT IN THEIR LIFE WHEN THEY FINALLY REALIZE THEY NEED TO SEEK TREATMENT?

Typically, it’s something like the Rush scenario — maybe not as dramatic though. Very few say, ‘I need to just go to treatment today,’ and then check themselves in. It’s usually because of their job, wife, spouse or the criminal justice system. And there are some who say they need help and they have no choice, and don’t know what do do. At times, the individual gets help for themselves not knowing how severe they really are.

Courtney Love probably wouldn’t have got treatment is she didn’t show up drunk at an event. There is usually something that gets them in the spotlight and friends and family realize the addiction is there and is getting worse, and tell them to get help. Divorce can trigger it as well — when the spouse says they have had it.

Rush Limbaugh might not have checked himself in if his maid wouldn’t have come forward. It takes something happening to get someone into rehab.

IS THERE A DIFFERENCE BETWEEN CELEB AND WHITE COLLAR ADDICTS?

Addiction and treatment is the same no matter who you are. What’s different is when the patient leaves treatment. It can be more difficult for celebs. They can’t just go off and not hang out with the same people. They have to integrate their recovery with their lifestyle. It’s tough for everyone though.

DOES MONEY MAKE ADDICTION MORE PREVALENT?

Money makes it easier to hide and obtain. And many times other people don’t want to confront you. If you add in high profile people, those people have a network that supports them. That network is not necessarily made up of addicts. It’s typically not — maybe there is one, but usually not.

HOW LONG IS TREATMENT?

Thirty days for an addict — sometimes 90 in more severe cases. Celebs are in the population with everyone else, they recover just like everyone else.

David C. Rosenker is executive vice president of Treatment Services at Caron Foundation. He has 25 years experience in chemical dependency, and has been responsible for all treatment that occurs with Caron for the last 14 years. Mr. Rosenker has and continues to serve as a spokesperson to national media on the subject of adolescent substance abuse and addiction. To learn more you can also visit the Caron Foundation Web site at: www.caron.org