The Illusion of Legitimacy
But perhaps the biggest contributor to Rx-drug addiction is ignorance: People assume that the medicines aren't harmful. They see drugs such as heroin as "bad" and drugs like Vicodin as "okay" because they were given a stamp of approval by the FDA, prescribed by a doctor, and purchased at a pharmacy.
"That's a frightening and misguided assumption," says Wilson Compton, M.D., director of epidemiology, services, and prevention research at the National Institute on Drug Abuse. The active ingredients in heroin and opioid painkillers like Vicodin and OxyContin are essentially the same. They work very quickly on the brain, releasing the pleasure-boosting chemical dopamine. If you keep taking them, your tolerance could increase, you'll need more to achieve the same effect -- and if you stop them suddenly you may experience harsh withdrawal symptoms, including sweating, nausea, and violent shaking, for up to a week. You are hooked, sometimes in only a few months.
Anyone can become addicted because the drugs are so powerful, says Johanna O'Flaherty, Ph.D., vice president of treatment services at the Betty Ford Center, in Rancho Mirage, California. But four risk factors appear to increase your vulnerability: a history of mental-health problems, such as depression or bipolar disorder; prior drug or alcohol abuse; a family history of alcoholism or drug abuse; or past trauma, such as child abuse or rape.
The stress of motherhood can make some women especially vulnerable. "They are exhausted, they are worried, and they can't sleep," says Dr. Ross. "Any time you are in a heightened state of stress, you're more at risk." After Michaelanne (who wanted her last name withheld) gave birth to her daughter in 2006, she wasn't just stressed -- she was seriously depressed. "I didn't even want to hold her," says the mom from Austin. "I became very anxious about dropping her." She was having trouble breastfeeding and blamed herself for not being able to provide nourishment for her daughter.
Her doctor diagnosed her with postpartum depression and prescribed an antidepressant and the anti-anxiety drug Xanax -- and almost immediately Michaelanne felt better. "Everything smoothed out and I was able to take care of my daughter." Life was going as well as it could, she believed: "I was so happy about the baby, and my fund-raising consulting business was booming." Her husband, a nuclear physicist, had just landed a great new job, and they lived in a beautiful home.
The only problem: She couldn't get through the day without three or four -- then five or six, and eventually as many as ten -- Xanax. (She'd been instructed to take one pill per day.) Her 90-day prescription didn't last anywhere near 90 days, so she started buying pills from online pharmacies, which don't require a prescription. She found herself paying $500 for a FedEx delivery of drugs that would've cost $25 from her local doctor. She kept this up, trying out more and more pharmacies, until one day she received a letter in the mail from the Drug Enforcement Administration (DEA), threatening to investigate her if she didn't stop.
"That was the biggest wake-up call I could've gotten," Michaelanne says. She went cold turkey and didn't hear back from the DEA. But she finally revealed to her husband that she was addicted. "I told him I was detoxing off Xanax and that's why I was sweaty and shaking and vomiting," she says. "He was shocked at the amount of drugs I'd been taking and shocked that I hadn't told him." He insisted that she never go near the drugs again, but he also stayed by her side during an excruciating week of withdrawal at home -- not a strategy recommended by experts, who advise doing it only under medical supervision. But Michaelanne got through it and has been in recovery for three years.