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The Pill Problem

Written on: September 24th, 2008 By:

As prescription drug abuse soars in the United States, Dana Point’s SouthCoast Recovery is taking the issue head on

By Nathan Wright Dana Point Times

Howard Larkin still carries his jail identification card in his wallet, a grim reminder of darker days. His former life ended abruptly in 1999 when he was arrested inside a Carlsbad meth lab and handcuffed to a telephone pole while drug agents gathered evidence to build their case against him. “They charged me with possession of chemicals to manufacture methamphetamines,” he said. “They told me 25 years to life. I spent three days in jail thinking, I’m going to die in prison.” Larkin avoided the sentence and found a new life at SouthCoast Recovery, a rehabilitation and wellness center based in Dana Point and San Juan Capistrano that treats drug abuse and the underlying problems of why patients turn to drugs. Now nine years sober, Larkin works with patients struggling to overcome addiction.

Many of these patients have never stepped foot inside a meth lab or approached a drug dealer. They didn’t have to. Their addictions began in an orange bottle with a white cap and a prescription label. The prescriptions range from opiate-based painkillers—OxyContin and Vicodin for example, which belong to the same drug family as heroin and morphine—to “benzos”—mood enhancers and anti-depressants like Xanax and Klonopin.

In the past few years many South County residents have arrived at SouthCoast Recovery looking for help breaking free of addictions to opiates and benzos, so much so that the center has developed specialized programs for prescription drugs. Often patients check in for alcoholism only to discover they are addicted to prescription drugs as well.

“When they first arrive they might not even know they need to stop taking their Klonopin,” said Tom Petersen, the court liaison at SouthCoast. “More than half of our clients are addicted to some form of prescription medication as well as alcohol.”

The ignorance of the dangers of prescription drug addiction is common, according to Robert Goodman, the co-chair of the Human Services Department at Saddleback College. “Many believe that since they’re prescribed and legal they are not, in fact, harmful,” he said. “Prescription drug abuse has been around as long as they’ve been prescribed, but it’s really been in the past half decade where it’s expanded greatly.” Authorities say prescription drug abuse is a national problem, attracting the attention of the Drug Enforcement Agency and other law enforcement organizations used to chasing cocaine dealers. “Prescription drug abuse has increased throughout the country and is definitely an area of concern to the DEA,” said Special Agent Sarah Pullen with the Los Angeles Field Division. “One of the primary means for obtaining prescription drugs is through doctor shopping, both in person and through the Internet. Street sale of prescription drugs is also common in Southern California.”

Experts say that getting prescriptions for legal narcotics including opiates, and for benzos, is not difficult for those who know how to play the game. Doctor shopping—visiting multiple doctors complaining of symptoms that are commonly treated with painkillers in an effort to get prescriptions—is one of the most effective methods.

“They go from one doctor to another, looking for Vicodin prescriptions,” said Dr. Michael Rudolph, a consulting physician at SouthCoast. “Unless the patient tells the doctors about the other prescriptions there’s no way the doctor would know about them. They’re not allowed to share that information because of HIPAA [Health Insurance Portability and Accountability Act] regulations.”

Those with Internet savvy don’t even need to go through the trouble of doctor shopping in person. “You go online for an interview with a physician, you explain your symptoms, explain why you need the painkillers, and if the doctor agrees he will give the prescription through an online pharmacist,” he said. “The pharmacist ships you the drugs in an unmarked white box.”

And so the addiction continues in the privacy of the home, minus the trips to a drug dealer. The Orange County Sheriff’s Department does encounter prescription trafficking from time to time, but the problem isn’t as visible as heroin, meth or cocaine deals.

“It’s out there, but I wouldn’t say it’s a big problem,” said Sgt. Doug Doyle of the OCSD South Narcotics Unit. “We run across it maybe once every couple of months. Kids are buying OxyContin on the streets, but it’s expensive, about $80 a pill.”

While prescription abusers largely stay out of the police blotter, they are regulars in hospital emergency rooms. Dr. Kevin Hegewalk, an emergency physician at Saddleback Memorial’s San Clemente and Laguna Hills campuses, encounters the problem often. Some patients come in looking for more pills. Others come in suffering from medical problems caused by their addictions.

“They began taking [prescriptions] for a reason, maybe they were sick for a time, and now instead of treating an illness they’re treating an addiction,” Hegewalk said. “They get higher and higher doses and over the years they get dependent and it has a spiraling effect on their ability to function. It can make them very sick.”

Often addicts abuse prescription drugs addiction by taking them in massive quantities, or by simply crushing them into powder. “If the pill is crushed up it defeats the time release property, giving [OxyContin] a similar potency to heroin,” Goodman said.

By the time an addict arrives at SouthCoast he or she often requires detoxification followed with counseling, education and support. Patients live in eight homes in Dana Point, Capistrano Beach and San Juan Capistrano in either 30-day or 90-day programs, spending their days in wellness centers and their nights under supervision. Patients are not allowed to leave or host guests, although they are not under lockand- key. If they leave, they leave the program. “This is a voluntary program,” said Petersen. “Anyone who is here wants to be here.”

Patients in SouthCoast follow a 12-step program designed to acknowledge and treat their addictions. They also receive holistic and Eastern medical treatment including acupuncture. “It’s often the back pain that took [the patient] to the doctor to get the OxyContin in the first place,” said Grant Collins, a licensed acupuncturist who works with SouthCoast. “We don’t treat with drugs; we treat with herbal medicines and acupuncture, and we make the problems go away.”

Recovery isn’t easy, but possible. Howard Larkin and a majority of SouthCoast’s staff have suffered from addiction and stand testament to an individual’s ability to break free. “For a hit off a crack pipe I would have traded my mother and my father,” said Larkin. “Now I wouldn’t trade my life for the whole world.”

For a look at SouthCoast Recovery’s entire program visit

A Local Issue, But Part of a Larger Problem

“Many feel that if a doctor can prescribe it, the drug can not be as harmful to your health when compared to what some might consider more conventional street drugs such as heroin or cocaine. According to the 2005 Partnership Attitude Tracking Study, 40 percent believe that prescription medicines are ‘much safer’ to use than illegal drugs. Furthermore, the same study concluded that 31 percent believe there is ‘nothing wrong’ with using prescription medicines without a prescription ‘once in awhile.’ The truth of the matter is, these controlled substances are not just highly dangerous; they can prove lethal.”

—Joseph Rannazzisi, deputy assistant administrator of the DEA’s Office of Diversion Control, speaking on Internet pharmacies and drug abuse before the House Judiciary Committee on June 24

“We no longer just fight traditional drugs of abuse. In just five years, the number of Americans abusing prescription drugs rose more than two-thirds—from 3.8 million abusers to 6.4 million. Fueling this increase is the proliferation of illicit Internet Web sites that make it possible, with one simple click, to purchase controlled substances.”

—Karen Tandy, DEA administrator, speaking before the Senate Committee on Appropriations in April 2007

“The abuse of prescription drugs is a serious and growing health problem in this country. According to the 2005 National Survey on Drug Use and Health, there were more than 6.4 million current non-medical users of psychotherapeutic drugs in the United States—more than the number of Americans abusing cocaine, heroin, hallucinogens and inhalants, combined. If we look at the people who are just starting out as new drug users, prescription drugs have overtaken marijuana and cocaine as the gateway drug of choice.”

—Joseph Rannazzisi, Deputy Assistant Administrator of the DEA’s Office of Diversion Control, in a written statement to Congress in July of 2007.


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