Special report: Painkiller abuse can pave path to heroin

A simple prescription — that’s how it started for Barrett Hamilton.

“I got injured at work and went to the doctors and got prescribed Vicodin,” Hamilton said recently.

Within a short amount of time, he was hooked.

“It got to the point where I was taking six 80 milligrams (of) Oxycodone a day,” Hamilton said.

That’s almost 10 times the average dosage.

“If I took an 80 (mg) Oxycodone right now, I would have to go to the hospital,” Hamilton said.

Oxycodone and Vicodin are opioids. They are not only highly addictive, but you also need to keep increasing the dosage for the same impact.

“The more you take, the more you need, or otherwise you’re going to get sick from them,” Hamilton said.”Once I couldn’t get any more from the doctors and went to the streets to buy them.”

On the streets, you’re paying a hefty price to keep up your habit. One 80 mg pill of Oxycodone goes for about $100.

“So eventually I just turned to heroin, because that’s just cheaper,” Hamilton said.

It’s a progression that is all too common in Central Oregon.

“We have a lot of people who are currently hooked on opioid prescription drugs who are switching to heroin,” said Rick Treleaven, executive director BestCare Treatment Services.

That is because heroin, just like Oxycodone and Vicodin, is an opioid. It has similar effects — at a much cheaper price.

While many teens would never start with heroin, partying with some pills has become a lot more socially accepted.

According to a survey included in a study by the Trust for America’s Health, one in four teens in the U.S. say they have abused prescription drugs in their life.

“Pretty much middle-class kids from pretty decent homes, partying with prescription drugs — and pretty soon they’re hooked,” Treleaven said.

But it’s not just teens. It’s estimated more than 6 million Americans abuse prescription drugs — and Oregon is No. 1 in the country.

“About five years ago, we really began to see a real spike in prescription drug abuse,” Treleaven said.

In the wrong hands, these painkillers can be deadly. Fifty Americans die from prescription painkiller overdoses every day. In 2009, the number of painkiller overdoses surpassed traffic crashes as the leading cause of death in the U.S.

“Almost everyone I grew up with is either dead or in prison,” Hamilton said.

Even the withdrawal is similar to heroin.

“It makes you want to crawl out of your skin,” he said. “Your bones hurt. Your stomach hurts. You can’t sleep. Everything aches.”

A big part of the problem is that there are just too many pills out in the community. Between 1999 and 2010, sales for prescription painkillers have quadrupled. Enough painkillers were prescribed in 2010 to medicate every American adult continually for a month.

“From probably the mid-1990s to the last two or three years, the pendulum had swung to pretty much in terms of relatively liberal prescription of narcotic medications,” said Robert Ross, medical director of community health strategy at St. Charles in Bend.

A big part of that push came from pharmaceutical companies.

“Every time they come out and say, ‘Oh, this is not addictive,'” Treleaven said. “But it’s in the nature of the medication that it’s addictive. They pay attention more to their bottom line, more than they are about the addictive consequences.”

Ross said, “There was quite a bit of advertisement and what we call drug detailing to physicians, and that didn’t help, because that increased, to some extent, the prescribing.”

With more pills came greater access.

“The issue with the over-prescribing is that it creates a large amount of pills in the community that could be diverted,” Treleaven said.

Just over 70 percent of people who abuse prescription medication say they get their pills from a friend or a relative, while others simply go from doctor to doctor.

“We’ve actually seen people go literally from Seattle, to every ER, all the way down the I-5 corridor,” said Kristin Powers, manager of St. Charles’ health integration project.

Health professionals are making changes to stem the tide and save lives.

Since January 2014, a new monitoring system has been put in place, tracking prescriptions filed in emergency rooms across Oregon, Washington and Northern California.

It’s not just ERs that are responding to the problem.

“It’s one of those conditions that our physicians felt like that they needed help in treating it,” said Kim Swanson, a psychologist with St. Charles. “So many other things go along with chronic pain, such as sleep issues and depression, that they wanted us to do that.”

Pain management clinics are designed to offer patients and physicians an alternative to medications.

“The piece that we work in the class is really an approach to teach them chronic disease management as they live with pain,” Swanson said.

As health care professionals are switching gears, Barrett Hamilton has overcome his addiction and is now a recovery mentor at BestCare in Redmond.

In his office, he has a reminder on his wall.

“These are all the mug shots since I’ve been in Central Oregon,” Hamilton said. “It reminds me that I don’t want to go back to that. I don’t want to go back to living that life and being that person.”