The 'accidental' addict: soccer moms, painkillers and addiction

A pharmacy employee looks for medication as she works to fill a prescription while working at a pharmacy in New York December 23, 2009. REUTERS/Lucas Jackson (UNITED STATES - Tags: HEALTH POLITICS) - RTR28BCM (REUTERS/Lucas Jackson)

Meet Peggy (not her real name). She is a 45-year-old mother of three kids ages 14 to 19. She is married to her college sweetheart who now runs an investment firm. Peggy has a master’s degree in education, has been active in the PTA, has traveled around the world with her family, goes to the gym three times a week and volunteers at her local church.

She is also a drug addict.

Peggy defies the popular stereotype of addiction: syringes, tattoos, the poor and uneducated. But Peggy is not alone; there are hundreds of thousands of addicts like Peggy, who are upstanding family members, well-educated, successful…yet in-the-closet addicts.

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But how did this happen?

I got to know Peggy last summer when she entered treatment at The Dunes in East Hampton, New York, is a perfect example of what I like to call “the accidental addict”: a person who trips down the rabbit-hole of addiction after being prescribed pain or anxiety medications by a well-intentioned doctor.

It is an old story: a person goes to their doctor because they are suffering from post-surgical pain or anxiety. If pain is the culprit, the doctor usually asks the patient to rate the pain from a scale of one to 10. Problematically, there is no objective measurement of pain — it is all self-reported by the patient. The doctor will then usually recommend some type of opiate for pain relief/pain management, such as Vicodin, Percocet or Oxycontin.

But the increase in the number of pain-pill prescriptions written over the last 20 years is very troubling. According to the National Institute of Drug Abuse (NIDA), in 1990, there were 75 million opiate pain med prescriptions written nationally. By 2010, that number had risen to 210 million, an almost three-fold increase.

Why? Are we in more pain as a nation?

While this answer can be varied and complex (sociological factors, pharmaceutical market penetration, etc.), what is clear is that the sheer volume increase of opiate prescriptions make it much more likely for “accidental addiction” to occur.

In Peggy’s case, she was prescribed Vicodin after minor surgery and Xanax for a growing anxiety issue. Not having been properly warned about the highly addictive nature of these medications, Peggy soon developed a tolerance for them and needed increasingly larger amounts to gain the same effect. Eventually, she was no longer taking them for medically prescribed purposes, but to satisfy a deepening addiction that she hid from her family.

Peggy’s case also illustrates one of the biggest problems that I have seen in my years working with “accidental addicts” – the failure of the prescribing doctors to adequately educate or warn their clients about these medications. And the problem often lies within the training that physicians receive, which may be only one day of addiction education during six years of medical school training.

To be clear, “accidental addicts” may also have underlying issues that may make them more vulnerable to developing an addiction issue if they are prescribed pain or anti-anxiety medications by their physician, such as underlying mental health issues, childhood issues, trauma or certain temperaments.

“Soccer moms” like Peggy can often be alone and feel isolated, another potential ingredient in drug abuse. These mothers can also often be over-stressed with the pressures of juggling parenting responsibilities and the daily grind of household management. Add to that a lack of social support and the pressure to maintain the “super mom” façade, and the soothing, instant relief of an opiate or an anxiety medication may instigate an “accidental addict.”

The following are common warning signs for accidental addiction:

• It becomes a struggle to hide the drugs or alcohol from children or other family members.
• Your marriage or relationships have struggled because of drug your pill use.
• You are talking to multiple doctors to get several prescriptions of your pills.
• You find yourself less interested in activities that once brought great joy.
• You have accidentally forgotten or neglected your children because of substance use.
• Your children have seen you high or “sleeping it off.”
• You recognize that something is not right.
• You feel overwhelmed and afraid to talk about these feelings,

At the Dunes, whenever we have dealt with successful, educated, family-involved addicts of the “soccer mom” variety, it is very important to help the client better understand the nature of their own addiction as well as to help them de-stigmatize what addiction is.

It becomes important to understand that addiction is less of a stand-alone 'thing' (or disorder) and more of a process. Thus we analogize addiction to a "perfect storm" that is an amalgam of a person's biology (both genetics and neurochemistry), their environment as well as their psychology (or temperament).

And each addict's "perfect storm" of addiction is different; for one person, it may be the childhood trauma of sexual abuse that was the dominant storm front in their addiction process; for another, it may be their neurochemistry (i.e. clinical depression or anxiety) that has predisposed them towards self-medicating.

Thus the key to treatment is not to use a cookie-cutter "one-size-fits-all" treatment approach but, instead, as we do at the Dunes, doing a thorough and thoughtful assessment that identifies the specific variables that compromise each addicts 'perfect storm' in order to then best guide their individualized treatment wherein those various 'storm fronts' are all addressed."

Then the client can begin to explore what underlying contributing factors may have been present as they begin learn new, healthy coping skills to deal with the everyday stressors of life. Combining traditional psychotherapy with more holistic stress-management practices such as meditation, yoga, emotional regulation and hypnotherapy can also with the process.

Once the “accidental addict” has gotten clean and sober, educated about the addictive potential of certain medications and learned new, healthy coping skills, they can then transition back into a healthy and fulfilled life.