Family physician Brian Harrington talks with his associate Kim Mosher inside the offices of  Yampa Valley Medical Associates on June 26. Harrington said the most important part of prescriptions is monitoring patients closely and that the important role of medication as a treatment should not be overlooked.

Photo by John F. Russell

Family physician Brian Harrington talks with his associate Kim Mosher inside the offices of Yampa Valley Medical Associates on June 26. Harrington said the most important part of prescriptions is monitoring patients closely and that the important role of medication as a treatment should not be overlooked.

Physicians weigh risk of drug abuse vs. benefits

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Addiction specialist Dawn Obrecht says some of her patients are dealing with addictions to prescription drugs.

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Addiction specialist Dawn Obrecht says some of her patients are dealing with addictions to prescription drugs.

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Drug seekers easily can abuse prescription drugs like Xanax.

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Ronna Autrey, a suicide prevention coordinator with Reaching Everyone Preventing Suicide, said a community health fair planned for Oct. 24 will have a drug drop-off station, to collect and dispose of unused prescription medication.

To learn more about addiction to prescription drugs, visit:

- The National Library of Medicine Drug Abuse: here

- The Nemours Foundation Teens Health Prescription Drug Abuse:

here

- Office of National Drug Control Policy Prescription Drug Abuse Prevention:

here

— The going price for prescription pills in Steamboat Springs is $1 per milligram of painkiller or antidepressant, local physicians say, warning that the abuse of prescription drugs is rising.

Police say the trend is noticeable but not overwhelming in Steamboat. Most visibly, the search for prescription drugs led to the March 16 arrest of a 23-year-old man suspected of burglary at Lyon's Corner Drug, a downtown pharmacy. Police said the man dropped bottles of a prescription painkiller when he was taken into custody. Doctors and police report that drug-seeking behavior, and the addiction that drives it, is becoming an increasing concern in Steamboat.

Steamboat Springs Police Department Capt. Joel Rae said determining the extent of abuse in Steamboat is tricky for several reasons.

The department keeps track of drug arrests by the classification of the substance - Schedule 3 substances include codeine, anabolic steroids, testosterone and some depressants, for example - not by whether the medication is prescribed. It's also harder to detect people who are abusing prescription drugs, Rae said.

"I think we hear a lot more than we see. I know that we have great concern for the youth in our community pertaining to prescription drugs, and it is becoming a drug of choice," he said.

Rae said that there occasionally have been reports of prescription drug abuse in Steamboat schools and that the frequency has been increasing throughout the past several years.

"We hear rumors through the high school and even the middle school at one point last year," he said. "We've had rumors of kids taking drugs and selling them to their friends."

School Resource Officer Josh Carrell, who works in Steamboat Springs High School, said he has learned about prescription drug abuse and how to spot it through training, but he does not regularly find that kind of drug abuse at the high school.

"I did have at least a few cases this year," he said, adding that it was not a continual problem.

"The more common (drugs) are obviously alcohol and marijuana," he said.

Dr. Dawn Obrecht, who specializes in addiction medicine in Steamboat, said she has seen a great deal of abuse across town.

"It's a small resort town, there are a lot of children of the '60s, flower children and their children," she said.

Obrecht said the problem stems from doctors in town who give medications too easily, including those who issue refills without seeing the patients.

"Out of a very small number of doctors, there are a few who prescribe very, very inappropriately," she said. "Every addict in town knows who they are."

Pain management specialist Dr. Brian Siegel said the doctors may not be as diligent as they should, but he does not see the rampant abuse Obrecht described.

"Yeah, there are some physicians who may give the medications easier, but who's to say they're not making adjustments?" he said.

Siegel said he doesn't think there are "bad doctors" in Steamboat who prescribe inappropriately.

"Some (doctors) will just give medication and may not be as diligent on following up on how patients are using it," he said.

Because of prescription drugs' potential for abuse, Obrecht said such medications should be prescribed on a short-term, limited basis. Prescriptions that are most commonly abused, she said, are those that contain benzodiazepine - such as Xanax, Valium and Ativan - and narcotics. Benzodiazepine is a sedating tranquilizer taken to counter disorders including anxiety and insomnia.

Siegel agreed with Obrecht that there is a problem of prescription drug abuse, but he disagreed that the problem in Steamboat is any larger than in other parts of the country.

Doctors often are put in a hard position, he said, because patients often feel entitled to pain medication as a part of their treatment, and doctors are obligated to treat their patients appropriately.

"Patients : have this sense of entitlement for their pain, whether it's a real problem or a perceived problem," he said. "If we don't treat, we can be sued for under-treatment."

On the other side of the problem, Siegel said doctors "frequently get caught up in prescribing medication where it may not be appropriate."

Siegel said doctors face a challenge in prescribing appropriately but that, that should not stop them from prescribing medications. Instead, he said, there are many ways to prescribe medication and monitor its use, including randomized urine analysis from patients to ensure that they are taking the medication instead of selling it and that they are not taking other medications not prescribed.

"We're testing five to 10 patients a week," he said. "Almost every week, I'll get (a test result) that shows something inconsistent."

A place for prescriptions

Dr. Brian Harrington, a Steamboat family physician, agreed with Siegel that the risk of abuse does not outweigh the benefits prescriptions can provide, even to addicts as they come down from highs.

People who are known addicts are at especially high risk of abusing the drugs used to help them come off of illegal drugs.

"There can be a risk of abuse, because if a person is already abusing substances we are just trading one substance for another, but I don't worry about abuse (right then)," Harrington said. "If somebody is going through alcohol withdrawal, we're medically supposed to reduce the risks, which includes giving them some of these drugs."

Harrington said withdrawal can bring delerium tremens, a severe part of withdrawal that can be treated with the benzodiazepines.

Harrington said the most important part of prescriptions is monitoring patients closely, and the important role of medication as a treatment should not be overlooked.

"Ultimately what we'd like to do is to give everybody the tools to cope healthfully with stress and mental health problems in their life and to do that without a dependence on a substance," he said. "I think that if any of us take an absolute position for or against the role of medication in treating these disorders, we're probably doing a disservice from patients out there who could benefit from either stance."

To prevent children or other people from abusing drugs, Rae said, parents should be cautious with prescription drugs that are left over after their treatment no longer is needed.

"The best advice I would give is if you have old medications at home, to flush them down the toilet or throw it away," he said.

Carrell agreed and said that his training taught him that home medicine cabinets are the most likely place students will get access to drugs.

"A lot of people tend to hang onto prescriptions that they didn't take all the way through, just to have them if something else comes up, especially pain relievers," he said. "Make sure you get rid of those."

Comments

jhr2000 5 years, 3 months ago

Haven't drugs flushed down the toilet become an environmental problem in some communities as the drugs enter the water system?

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freerider 5 years, 3 months ago

Death by prescription...Pharmacedicals kill ten times more people every year than all illegal drugs combined..Elvis , Michael Jackson , Danny Gans , Heath Ledger , Rush Limbaugh ...well we can only hope that Oxy Rush check's out sometime soon.....Big Pharma spends more money than any other lobby in D.C. Selling poison like Guardasil ...which by the way is killing young girls or paralizing them ...The AMA wants to ban holistic healing and make herbs go under the control of the FDA ...That would be the food and death administration...can you imagine places like healthy solutions or the bamboo market under the control of the government...AZT the most toxic crap on the planet...the religious right got the FDA to sell that to Aids patients and doctors went along with it ...most doctors don't even know what they are prescibing...if you take AZT you die...Magic Johnson stopped taking it that's why he's alive..AIDS scam of the century..HIV was never isolated but your doctor won't tell you that..they will sell you AZT at $1500.00 a month...the list goes on and on...stay away from meds...period...I'm in my mid fifties and never take meds..don't need them and never will

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aichempty 5 years, 3 months ago

Freebie,

I was the same as you about all this stuff until the night my wife had to take me to the ER because my lungs were filling up as a result of allergic asthma and bronchitis. I had worked up a sweat from the effort of trying to breathe, and knew I was about to be in big trouble. 15 minutes later and a few puffs of albuterol, and I was out of the woods. Scary, but an effective lesson. Now when I get a chest cold, I see the doc and do what he says.

After two years of treatment with various allergy drugs and inhaled etceteras, I'm off all of them except one bi-weekly injection that suppresses allergic reactions.

I'm as against needless prescription drugs as you are, but without them I'd have probably been dead a year ago. Now, as happy as that would make some of the folks who read this forum, I wasn't ready to go.

So, be sensible. Use the minimum when you need it, because you can die if you don't. On the other hand, being sick should not be a reason to sit around getting high for the rest of your life. People have to take personal responsibility.

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