How easy is it to develop a dependence on opiates

The following is part II of a radio interview Dr Schiesser Performed with Dr Marvin Seppela

Dr. Michael Schiesser: Welcome back to "Health Dimensions" this morning. I'm here once again with Dr. Marvin Seppala, who is the medical director for Beyond Addiction, in Beaverton, Oregon.

And I want to remind people to, really, take a chance to visit the "Turn to Help" website. "Turn to Help" is a resource for persons with addiction to prescription painkillers, or street drugs that are also opiates, like heroin, and it's also a resource for their families. And it has lots of modules for whatever level of recovery you're in, including never even seen a doctor for this problem.

Dr. Seppala, tell our listeners a little bit about how difficult it is to get on these medications.

Dr. Marvin Seppala: Well, it's remarkably easy to get on these medications, and that's part of the problem. When I talk about the opiate pain medications, I always say that it's the good and the bad news. They work extremely well. They're remarkable medications for pain, and they're the best thing we have going. When people need them, after a broken leg or a surgery or some other kind of pain, they're a godsend.

On the other hand, they are extremely rewarding medications. And as a result, they are highly addictive and extremely dangerous. And basically, people have this sense of safety because they're prescribed medications. It's as if, "Well, I got it from my doctor. It can't be that bad."

But the truth is, all of these opiate pain medications are basically of the same class of drugs. So when we say heroin, people often kind of shudder in fear of that awful drug, but it's basically the same thing as morphine, as OxyContin, as Vicodin; just, you have to inject heroin, and it works very rapidly. But with OxyContin, you could crush it and snort it, and it works extremely rapidly, and it's just as dangerous, as is Vicodin.

And so it's remarkably easy to obtain them. People get them going to their doctor, for any kind of pain. And in fact, a friend of mine, an anesthesiologist at the Mayo Clinic, told me that he was giving a talk on drug addiction and the ease at which people can obtain these medications, and doing it at one of their outlying clinics in southern Minnesota.

And he went and talked with the head of the clinic, who described to him a really unfortunate tale, that a 13-year old boy came into his office with his mother, and he learned from the mother that this boy had just been picked up for dealing OxyContin at school, actually selling it to his friends. And this physician asked him, "Well, where do you get this OxyContin?" And he said, "I get it right here at your clinic."

Dr. Schiesser: Oh, my gosh.

Dr. Seppala: Yeah. "I can come in here, and I can complain of a sprained ankle or a sore back. They started with Vicodin, and then they started giving me OxyContin. And that's what I tell them works."

Dr. Schiesser: Did you hear about the recent ruling against the executives of the manufacture of the OxyContin tablets?

Dr. Seppala: Yes, I did. And I was glad to see that, because of the inaccurate information that they provided to us, physicians and the public, about the risk of that medication.

Dr. Schiesser: For our listeners, the Purdue Pharma Company, the makers of OxyContin, were convicted of conspiracy to deceive physicians around the addictive potential of OxyContin, which is a sustained-release oxycodone prescription painkiller, and were fined, I think, $650 million, the executives were.

And this is relatively unprecedented, I think, in this particular community, as far as pain management, because there is a strong movement right now to increase treatment for pain, and as you said, very appropriately. But also, we're seeing such a surge in addiction, to OxyContin in particular, that it was, I think, good news, as far as I'm concerned.

Dr. Seppala: Yeah, I agree. And it was interesting, I'm on the board of the American Society of Addiction Medicine, and I got an email from a fellow board member that showed pictures of the three main figures in that lawsuit from Purdue Pharma. One of them was a physician who had actually been at our annual ACM meetings, at a pain and addiction course, for several years running, up until the problems began, related to that lawsuit.

And so there was an infiltration, so to speak, of someone really promoting a drug for relief of pain at an addiction conference, where people were trying to figure out how to address pain in those that are addicted, or determine when addiction results from the treatment of pain.

It's unfortunate that they took the tack they did, because I think we need to have pain relief, and we also need to understand addiction and how to address that. And I think they were coming in on the side of revenue. [laughs] Make as much money as they can selling this medication.

Dr. Schiesser: Right.

Well, Dr. Seppala, I appreciate you coming on our show this morning.

My guest today has been Dr. Marvin Seppala, who is the medical director from Beyond Addiction, in Beaverton, Oregon. We've been talking about addiction. And I want to remind listeners to view the TurnToHelp.com website for more information on treating some of the problems that we've been discussing on today's show.

Thank you, Dr. Seppala.

Dr. Seppala: Thank you, Michael.

Dr. Schiesser: You're welcome.

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Dr. Schiesser: You're listening to "Health Dimensions". This is Dr. Michael Schiesser. This program is sponsored in part by an educational grant from Reckitt Benckiser Pharmaceuticals, Inc.

For more information, see TurnToHelp.com.

"Turn to Help" has resources for people with addictions. For treatment of opiate dependence and other addictions, call 425-644-6048. For more information on Creekside Center, visit CreeksideMedicine.com.