Look around you. Statistics indicate that 5 percent of your acquaintances are addicted to a prescription narcotic. Dr. Seth Ivins of Newark believes that number is low, that up to 20 percent of the people you know may be addicted.
Numbers aside, “Addiction is a huge problem in the country,” says Ivins, a specialist in addiction therapy. “But it’s especially disturbing in a small state like Delaware.”
The main culprit, Ivins says, is the opiate oxycodone, better known by brand names like OxyContin, Roxicodone and Percocet. Oxycodone is more powerful than any heroin, also an opiate, available in Delaware. Oxycodone is commonly prescribed to treat pain, yet some patients will find themselves hooked. Those people come from all socioeconomic classes, from the impoverished and uneducated to the so-called soccer mom. One-third of Ivins’ patients see him for addiction therapy, and most are solid middle class professionals like lawyers, nurses and teachers.
“It’s a difficult problem to tackle,” Ivins says, both in treatment of the individual and in implementing public policy that could curtail abuse of the drug.
The pathway to addiction is straightforward. A patient is prescribed oxycodone for a legitimate medical problem, but upon using it, experiences an unintended effect, what Ivins calls an “energized euphoria.” As the patient builds tolerance to the drug, more is needed to induce the euphoria until, finally, the feeling fades entirely, no matter how much they use. Yet quitting the drug induces a sickening withdrawal. The patient is left with a powerful physical addiction—an altered brain chemistry and physiology—but no good feeling, and they’re in such need, they are forced to acquire the drug in illicit ways.
“It’s not bad behavior,” Ivins says. “It’s a disease.”
Ivins tries to break the patient’s dependency with a combination of therapies. First he treats with medicines formulated to cancel the effects of oxycodone. Doses of those medicines are gradually reduced until the patient no longer feels a dependence. Second, he finds counseling to address the psychological issues underlying the addiction.
Ivins believes good doctors are becoming more aware of the risks of oxycodone and better at managing their patients. “We have to treat pain. We can’t hide it. It’s why people seek us out,” he says. “But we have to find another way so we don’t cause more problems. We have to treat it ethically and responsibly.”
He blames three or four physicians for writing orders that result in “dumps of thousands of tablets on the streets.” He believes the state needs a targeted statutory approach to prevent illicit trade without harming people who truly need the medication.
“If we can’t stop the drug,” he says, “we have to stop the doctors.”