Substance abuse targeted

Lortab and Oxycontin, used properly, are among the most effective pain relievers. They are also extremely popular with people who take them not for pain but for pleasure.

Over the past decade, prescription pain killers have joined a long list of substances that are abused. Addiction can create physical, emotional and economic problems.

Substance abuse is the topic of Saturday's Deseret News/Intermountain Health Care Hotline. Dr. Michael Crookston, medical director of LDS Hospital's Dayspring program, and LaMar Drollinger, licensed clinical social worker at the Wasatch Canyons campus Dayspring, will answer questions from 10 a.m. to noon. They'll discuss anything from treatment options to how to tell if a loved one has an addiction. They can also answer questions about popular "club" drugs like Ecstasy.

Adolescents seem willing to try almost anything, so experts see a lot of inhalant abuse, including glue, paint thinner and whipped-cream propellant. More and more abuse over-the-counter drugs like Coricidin. ("They take 12 at once. For the life of me, I'm not sure why they think that's fun," Crookston said.) But the trend has been toward prescription pain pill abuse.

Crookston says the detox process with high doses of Oxycontin and Lortab is "virtually identical to heroin, which more younger and younger people are using." Heroin is readily available. For prescription items, they often just raid the medicine chest.

Usually, young patients have an easier withdrawal because they haven't used the substance as long, they're more flexible and they generally heal faster.

Many who abuse substances started out with legitimate chronic pain. "But for some it spirals out of control, and they are less and less functional. When they try to get off the drug, the pain makes it even harder to stay off it."

For most, pain-killer use never becomes a problem. At risk are those with a "susceptibility or prior history of substance abuse," Crookston said. Risk factors include depression, anxiety, stress or childhood neglect or abuse. "Virtually anyone under the right circumstances can become addicted."

Addiction includes compulsive use despite negative consequences. "If it's causing problems in marriage or work or school and you're still using more and more anyway, that's an addiction," Crookston said.

"We are all capable of pretty significant degrees of denial and rationalization and minimization," so substance abuse may not be recognized.