Addicts con doctors for drugs

Abuse of prescription drugs is a major problem, with addicts telling doctors sob stories and lies to get their fix, writes Kylie Munro.
Aucklanders addicted to prescription drugs are conning doctors, stealing and selling their prescriptions to feed their habits. Community Alcohol and Drug Services regional manager Robert Steenhuisen says narcotics, such as morphine sulphate tablets and codeine, and benzodiazepines, minor tranquillisers for sleeping and anxiety disorders, are the two main culprits. Addicts rotate around as many as 20 doctors, spilling sob stories and lies to gain their prescriptions. Some start out as legitimate patients and develop a physical dependency, others get hooked on the streets. Mr Steenhuisen says addicts upgrade narcotics from codeine to morphine to heroin. Some inject the prescription drugs and some sell them. National Drug Intelligence Bureau figures show morphine sulphate tablets have a street value of $1 per milligram and benzodiazepines such as nitrazepam and temazepam fetch $5 per tablet. Mr Steenhuisen says the New Zealand narcotics scene is vastly different from Australia, where scoring opiates in Sydney can take just 30 minutes. ``Here, in New Zealand, you can't do that,'' he says. ``The majority of opiate abuse takes place with prescription drugs. Other people score them from doctors, break into pharmacies or wholesalers, or have them sent out from India or China.'' Mr Steenhuisen says, occasionally, methadone leaks onto the street where it sells for $1 per milligram. He says the majority of 1100 participants in the service's Auckland region methadone programme are happy to be on it, and it is a minority who divert. Strict prescription and collection procedures and urine testing, to tell how much methadone has been taken, help curb diversion. Lesley Gamlen, a senior clinician at Tranx, a community outpatients service specialising in benzodiazepine addiction, says national prescriptions for the minor tranquillisers have risen since they became a controlled drug in 1999. In 2005, more than 50,000 scripts were written. Tranx has about 60 clients and a third of these are street addicts who may mix benzodiazepines with opiates, alcohol, P or methadone. Two-thirds of Tranx patients became addicted through prescription use. Ms Gamlen says, often, addicts who doctor-shop know they're addicted, but many patients with genuine prescriptions aren't aware they're dependant. ``A lot of our clients don't realise they are becoming dependant, and attribute the symptoms to something else,'' she says. ``Benzodiazepine withdrawal is quite unique in that you can be in withdrawal while still taking it as prescribed.'' Withdrawal symptoms include anxiety, insomnia, shakes, sweats, depression and irritability. Tranx works with patients' GPs to switch them onto diazepam and then gradually reduce the amount they take. Contact Community Alcohol and Drug Services on 845 1818 or Tranx on 356 7305.
STOPPING THE MAD CAROUSEL
For almost 40 years Nola has lived in prison. Not the concrete and metal bars type - but a prescription drug-induced cloud of emotional and psychological confusion. Nola, 64, is a drug addict. Not the P-crazed kind - but a mother, a grandmother, trying to wean herself off prescription tranquillisers. The Mt Wellington resident is making slow but steady progress, battling withdrawal symptoms to cut down from her daily fix of 20 milligrams of valium to 13.5 milligrams. She hopes to be drug-free by February 2008. The merry-go-round, as Nola calls it, started with a cocktail of valium, normacin, tryptonal and cerapax in 1968, when she was diagnosed with post-natal depression after the birth of her third child. Nola believes the difficult birth of her daughter and separation from the newborn when it needed hospitalisation triggered emotional flashbacks to 1961 when her first child was forcibly taken from her and adopted out. ``When I tried to tell the psychiatrist it was emotional he brushed it to one side,'' she says. And he made no mention of addiction. ``He never told me they [the drugs] were addictive,'' says Nola. Nola moved to South Africa and doctors there prescribed the drugs. She dropped down to only valium and normacin in the early 80s and, later the same decade managed to kick them, too. But marriage problems and a subsequent break-up had Nola back at the doctor's, back on valium and finally in hospital after a new doctor took her off the drug cold turkey and then diagnosed valium withdrawal. Xanax was the replacement pill. Back in New Zealand the prescriptions kept coming. Panic attacks followed as Nola's body became increasingly tolerant to xanax. She was taking the drug and was in withdrawal at the same time. Nola says the drugs affected every facet of her life -clouded her thoughts, toyed with her logic, blunted her emotions, and affected her parenting. Yes, the children were well fed and clothed, but Nola says the bond between mother and child was missing. ``I would have showed a lot more love,'' she says regretfully, ``but I was on a merry-go-round and I could not get off. You feel like you are in a prison that the doctors have put you in.'' Finally, Nola is breaking out with the help of a new GP, a counsellor and Tranx, a community-based outpatients addiction service specialising in benzodiazepine addiction. She's off xanax and on valium - it's easier to taper off that way. Each fortnight she drops half a milligram and rewards herself with a small gift. It's a process Nola approaches with a combination of optimism and trepidation. ``I don't know what I'm like drug-free,'' she says. ``I'm 64 and I'm just finding out what kind of person I am.''