How pain management can lead to painkiller abuse

People getting hooked at young ages for pain management

SAN ANTONIO – It’s no secret that drug use is pervasive in communities of all types. It does untold amounts of harm to people and their families, workplaces and jobs, and in some cases, result in death.

The use of opioids especially has grown significantly, especially in the last 16 years. Since 2000, the Center for Health Care Services in Bexar County reported that opioid use spiked three times the national rate. That includes both prescription pain medications like Vicodin and OxyContin, and the illicit opioid, heroin.

But how does a person arrive at either type of opioid addiction? For some, it’s because of a pain problem like a back ache or other medical concern. Others begin an addiction as a young person.

The numbers are staggering: According to figures gathered by the Center for Health Care Services, nationally, just under 1 percent of the population had an opioid-use disorder in 2014. That included 1.9 million people who are addicted to prescribed painkillers, and another 586,000 people who are diagnosed with heroin-use disorder.

Pain management

Will, a student at the University of Texas at San Antonio, said his mom took a doctor-prescribed  opioid to manage her pain.

“My mom used to have to take a lot because she got in a bad car crash and she had to take a lot for her back,” he said.

Will said his mom made herself aware that the medications are addictive and was careful to avoid the problem.

But for others, that’s not a major concern. Will said he’s seen classmates also use opioids that they didn’t need.

“People play around with drugs that they shouldn’t, a lot, and sometimes the painkillers, they’ll take (them) when they’re drinking,” he said.

Dr. John Tennison, medical director for the Center for Health Care Services, an opioid addiction treatment center in San Antonio, said rates of opioid use are high all over the country. They’re higher in Texas, he said, and many times the addiction started off innocently.

“Many people do become addicted to them from having had a pain treatment, which was well-intentioned and perfectly legal,” Tennison said. “They have devastating effects on the lives of the people who become addicted to opioids.”

Texas has suffered more than other states.

“One thing that’s probably not well appreciated by the public is the fact that even though the problem nationally has been declared an epidemic and is at an all-time high degree, it was already three times that rate in our region of Texas back in the year 2000,” Tennison said. “Based on inquiries, it’s probably even higher than three times that rate now.”

The school component

“Kids’ brains are ripe for addiction."

Alamo Heights Independent School District lost four children to drug abuse in 2009, and according to district wellness coordinator Michelli Ramon, the community of Alamo Heights has lost one child to drug overdose per year since that time.

Ramon said drugs change the landscape of young minds because students are still developing intellectually, emotionally, and physically.

“Social science research supports this,” Ramon said. “Kids’ brains are ripe for addiction. When you look at any child, you can see that they become addicted to almost anything they try. If they love soccer, if they love Pokemon, if they love marijuana, kids are very naturally intense and their brains are ready for learning, and addiction is a kind of learned behavior.”

And the drugs are readily available -- from medicine cabinets to street vendors.

“Certainly when we talk about prescription medication and alcohol, we do hear a lot of students report getting it in their homes,” Ramon said, with meth, cocaine, and heroin easily available on the street.

Crawford Banks, 17, did every drug he could get his hands on, including opioids.

“I was into whatever people handed me,” the Alamo Heights senior said. “I was into getting out of the normal life routine. I smoked a lot of pot, I did a lot of hallucinogens, took a bunch of pills, and drank a whole lot. It’s not hard to do that in this society.”

Banks said he loved it because the drugs got him away from himself. They cured mental dysfunction, he said.

Banks is in recovery and recently celebrated a year of sobriety. He continues a daily struggle by making a decision to stay clean. For some trying to stay clean, their availability makes it more challenging.

“Drugs are everywhere,” he said. “We’re not really going to escape them. People are getting it from one dealer. That dealer is getting it from another dealer. That dealer’s getting it from a distributor. That distributor’s getting it from somebody who makes it. They’re just everywhere.”

The right combination

Michelli Ramon will soon leave her seven-year tenure with Alamo Heights, but she’s not giving up the fight to help kids with addiction problems. She will go to work for Rise Recovery, a program that helps teens and young adults overcome addiction.

She said she will do the same job as she does now, but wants to help more districts address the issues facing young people.

Ramon said both adults with prescriptions and minors gaining access to the drugs contribute to the overall massive drug problem locally, throughout Texas and the country,

“There are adults who are driving the business because they’ve got those prescriptions, they have access to those drugs and they’re ready to sell them, and then you’ve got a kid who just has the right combination of being isolated and having the ability to buy it,” Ramon said.

“You put those two things at the table and it’s kind of a nightmare,” she said.