February 9, 2008 - White House Office of National Drug Control Policy
Breakthrough Addiction Recovery Hour show transcript
February 9, 2008
Welcome to the Breakthrough Addiction recovery hour. During this hour we will be discussing topics on addiction as it relates to alcoholism and other drugs. Our phone lines are now open, so call us at 770-226-0920 with your questions and comments.
Brian: Good afternoon, Atlanta. Welcome to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, clinical director at Breakthrough Addiction Recovery, and with me is my cohost, Jill Mattingly, our physician assistant, and Jill, take a look outside, isn’t it a gorgeous day, Atlanta? Beautiful!
Jill: I know, what are we doing in here?
Brian: Well, you know, last week…
Jill: This is when we should be in the parking lot of, like, Lenox Mall doing this, so we could enjoy the weather, you know what I mean?
Brian: We’ll need to talk to our boss about that… that’d be great. You know, we had a wonderful experience last week, being able to talk about the issue relating to opiates, and also the key is that we had that antidrug campaign and we really had a wonderful time talking with Laura Ashley Overdike, who’s with the White House Office of National Drug Control Policy… that is a mouthful…
Jill: I know, can you imagine?
Brian: I hope everybody did see the Super Bowl, and did see that ad…
Jill: Oh my gosh, I did see the Super Bowl, I was a big Giants, I was for the Giants, so I just gotta say that, yay!
Brian: You did. (laughs)
Jill: But anyways, I was real excited about watching for the commercials, and it was probably right before halftime, if you were watching the Super Bowl, you might have seen a commercial where a guy, kind of a seedy character, was next to a payphone waiting on a call. He was obviously a drug dealer, and he was saying, hey, you know what, I’m out of business because where the kids are going now are right upstairs to their parents’ bathroom in their medicine cabinet…
Brian: That’s right…
Jill: …and that’s where they’re getting the drugs these days. And I thought, that was really a great ad. And I hope it wasn’t lost on people what was actually going on. I’ve actually seen one other ad in U.S. News & Report. It was on the back fly of the magazine, and it shows a regular medicine cabinet sitting on the side of a brick wall in an alley, trying to get home to people that…
Brian: Well, that makes it home, you can get your drug dealer right out of the daggone medicine cabinet hooked on to the back wall of an alley…
Jill: Exactly. Yeah, I’m just, you know, I was excited, you know, over a month ago we were talking about this on the radio show, and then found out that this huge national campaign is taking place, and I think it is so timely and the message has to get out because, you know, learning some of those things that we found out from Laura Ashley about how teens are getting into this type of drug abuse…
Brian: Let me just recap… We have come to understand just basically having overheard with Laura Ashley that the past 12 years there was 12.6 million nonmedical users of pain relievers. Can you imagine that? Nonmedical. That means they were using this medication in nonprescription ways.
Jill: Absolutely.
Brian: 70 percent obtained them from a friend or relative. Now whether or not they were given them or they actually took them, the issue is 70 percent were able to obtain them. So when you are talking about medicine cabinets, not just that only family members can go in there, but who knows, we have friends of family members who are over there, and they may be kind of looking around and perusing each others medicine cabinets trying to find this, such as oxycontin and percocet and lortab. There are approximately 2500 teens who try prescription painkillers to get high for the first time each day.
Jill: Oh, that’s the one…
Brian: That is absolutely phenomenal.
Jill: and that’s their first time for doing anything to get high…
Brian: That’s right.
Jill: …which, it used to be, you know, most of us remember…
Brian: a cigarette…
Jill: Yeah… No. No, now Brian, you’re really aging yourself. No, back in the day, it was, you know, marijuana was that first drug that you’d use with the friends in the basement and things like. But now it’s becoming, let’s just go to parties with a handful of mom and dad’s pills. And sometimes they even do what they call pharming, or pharm parties, where they actually take drugs from the medicine cabinet of their parents, go to parties, put them in a bowl… and I know that was back in the 60s that was pretty popular, but they are doing it again because they’re so easy, easy to get from their own homes.
Brian: That’s right.
Jill: And, you know, when we were talking about this last week with parents, we didn’t want to say, ok parents, all of the teenagers out there, including yours, are trying to do this. Well, that’s not the message we’re trying to say. We’re trying to say, anyone that comes into your home, anyone can be susceptible to the lure of easy medication, easy drugs.
Brian: You know, Jill, I’m really glad you said that because so many times parents think, oh, not my little child, that person would not be doing this. But you know the interesting thing, the average age, prescription drugs are the drug of choice among 12 to 13 year olds. Now that’s got to be a shocker for individuals who have young teens or even preteens to realize they’re already experimenting at that young age. The question then is, why do they feel they need to feel high at that young age?
Jill: Well I think that just goes back to being a teen. Most teens start to experiment with something and, you know, like I said, it used to be something that was kind of hard to get, you know, the marijuana, the alcohol, you know, sneaking the alcohol from your mom and dad’s liquor cabinet, things like that. This is much more difficult to detect, first of all, and as we know about the brain disease of opiate addiction and benzodiazepine dependency, it changes the brain…
Brian: Yes it does.
Jill: …much more efficiently than marijuana and alcohol do at that young age. Yes, alcohol does have a bearing on the brain. However, these medications create a very intensive dependency very early…
Brian: …and very quickly. And when you begin realizing how easy they are to get, in fact, I still remember about your niece saying, when she was there at her locker, and someone actually came up to her locker and offered her these kinds of pills crushed up in such a way they could actually put it in a ballpoint pen and saying, buy some of this. This is just, blows my mind. How easy it is to pass this on, even at the lower school levels.
Jill: Yeah, and it seems like it’s a safer high, too, because…
Brian: That’s the false thinking…
Jill: Yes, exactly. But, you know, we at Breakthrough Addiction Recovery, we treat opiate addiction, benzodiazepine dependency, alcohol. But here’s the thing, we got into this antidrug campaign because what we see at Breakthrough is the average age of an opiate-dependent person is usually from 20 to 35.
Brian: Mmm hmm.
Jill: And so I always do a very intensive medical history and exam, and in talking to these yioung people, I find out they started this whole situation back in high school, 17, 16, they started taking oxycontins, because they were in the house, or because a friend of them said, hey, this will make you feel better, or you know what, the girl may say, you know, I had really bad menstrual cramps so I started taking them from my friend because they took care of it. But then they find out very early on that they have to have that or they start to get sick, the withdrawal.
Brian: Right. And you know it’s interesting you say that, too, because from your side of the house, as you’re doing your medical assessment and finding that age, as I’m doing treatment on a daily basis, I said, well how early did you start drinking alcohol? And usually it’s around 13, 14 years old. So here we go, we’ve got youth testing and trying out alcohol at 13, 14, 15 years old, and then you’re saying they’re experimenting now with these opiates, these pain medications… what a deadly combination that is.
Jill: Absolutely. I hope in our listening audience if you hear this, what you, we have been saying this every week, go to your medicine cabinets, find the medications such as the benzodiazapines, which were going to talk a lot about today, and all the pain killers, or pain medications, put them in a safe place. Maybe a locked area that your children or you know people that visit you are not going to be able to get to when they use your restroom. And, you know, we have also come upon people saying they even go into, what is that, open houses that real estate agents have…
Brian: Oh yeah, when, like on Sunday open house people end up going to these various real estate open houses, they visit all the homes, they take a look…
Jill: …and the owners are gone…
Brian: Yeah, that’s right, they’re gone, and unknowlingly they leave their medications ion the cabinet, people go there, and they kind of have a heyday. They say, oh, here’s a bottle. In fact, we know based upon what Paul was saying…
Jill: Yes. If you are selling…
Brian: …I’m just grabbing this opportunity out of the shelf and stick it in my pocket.
Jill: If you are selling your home, please be aware you need to lock up your medications, because people will be coming through and looking at your home…
Brian: Yes. And keep it safe.
Jill: …and making excuses to go to the restroom.
Brian: Exactly.
Jill: So we’re going to talk a lot about some very devastating news that came out a couple weeks ago, the death of Heath Ledger, and were going to talk a little about that dangerous mixing of medications. So I really hope if you are listening today, you’re going to stay tuned. We’re going to really help you know one important thing, and that is, if you have these medications in your medicine cabinet, there could be a time when you take more than you intended to take. And we’re going to talk about the mixing of medications when we come back. And if you want to join us, 770-226-0920. You can call us, ask a question, and comment, get in on the conversation. Also, outside of Atlanta, 1-888-920-2665. Stay with us, Atlanta. Be right back.
<commercial break>
Brian: Welcome back to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, and my cohost is Jill Mattingly. And today we’re continuing our discussion about the issues related around opiate addiction and also opiate treatment. And Jill, you know, we’ve been looking today at all the different issues related to the promotion of understanding how people are actually going to individual’s medicine cabinets and pulling out these drugs and using them at a very, very early age. I know there’s a deep concern, especially as a physician assistant and me as a person who does clinical treatment on a daily basis, how these are impacting our young people. I love the way you said the other day, I mean, just a few minutes ago…
Jill: The other day…
Brian: Yeah, the other day…about how individuals, 21, 22, are now getting to the point of addiction, but they’d actually began at 14, 15 years old. So we know this does take some time, as people begin to continue to use and their brains begin to change. Here they are now using it instead of just socially, they’re now becoming addicted to them.
Jill: Yeah, and that doesn’t show up right away in some of the teenagers. You know they may do it here or there at a party, you know, it’s something, you know, a claim to fame, like, oh yeah, I had that at a party. But then they get into college or post-high school and they start to remember, you know, I remember how that made me feel, and I’m a little stressed out now, so I’m going to try to use this for sleep, or they have something where they actually get a, you know, medical reason to get these pain relievers…
Brian: And that’s where so much of it begins. Maybe they had oral surgery, or perhaps they had lower back pain…
Jill: Uh huh…
Brian: And now they’re using this, initially using it as a way to deal with their pain…
Jill: Right.
Brian: …a healthy pain that we know is there. But now, they probably had that memory.
Jill: Plus, you know, remember that opiates, when you’re talking about them, don’t treat everyone the same. There are people out there who are listening know the first time they had surgery and tried to take an oxycontin or vicodin they felt very sick to their stomach, dizzy, and it was not a pleasant experience whatsoever, so they determined, I’m just going to go with naproxen from here on out. Then of course you have those that say the first time I took this med, I was on, I felt good…
Brian: …fantastic…
Jill: …calm, I could do anything I set my mind to. That means, biologically, they have a very high tolerance or propensity to go into dependency…
Brian: Propensity. Indeed.
Jill: Here’s the thing, they go into high school, college, they have the stressors of life, and they start to take it on a regular basis. And then they have to get it, because then once they’re dependent they’re going to get sick if they try to stop. Well, what I see at Breakthrough when people come in, they’ve been on this medication for 3 to 5 years. They are actually looking at a very difficult life, and they are looking at it and their families are looking at this, and that’s usually why they come in, because all of a sudden they realize, I am completely a prisoner to this, and they’re only 22 years old.
Brian: And they’re wanting to stop because their lives are just getting miserable. They’re beginning to have these withdrawals, they know when they stop taking it they get these severe flu-like symptoms, they’re just really trying to find some way to get their lives back. Especially at 23, 24, 25 years old.
Jill: And that’s where suboxone can actually be a lifesaver. Suboxone treatment, for those of you that don’t know, it’s an FDA-approved medication, and we use this medication to help people get off opiates when they are dependent on them. And it’s basically just a day and a half to two days, um, induction, they get medical and clinical wraparound services to do so at our location. And, it’s becoming very easily managed…
Brian: …And I’m glad you said that. Right.
Jill: It’s not something like methadone that you have to do every day.
Brian: And that is, we need to make sure that our listening audience understands, it’s not just only the detoxing. It’s so critical to get that psychosocial support that therapy, because they really need to work on something. Looks like we got a call coming in here, Carrie from Norcross. Hello, Carrie.
Carrie: Hi.
Jill: Hi, Carrie. Did you have something, we were going to be talking about Heath Ledger. You probably heard us talking about that. Did you have a story or something about Heath Ledger’s death you wanted to talk about?
Carrie: Well, it was just a, in our family, a couple of years ago, my 22-year-old nephew took an accidental overdose.
Jill: Oh, wow.
Carrie: And the interesting part to begin with was that we didn’t even know he had a drug problem. His family, his parents didn’t let us know, and, um, he had become addicted to xanax. And they sent him off to rehab, he came home, he was clean for about a week. He went out with his friends on a typical, you know, like a Saturday night type of thing, and the next day he did not show up for work and the police found him in his apartment. He had one pant leg on, they said he was trying to get dressed, he was putting his uniform on, he was trying to get dressed for work and his heart failed.
Jill: Oh, wow.
Carrie: The autopsy showed that he had taken at that, evidently at the party or wherever he was, he had marijuana, cocaine, xanax, oxycontin. Um, there were also other drugs found, one was an a sleeping drug. So it just really brought back a lot of memories, and…
Jill: I’m sure it did.
Carrie: I think that a lot of people don’t understand how important it is to know these things. I mean families try to keep everything a secret, and had we known, you know, maybe we could have done something. Maybe something could have been said, we could have been more proactive, but, um, needless to say we lost a wonderful young man. It was a horrible waste of life.
Brian: It is. And you know you’re so right, and that’s the reason I think programs like this, Carrie, are so important to help the general public understand the dangers involved. I think so many times we have a feeling, well, it’s medicine, it’s been prescribed by a physician and filled by a pharmacist, and so we think it’s all fine. And as a result we don’t really understand how the dangers occur. And again, I think what Jill is saying here, that really when they start using opiates at a very young age these days, and then they just begin to move more and more into using those, and now the brain chemistry has changed, and in that…
Carrie: But what I found interesting was that the xanax had been prescribed to him because of depression he was experiencing due to his parents’ divorce and remarriages. Both parents remarried, both parents started new families, and he was the ping pong ball going back and forth…
Jill: And Carrie, how old was he when he passed?
Carrie: When he died, he was 22.
Brian: 22.
Jill: Ok. Wow.
Carrie: So, what really shocked us was that it was, the original intent was to of course to bring him out of his depression but unless he got any counseling, that wasn’t, there is no magic pill. But he was mixing that with his drug use.
Jill: And probably alcohol also.
Brian: Yeah, I’m sure alcohol was part of it.
Carrie: Oh absolutely, because he was a bartender.
Jill: Yeah, well…
Brian: Oh that’s, ok…
Carrie: So there were so many… and so what upset me too was by the time we got to Florida, and we got to the church, and we began to see his group of friends begin to file in, my husband looked at me and said, most of these kids are high.
Brian: Mmm hmm. And you know that’s so true, Carrie, because so many times we hear this, if their friends are there, the way they’re going to cope with the death of a deep friend is to use, so they can cope with the fact of their own grief.
Carrie: Literally it looked as if it didn’t even phase them.
Brian: Yeah, I mean, if you’re under the influence, it probably looked like it didn’t phase them. But believe it or not, there’s a lot of struggle. We hear this so often…
Jill: Yes, we do.
Brian: People are saying, you know, I had a friend who passed away as a result of an overdose. I know I was taking this, I know how close I could have come to doing this, and I had to just have a pill or two, just so I could make it through the funeral.
Carrie: I don’t know if any of you know this, but the interviews with Heath Ledger prior to his drug abuse, I think he was, I think he became dependent on drugs. Because the interviews right before his death, the pictures of him, he looked unkempt…
Jill: Yes, he did…
Carrie: …he looked like there was something definitely wrong with his appearance. Which is what I noticed, the pictures they put on top of the casket, they showed his senior picture, this nice healthy-looking young man, you know, with meat on his bones. And then the most recent picture he had a shaved head, he had piercings all over his face, he looked like his cheeks were drawn, he wasn’t that boy anymore.
Brian: Right.
Carrie: And if that doesn’t tell you something that maybe there is something else going on…
Jill: Absolutely. You know, that’s one of the things were trying to get out to parents, too. And Carrie, thank you so much for this call…
Carrie: You’re welcome.
Jill: And we’re going to continue talking about this Heath Ledger overdose and really try to educate people on that.
Carrie: That’s a good idea.
Jill: Yeah. Thank you so much for your call….
Brian: Appreciate your call.
Jill: …and we are going to go to a break now, Atlanta. Please stay with us and we’ll be right back.
<commercial break>
Jill: Welcome back to the Breakthrough Addiction Recovery hour. My name is Jill Mattingly, and my cohost, Brian Fujii. And we are talking about some difficult things. We just had a caller talking about a nephew of hers that had been found, dying from an accidental overdose similar to Heath Ledger’s. We’re going to talk a little bit about what was found in the toxicology report from Heath Ledger. And I want to clearly get across to the listening audience how the medications that Heath was taking were actually prescribed to him and were legal medications. We are going to go through each medication and how it can be very dangerous to mix these. But it looks like we have a call. Brian?
Brian: Todd, Atlanta. Welcome to the show, Todd.
Todd: Ah, yes, thank you. I just had a quick question regarding teenage opiate addiction. And I was curious how it affects teenagers neurologically because I know that they’re still in a developmental phase in a lot ways, and how it affects them compared to adults. And how opiates differ from, like, Ecstasy addiction in the brain.
Brian: Ok, well, typically, Todd, when they’re really young, from what I understand, the brain actually develops from the back to the front, if you want to put it that way. And around age 21, 22 is when really gets to its full development. And one of the things we’re finding out for teenagers and really, pre-adolescents as they’re using we’re finding out many times their brains don’t seem to develop as quickly or as maturingly. As a result, they’re not really thinking very clearly, and this is why they end up start taking all kinds of high-risk behaviors. They definitely have seen that frontal part called the prefrontal cortex, where we get the majority of our logical thinking, and so if that part of the brain is not being developed because the use of painkillers or alcohol or other types of drugs, they really are impairing their future thought patterns.
Jill: Right. And you’ve got to understand, having a drug that attaches to an opiate receptor, which most painkillers do, is going to send out neurotransmitters, and that’s going to strengthen a neuroconnection with the psychological part of the brain. It strengthens, I feel stress, and so the brain will send out messages to your frontal cortex, then this is what you need to do. So it starts what I call a neural connection or a neural circuit that strengthens with each use that is telling the brain, this is how we handle stress, this is how we handle sadness, this is how we handle depression…
Brian: Exactly.
Jill: And the other thing you asked about is Ecstasy. Ecstasy is kind of related a little bit to the amphetamines, which has a different function. It doesn’t join to a receptor per se, but it causes dopamine to be released by the neurons, which gives you that excitatory kind of feeling, and actually that can have the same effect. You have a release…
Brian: …a dopamine dump…
Jill: …yes, a hyperrelease of neurotransmitter, and that produces a great, great feeling, and so the brain remembers it. The biggest problem for the teens and anyone that’s using a medication to alter their mood is your memory. Because your memory will work against you when you start to have things like sad ness, depression, stress…
Brian: That’s a great point, Jill. You know, Todd, that’s one of the things that we talk about in our treatment is, the brain has tremendous drug memory. It usually as it goes through what we call the pleasure pathway of the brain, in that lower brain, that’s basically the part of the brain that’s basically responsible for fight or flight, or pleasure pain. When they start feeling that kind of pleasure, it moves right back to a part of the brain that has great emotional memory, and so as a result, with that emotional memory, if they use any other type of drugs or alcohol, it triggers that brain to remember how good it felt and they’re right back into relapse or really feeling intense. And I like what Jill said, too, you know so many times when you’re taking those drugs at such an early age, and so if you’re taking those drugs because you’re sad or you’re frustrated, or you’re worried, or you’re anxious…
Jill: Or you’re having a good time.
Brian: …or you’re having a good time too, yes, either the good or the bad. What happens there is that the only thing that is being truncated here is that, they’re saying, if I feel this way, the drug will help. Rather than learning how to cope with these particular emotions in a mature way so they really are impacting both their emotional growth as well as their psychological growth.
Jill: Are you still with us, Todd? We’ve given you a big earful, huh?
Todd: Oh, no, that’s great. I’ve, that’s a tremendous show. I just have one more question: Does the opiate receptors in the brain, do they grow with the continued use of the narcotic?
Jill: That’s an interesting point. There are different studies out there about what the opiate receptors do. There’s actually I think 4 different ones, and what we’re interested in usually in treatment is the mu receptor, opiate receptor, which is what suboxone works with, but actually there are some amazing books and studies out there that talk about opiate receptors being all over our body, not just in the brain, and they are actually found in one-celled animals like hydras and things like that so opiate receptors must be important for our survival or they wouldn’t be all over our body. I don’t think they are destroyed and I don’t think that you get more of them, I think it’s just a situation where we have them and they can be used to make us feel better naturally or we can take something in to tickle them and make us feel better.
Todd: Wow.
Jill: Very interesting stuff. There’s an interesting book out called Bliss, by Doctor Candace Perd if you ever want to look more into the science of opiate receptors. She actually discovered that in 1972 as a biochemistry graduate student, and she was the one that discovered, not discovered but proved that there was an opiate receptor. Interesting stuff. Todd, thank you so much for your call.
Brian: Great questions you asked today.
Jill: I could talk for hours, can you see that?
Brian: Thanks for your call.
Jill: Looks like we’re coming down to a break, and we are going to get to the Heath Ledger accidental overdose. Stay with us.
<commercial break>
Brian: Welcome back to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, and my cohost is Jill Mattingly.
Jill: Me.
Brian: And today we are talking about painkillers and how they impact the brain but also how they impact devastating lives. And if you are listening out there today and want to be a part of this conversation, give us a call 770-226-0920. Or out of the area is 1-888-920-2665. You know, Jill, we really need to let people know about our wonderful website. We have a tremendous amount of information on our Breakthrough Addiction Recovery website, and if you’re wondering about how all these different kinds of medications or drugs or alcohol can impact you or your loved one please go to that website. It’s www.breakthroughaddictionrecovery.com. And we offer a free consultation. It’s a wonderful opportunity for people who just say, you know, I’ve got a loved one that needs some help, or I need help, I don’t know what to do. We get this call a lot, and so if you’re just wanting to know, what can I do for my loved one or for myself, you know, we’d like for you to give us a call for a free consultation at our office at 770-734-8091. That number again is 770-734-8091.
Jill: That’s our office number.
Brian: That’s the office number, that is correct. So, you mentioned talking about Heath Ledger and his tragic death as a result of overdosing on several different kinds of medications. And they did determine that it wasn’t a suicide, that it truly was an accidental death.
Jill: Right, and it did say, the medical report did say acute intoxication, and unfortunately, when they did the toxicology report, it does show he had 6 different medications that when taken by themselves actually do someone good, you know, can help take away pain, can help a person get to sleep, can help with anxiety. But once you mix these together and you don’t understand pharmacologically how they work, you can easily and mistakenly end your own life. You just don’t wake up.
Brian: Well, we know that he had at least oxycontin and vicodin, and both of those definitely are painkillers…
Jill: Exactly.
Brian: What people need to understand is they also can depress the respiratory system.
Jill: Yes, when they reach a level that is, actually we call it, like, a tissue dependence, when they reach a level that it can actually work on the brain stem and start to decrease respiration. Now that may not end up in death. You could actually find someone passed out from the pain medication, take them to the ER, give them a medication called Narcian, reverse the whole process and they’re breathing again and they survive. However, when you mix in other things—alcohol, benzodiazepines, barbiturates—when you mix those medications in, unfortunately they do the same thing, they depress respiration at different places in the brain and actually can cause it to be very difficult to reverse if you find someone that actually has taken too many of these medications. And it looks like we do have another call coming in. This is Phyllis in Norcross.
Brian: Welcome, Phyllis, to the Breakthrough Addiction Recovery hour.
Phyllis: Well, good evening, good afternoon I should say. I am appreciating and I’m learning so much
Jill: Great.
Brian: Wonderful.
Phyllis: …I’m just glad I happened to tune in to your show for the first time last Saturday. I’m also listening today. But my question is, what does opiates, or opiads, what does that term mean?
Brian: Well, it means an opiate is any particular medication that is generated or manufactured from the opium plant.
Phyllis: Ah, so its o-p-i-a…
Brian: O-p-i-u-m. Opium.
Phyllis: Oh, that’s what you were saying…
Brian: Uh huh. And opiates are actually medications that are derived from the plant called the poppy plant, basically, and the drug that comes from that is opium. So they are both actual medications that are either straight from using the opiate…
Jill: …like morphine, mmm hmm…
Brian: Morphine, directly from the opium, or they can be synthetics, which is a combination of opium and other medications. So sometimes they pout it together with acetaminophen, and combine some of these medications synthetically, and the result…
Jill: They are synthetically made.
Brian: Right. And those are called the opiates. So that’s the reason why, and they’re used as pain medications, and this is what Jill was talking about how they occupy the opiate receptor sites and help you to be able to usually withstand extreme pain. Our bodies normally have natural painkillers. They’re called endorphins, and we get that naturally from our bodies. But many times when you’re going through, say like you had back surgery, or maybe oral surgery, or something in which you have excruciating pain, then typically the physician will order some of these painkillers to help you manage the pain.
Phyllis: Thank you, and one more question: What’s the difference between an opium based drugs and cocaine-based drug?
Jill: A cocaine?
Phyllis: Yes.
Jill: Ah, ok. Different plant.
Brian: Yeah. They’re different.
Phyllis: I know it’s from the coca plant.
Jill: Uh huh.
Brian: Right.
Phyllis: But an opium, I understand they’re different plants, but what’s the difference between and what are some of those drugs that are coca based?
Brian: One of the things I was talking about was opium, of course, is dealing with painkillers, and typically things like cocaine is what we call a stimulant. And so that stimulant is one that will actually cause people to get an extreme high. IN fact, that’s one of the real dangers sometimes about using things like cocaine in a form called crack cocaine where they can actually smoke it. They get such a tremendous high, more than just your normal feeling of well-being.
Jill: And also, Phyllis, we were just talking about our website, breakthroughaddictionrecovery.com. We have sections that explain what these different drugs are and how they act right in our website. And if it’s not in the website it will link you. It’s full of information and very interesting.
Phyllis: Thank you so much.
Jill: You’re welcome.
Brian: Let me tell you that website again, www.breakthroughaddictionrecovery.com. Please go to that site. There’s a wealth of information there.
Phyllis: I appreciate you so much and I’m quite sure I’m not the only one that’s listening… I know that I’m asking questions that perhaps people who aren’t even calling in, but the information would be very helpful to them.
Jill: Thank you, Phyllis. You have a wonderful, beautiful day.
Phyllis: Thank you.
Jill: And it looks like we’re going to talk more about the Heath Ledger overdose when we do come back from this break. But I want you to listen to the drugs that were in his system when they were found: oxycontin, valium, or vicodin, valium, xanax, restoril, and unisom. If you have that in your medicine cabinet I want you to listen when we come back from this break.
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Brian: Welcome back to the Breakthrough Addiction Recovery hour. My name is Brian Fujii, and I have with me Jill Mattingly, my cohost.
Jill: Hello.
Brian: And today we’re talking about painkillers. And you know we just got through talking…
Jill: And benzos.
Brian: …and benzos. And also we just got through talking about 2 of the drugs found in Heath Ledger’s death report. And now we’re looking at valium. Tell us, Jill, what does Valium do for the body when it begins combining with all these other drugs.
Jill: Actually, you know, I want to talk about that. I’m going to talk about the other 3, because a lot of people don’t realize that these next 3 medications that were found are actually the same type of medicine. There’s valium, which is usually prescribed for anxiety. There’s xanax, which is very commonly prescribed for anxiety and panic attacks. And Restoril. Restoril is actually a metabolite of a longer-acting benzodiazepine, but it works for sleep. So what I see in that report there, other than that an antihistamine, an over-the-counter drug was also found called Unisom. Ands so what I see there in those last 4 drugs is that he had a lot of anxiety and sleep issues. And that is the number one reason people do take benzodiazepines. And don’t get me wrong, those medications work wonderfully for those people that really suffer with these problems.
Brian: Right.
Jill: You might see anxiety being treated with xanax, Librium, or valium and those are a little bit different from each other too, because their onset of action is different. Xanax is short-acting. You take it, you get an effect from it, and two to four hours later, it’s gone. It’s not gone completely out of your system but its efficacy has decreased. Now you’ll have, like, an intermediate-acting medications like Librium, klonopin, valium, those are all benzodiazepines also doing the same thing.
Brian: But they last a little bit longer.
Jill: They last a little bit longer and their onset of action is a little longer. Now this is where I see the possibility of Heath getting into problems, because he might have taken the xanax, the xanax wears off, he has taken valium but the valium is taking too long to work so he takes another xanax, or, you know, and I can’t presume to know what happened. However, the reason that someone sometimes gets caught up in this problem is that they are looking for an effect, and they’re not getting it right away, they’re not falling asleep, they’re not getting over their anxiety, so they take more. And unfortunately some of these start to kick in, 30 minutes to an hour later, and all of a sudden you have a synergistic effect or an additive effect of these medications. And like we said before, that can cause respiratory depression, they fall asleep, and they don’t wake up.
Brian: That’s what we’re seeing so many times, in fact when I get people asking me in treatment saying well I have a high tolerance for this medication, and so because I have a high tolerance, I should be able to take a lot more. And what they don’t understand is, what you were talking about, the synergistic effect. They may not be getting that feeling, but the medication is still having its impact. And there’s a difference between those two. And that’s how people can move into overdose.
Jill: Looking at half-lives, a half-life is half the time it takes for the medicine you took to be halfway out of your body, how’s that?
Brian: Great. I love it.
Jill: But, you know, all these medications have different half-lives. This has highlighted what Carrie said earlier, in the death of Heath Ledger shows us that this is devastating to people. And if you have this in your medicine cabinet, and you’re using this to control your stress, or to control pain, or sadness, or anything, you can end up in this same scenario, where you mix too much of the same thing. And you have to be very careful if these are actually prescribed to you. Usually doctors will not do that and prescribe a medication like this, but just looking at that today, watching the funeral for Heath Ledger and seeing his fiancée and his little girl and everything else. This is a devastating thing, and this is not the way to handle life’s situations. Hopefully this has taught some people, but I think we need to continue this information…
Brian: We do. And again, if this is a concern, give us a call at our local offices, 770-734-8091, for a free consultation. And we’d be willing and happy to help you or your loved one. Hope you’ll join us next week and I hope that you’ll be a part of this exciting and meaningful and informative program. And thank you for listening.