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Daniel E.

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More people seeking alcohol treatment; may go together with prescription pill problems
St. Petersburg Times
July 5, 2011

More and more people are checking in to treatment centers for alcohol abuse, both in the Tampa Bay area and around the nation, according to a new federal report.

One culprit: the prescription drug crisis.

It's long been the case that addicts abuse multiple substances. But alcohol combined with prescription painkillers and sedatives make for a particularly potent brew.

First, alcohol and prescription drugs are legal, so it's easy to think you're doing nothing wrong. And second, one can enhance the impact of the other, making it easier to get hooked and harder to realize you're in trouble, experts say.

Tampa's Drug Abuse Comprehensive Coordinating Office reports a 25 percent increase this year in people seeking treatment for alcohol abuse. About 80 percent of its more than 7,000 clients seeking treatment each year say alcohol is at least one of their substances of choice, said agency chief operating officer Liz Harden.

"Alcohol and Valium have similar sedating effects," she explained. "But when you combine the two, one plus one equals three or four or five.

"It's also socially acceptable because alcohol is legal and the pills are prescribed by a doctor. People think it's okay. After all, (they think), 'I'm not using cocaine.' "

Even though prescription pill bottles frequently carry warnings about not combining drugs with alcohol, Harden says many people don't pay attention. Some people believe they can handle the combination or that the warning on the pill bottle "doesn't apply to me," she said.

Consequently, even people who were taking the drugs for real medical needs can become addicts.

"Use sometimes starts out as legitimate. But pretty soon, use turns into dependence, and they're coming to us for treatment. It's a dangerous combination," she said.

A federal report published last week by the Substance Abuse and Mental Health Services Administration shows steady growth in admissions to treatment programs for alcohol abuse from 2005 to 2009, after declining in the five previous years.

At the same time, treatment admissions attributable mostly to prescription drugs also have soared, from 8 percent of all opiate admissions in 1999 to 33 percent in 2009.

"The problem is, these prescription drugs can be life-saving for people who need them and use them properly, but it's a real problem when they are used without medical supervision or misused," said Dr. Pete Delany, director of the substance abuse agency's Center for Behavioral Health Statistics and Quality.

"Many people are so used to drinking alcohol, they don't realize it shouldn't be mixed with their prescription medication. Now we have to figure out how we are going to work with different groups to tackle this complicated problem. It's a real public health issue for the country."

Gwendolyn Green is director of clinical services at Tampa Crossroads, a nonprofit residential and outpatient substance abuse treatment facility that operates in Tampa and St. Petersburg.

She said she noticed an uptick in alcohol admissions a couple of years ago.

"Alcohol seemed to be tapering down, and all of a sudden it's back in combination with some other substance, usually roxicodone and Xanax," she said of the popular painkiller and antianxiety drugs.

Turning Point, a private treatment facility in Tampa, saw a 15 percent increase in admissions for the first five months of 2011 compared with the same period last year. Chief executive officer and clinical director Robin Piper said that in the past couple of years, more than half of admissions to its drug-treatment programs have been people who are hooked on both prescription drugs and alcohol.

Most often, it's opioid painkillers, such as oxycodone and roxicodone, but antianxiety medications are common too.

"It's all the pills," Piper said. "Valium and Xanax are all very high with the young ones."

Cheap, legal, socially acceptable and easily available, alcohol always has been among the most abused addictive substances. What's different is that it's more frequently used in combination with other drugs, said Sonya Bufe, program manager of Project Recovery, an outpatient treatment program for women operated by the Centre in Tampa.

She started to notice a change in 2008. "Alcohol has always been in the top three among our clients, but more recently we're seeing a lot of combination abuse," she said, particularly Valium or oxycodone and alcohol.

If there's a silver lining in all of this, Delany says it's the fact that people are realizing they have a problem and are seeking help for it.

Turning Point's Piper also sees increased business at her center as a possible sign of a changing economy. For a time, out-of-pocket costs for private treatment, which can add up to thousands of dollars depending on your health insurance plan, put such programs out of reach for many.

"Things may be improving," Piper said. "It now seems people can afford the deductibles and co-pays, compared to the last two years."
 
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