Hidden Addictions

A Pastoral Response to the Abuse of Legal Drugs

Richard L Dayringer, Bridget C Mc Keever

• Publisher: Routledge
• Year: 2014
• Print ISBN: 9780789002679
• eBook ISBN: 9781317721185
• Topic: Law
• Subtopic: Law Theory & Practice
• Index: Law

In Hidden Addictions: A Pastoral Response to the Abuse of Legal Drugs, you'll find that beneath the gruesome, more public face of illegal drug abuse lies another less hideous, but just as destructive, layer of addiction--the addiction to prescribed drugs. In this revealing study, you'll learn how you can confront the hidden malady of legal drug dependency in individuals and ultimately break its chokehold on a world already ravaged by complacency and social-systemic dysfunction.The only book of its kind, Hidden Addictions is a concise, readable pastoral perspective on the creeping epidemic of legal drug abuse. Its illuminating case vignettes show you the social roots of addiction and give you the spiritual and religious resources necessary to put you and your loved ones on the road to holistic recovery. Specifically, you'll read about:

• groups most at risk--girls, young women, and older women
• types of drugs, including tranquilizers, sedatives, antidepressants, and painkillers
• over-the-counter drugs and look-alike drugs
• women and the pharmaceutical industry
• recovery methods, including detoxification, family therapy, and couple counseling
• spiritual resources and systemic reformIn a society already addicted to power, pleasure, and possession, you don't always see the "warning buttons" being pushed. But this book shows that you can turn back the quiet tide of spiritual sickness and psychochemical dependency that's sweeping the globe. So whether you're a pastor whose congregation is suffering, a social worker administering to addicted clientele, or a campus minister, Hidden Addictions will give you the pragmatism and awareness you need to heal the wounded soul.

Chapter 1

The Problem

Delma does not remember her husband's funeral. She remembers the police at the door telling her about the accident, hearing herself screaming, her son calling the family doctor for a sedative, and after that a blur of numbed pain. In fact, the past ten years during which she met, married, and divorced her second husband; parented a stepdaughter from age eight to age sixteen; babysat her grandchildren; and finally overdosed on Xanax have an unreal quality. She felt like a spectator in her own life, behind a shield that blunted but did not remove emotional pain, always struggling to drag herself day by day out of the quagmire of depression. She did not intend to kill herself when she took that overdose, only to end the agony which her life had become. Fortunately, she survived and found a better way to improve her life.

* * *

Guadalupe is sixteen; she is five-foot-four and weighs ninety-three pounds. That's four pounds heavier than when she was admitted to a center for the treatment of eating disorders. Her journey there began three years ago when, at a plump one-hundred-forty pounds, she failed to get a place on the cheerleading squad. Those chosen were all approximately a slim one-hundred-five pounds. For Guadalupe, the failure was the end of her world. She was smart, she was coordinated, her friends said she was cute, but she was just too fat. She stopped going out with her friends, her grades fell from Bs to Ds. She tried dieting, but food was her only comfort and after losing five pounds, she would give up and gain ten.

Guadalupe became more withdrawn; she began to tell her friends that she wished she were dead. In alarm her mother took her to a doctor who prescribed Prozac for her depression. The Prozac replaced her depression with bouts of anxiety and hyperactivity, but it had one great benefit. She stopped feeling hungry, she ate less and less, and the pounds dropped off. Life looked much better. Pleased with her progress, the doctor weaned her off the Prozac. Now her only problem was maintaining her weight loss. Remarking how skinny she looked, her mother began to urge her to eat more, and with her returning appetite, it was difficult for Guadalupe to resist. Then one day a friend confided to her the secret of her slim figure. She had a boyfriend who gave her pills that worked like a charm. She could get some for Guadalupe for a few dollars. Guadalupe felt a little guilty and scared about buying the pills, but her friend assured her that they were not illegal. “Lots of people get them from their doctors,” she said. The pills were amphetamines. A year later and forty-five pounds lighter, Guadalupe was very happy with her high energy and her slim body—until she passed out after gym class and was taken to the hospital emergency unit. Two months later she was referred from a drug rehabilitation center to an eating disorder clinic.

* * *

The Johnson's have just returned from their son's funeral. They are heartbroken. He was their oldest son, a fine student, and a splendid athlete. When he collapsed and died on the football field, it was thought that he had succumbed to a hidden heart anomaly.The autopsy revealed that he had been taking large doses of steroids. The steroids, rather than exercise, created his magnificent physique. Now rumors are flying that a doctor had been supplying him and others on the college football squad. The parents are bitter and confused. They will sue the doctor and the college but that will not bring their son back.

* * *

Marcia is worried about her father. It was a difficult decision to have him placed in a nursing home. But she and her husband, Jim, both work outside the home, and since his stroke, her father could not be left alone for a long period. Moreover, he was becoming incontinent and needed more care than a housekeeper could give. After being admitted to the home, her father had been very angry. Each time she visited, he complained about everything and demanded to be taken home. Then, to her relief, the complaining stopped. He became quiet and amenable. He stopped asking to be taken home. However, for the past several days he seemed quite “out of it.” He slept a lot, even nodding off in the middle of his dinner. Marcia asked the director about the change she had noticed and was told that her father was having difficulty sleeping and that he was given a sedative to help him adjust to the nursing home and to sleep. When she asked what her father was being given and how much, she was told that he was under good medical supervision and that she should trust the judgment of the medical personnel who were doing what was best for her father. Mareia was afraid to push the issue in case the nursing home would tell her to remove her father.

---

---

Many people similar to those described above would not consider themselves addicts. In fact, some of them might even be vocal opponents to the legalizing of street drugs. They could be anyone's mother, sister, father, or brother. They could be this writer; they could be you, the reader. They are abusers of legal drugs. They are like people whom pastoral ministers meet in the ordinary course of their ministry. They are like many who attend church or synagogue regularly, belong to youth groups, or are star athletes at church-sponsored colleges. Persons like them suffering from their hidden malady may be receiving ongoing pastoral therapy for another presenting problem without the therapist being aware of their hidden addiction. It is important that pastoral caregivers become aware of the nature and extent of this problem because often, if they only knew, they would be in a prime position to help.

PREVALENCE OF LEGAL DRUG ABUSE

According to a 1982 report issued by the United States General Accounting Office, more Americans die or are injured from the abuse of prescription drugs than from the use of all illegal drugs combined.¹ The Drug Abuse Warning Network claims that 60 percent of all drug-related emergency room visits and 70 percent of all drug-related deaths involve prescription drugs. A report from the United States Health and Human Services indicates that more than half of the fatalities from drug reactions are persons over sixty years of age. Some studies have shown that 90 percent of the elderly suffer drug side effects from the improper use of prescription and over-the- counter drugs and that 20 percent of them required hospitalization as a result. One of every twenty persons living in a nursing home has drug-induced senility, according to the National Institute on Aging.² Data reported by the Drug Abuse Warning Network indicate that, in 1987, fourteen of the twenty most common causes of drug overdose, dependence, or other adverse effects were caused by either prescription or over-the-counter drugs.³

PERSONS MOST AT RISK

For most people, the term “drug abuser” is associated with street junkies strung out on narcotics, pushers selling crack in inner city alleys, and amateur chemists brewing freebase in empty tenements. Their imagination may even stretch to include college students smoking pot in the fraternity and sorority houses, or to professionals discretely snorting cocaine in their offices between appointments and after office hours. Few associate the term with persons who buy their drugs at the local pharmacy or supermarket or take them from the family medicine cabinet. Even fewer think of over-the-counter medicines as possible substances of abuse. Milton Silverman and Philip Lee recount in Pills, Profits, and Politics how a patient warned by her doctor to take no drugs or medicines other that what had been prescribed continued to take large amounts of aspirin on the assumption that it was not a medicine because she could buy it at the corner grocery store.⁴

Elizabeth Lambert of NIDA's Division of Epidemiology and Prevention Research presented the following findings at the National Symposium on Medicine and Public Policy. Sixteen percent of persons in the United States aged twelve years and over have abused at least one prescription drug during their lifetime. Of these, 27 percent of persons between ages twenty-six and thirty-four were found to have abused prescribed drugs. As Lambert says, "Any kind of drug abuse should cause alarm, but when drugs are acquired legally, people may feel more at liberty to use them."⁵ Studies made in 1990 indicated that approximately 7 percent of male high school students have tried steroids and that 20 percent of high school football players use them. An estimated 17 to 20 percent of college athletes are users. These percentages represent a total of approximately one million students.⁶

Though anyone is liable to abuse legal drugs, some segments of the population are more vulnerable than others. These are youth, both female and male; women; and the elderly. It is important that pastoral caregivers be specially aware of the risk of abuse among these populations.

Girls and Young Women

Because of the cultural association between slimness and beauty, the abuse of diet pills is a major hazard for girls. A survey of drug use among high school seniors found that three times as many women used diet pills as men. Half of all female seniors reported using them in the past year. Amphetamines are still being prescribed for the treatment of obesity, though that use has decreased over the past several years. However, products sold in health food stores, drugstores, or weight reduction clinics lure the teen girl with the promise of a speedy reduction of weight and a svelte body. Pills made from the amino acids arginine and ornithine claim to stimulate human growth hormone. If the claim is true, then they may also stimulate other hormones and alter insulin levels and carbohydrate metabolism. Fad diets, pills, and potions may create more problems than they solve.⁷ Another hazard of the abuse of diet pills among young women is that they may become the prelude to eating disorders such as anorexia and bulimia.

Boys and Young Men

Whereas diet pills are the legal drug most likely to be abused by young females, steroids are frequently the licit drug of choice for young males. Being thin is the cultural ideal for females; being muscular is the ideal for males. Though some obtain steroids and information about them from physicians, the majority obtain them from fellow athletes, bodybuilders, through mail order catalogues, or from gyms. In these cases when an adverse reaction occurs, or when users incur physical damage through long-term use, they are less likely to have access to physicians who might detect problems and intervene.⁸

Older Women

Probably the group most at risk from the abuse of prescribed drugs are middle-aged women. In the late 1970s The National Institute on Drug Abuse (NIDA) statistics claimed that 60 percent of all drug-related emergency room visits were made by women. Two-thirds of these cases were suicide attempts; the remainder needed treatment because of dependence on mind-altering drugs. It was estimated that doctors wrote 90 million prescriptions annually. Most of them were written for women. NIDA estimated that there were in the United States between one and two million women who abused medication and who subsequently became dependent on these drugs.⁹ Demographics of benzodiazepine users and abusers in 1980 indicated 64 percent female to 36 percent male.¹⁰ Annabel Hecht noted that although a small number of women procured their drug supplies from the street, most of them did not resemble and did not identify with "street junkies." They were housewives, working mothers, college students, single parents, professionals. They cut across socioeconomic lines to include the affluent and those on welfare, ranging from a first lady to a destitute single parent.¹¹ The findings of a Texas study made in 1986 suggest that women over forty are a particularly high-risk group.¹²

It may be argued that these statistics reflect the decades when the public was having its romance with minor tranquilizers. When they were first marketed, Valium, Librium, and other benzodiazepines were thought to be safe for the treatment of anxiety and were recommended by the pharmaceutical industry and prescribed widely by physicians for even the normal tensions of life. Since the mid-1980s the dangers of prescribing these drugs indiscriminately and their potential for abuse have been well documented and are better appreciated by the general public. Several states have made moves to control the inappropriate prescribing of benzodiazepines. As a result there has been a decline in the number of minor tranquilizer prescriptions written. However, Xanax, a benzodiazepine, was ranked seventh in the number of prescriptions written between July 1992 and June 1993.¹³ Moreover, researchers Michael Weintraub and colleagues who studied the effect of regulatory laws in New York State note the following:

The main negative impact of the regulations measured to date has been increase in prescriptions for alternative medications. The alternative sedative-hypnotic medications are less effective, more likely to be abused, and more dangerous in overdose than benzodiazepines.¹⁴

It seems unwarranted, therefore, to conclude that the decline in the number of tranquilizer prescriptions indicates a corresponding decline in the numbers of women who use and abuse prescription drugs in the 1990s. This author has noted the scarcity of data on women and prescription drug abuse since the late 1980s. This phenomenon may indicate that the issue has gone into remission in public interest and as a popular topic for research—a situation which should be more alarming than reassuring.

Elders

It is estimated that twenty-five percent of all prescription drugs are written for persons over sixty-five years of age. However, these elderly comprise only...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• About the Author
• Table of Contents
• Foreword
• Preface
• Acknowledgments
• Chapter 1. The Problem
• Chapter 2. Pills, People, and Process
• Chapter 3. Sociological Roots of Addiction
• Chapter 4. Spiritual Roots of Addiction
• Chapter 5. Pastoral Response
• Chapter 6. Prevention
• Notes
• Bibliography
• Index