If they have the power to heal, they have the power to harm more. As they get embedded into your psyche and system, you are caught in an endless trap. It?s an addiction of a very different kind and intensity; you succumb to it with or without reason and at times, it is fatal. As the Michael Jackson tragedy unfolds, and even as investigations are underway, the writing is clear on the wall ? ?prescribed drugs? did it for MJ. An addiction, sources say, that began in 1984 when Jackson got accidentally burnt while filming a Pepsi commercial. Or was it 1993, the year he had another accident during his rehearsals that made him dependent on the prescribed painkiller Demerol? Valium, Xanas, Ativan and Diprivan ? the list of drugs that he seems to have been addicted to appears to be neither complete, nor final. The two bags of pills recovered from the King of Pop?s rented Holmby Hills home may just add to the kitty of ?prescribed drugs? that MJ was on and draw our attention to the cardinal issue of the use and misuse of such drugs.
Dependency factor
Most drugs which provide relief to the individual from pain, anxiety, sleep related disorders are addictive. According to Dr Samir Parikh, Consultant Psychiatrist, Department of Mental Health and Behavioral Sciences, Max Healthcare, there is also a probability that the same amount of the drug becomes inefficient in helping with the same problem and over a period of time increasing doses of the medication are required.
?It is definitely a common problem. However, it is erroneous to term it as addiction. Technically, it is termed drug dependency,? says Dr Sushum Sharma, Head of Department, Preventive Healthcare at Max Healthcare. The dependency, he says, manifests either as psychological or physical dependency. While in the former case it is the mind craving for certain medicines, in the latter it is the body that plays a significant role. ?It?s quite similar to smoking and drinking. It starts with psychological dependency and goes on to become physical dependency,? adds Dr Sharma. Right from painkillers, anti-anxiety tablets, anti-depressants to muscle relaxants, just about everything comes under the scanner.
Most people tend to fall into the trap without even realising ?how and when it happened?. Chetan Sanyal, 40-year-old mechanical engineer, recollects the time when Corex cough syrup became indispensable for him: ?It was prescribed by my doctor for a brief period of time, but somehow I just got hooked on to it. I was gulping down a bottle every three days. I could feel the congestion in my chest all the time ? I just had to have it.? It took years of nagging on his wife?s part to get him off the habit. Sanyal was fortunate to have escaped without any serious implications. Not everyone is. Most need to follow a de-addiction protocol and switch to anti-dotes under complete medical supervision to kick the habit.
Falling into the trap
Dependency creation happens over a period of time. ?Typically, medications prescribed by a physician do not lead to such developments. It is only when an individual gets significant and immediate relief from an acute pain or some such problem that there arises a tendency to continue with the medication in order to ensure that the problem does not recur,? says Dr Parikh.
The easy availability of prescription drugs over-the-counter makes access easy for them. Precisely the reason why Dr S K Jain strongly advocates for drugs with addictive potential not to be available over- the-counter. Some drugs trigger the production of certain biochemicals in the brain which make people feel good or euphoric. It makes them want to take the medicine to get the same good feeling repeatedly, explains Dr Jain, Sr Consultant (Medicine), Sir Ganga Ram Hospital. The opiate group of drugs, he says, is increasingly found to have addictive properties. The addiction is also fuelled by the withdrawal symptoms including anxiety, depression, insomnia etc set off by these drugs.
Vital signs
?The potential for drug abuse is well known and documented in medical literature,? says Dr Peeyush Jain. The Principal Consultant Cardiologist and Head, Department of Preventive Cardiology, Escorts Heart Institute and Research Centre too classifies dependency into psychological (read ? painkillers) and physical dependency (read ? tranquillisers, antihistaminics, and narcotic painkillers). And the list of such drugs is indeed long. (See box)
Caution is the key word even for prescription drugs. US Federal Advisory Panel this week recommended a ban on two popular prescription painkillers (Percocet and Vicodin) due to its effect on liver. Together they combine a narcotic with acetaminophen, an ingredient found in popular OTC products like Tylenol and Excedrin. While high doses of acetaminophen significantly contributed to liver damage, patients taking Percocet and Vicodin for long periods were found to be requiring increasingly higher doses to achieve the same effect.
The bottomline according to Dr Parikh, ?Consult the physician before taking any medications and follow the advice strictly in terms of dosage and duration of treatment.?
Out of thrill
•UK?s All-Party Parliamentary Group on Drugs Misuse, a whopping 1.6 million of Britons cannot live without tranquillisers, such as Xanax and Valium, or prescription painkillers including co-codamol and co-dydramol. The year-long government study found at least 30,000 people to be hooked on OTC painkillers, with some taking |up to 30 a day.
•Antitussives help relieve coughing and some even contain a narcotic. These act directly on the cough centre in the brain. Narcotics may become habit-forming, causing mental or physical dependence, if used for a long time. Physical dependence may lead to withdrawal symptoms when you stop taking the medicine.
•Analgesics are used in these combination medicines to help relieve the aches and pain that may occur with the common cold. These include: Acetaminophen, Aspirin, Other salicylates such as salicylamide and sodium salicylate. The use of too much Acetaminophen and salicylates at the same time may cause kidney damage or cancer of the kidney or urinary bladder. This may occur if large amounts of both medicines are taken together for a long time.
•Do not give any over-the-counter (OTC) cough and cold medicine to a baby or child under four years of age. Using these medicines in very young children might cause serious or possibly life-threatening side effects .
•Although serious side effects, in case of Antihistamine/Decongestant combination, occur rarely when taken as recommended, they may be more likely to occur if: too much medicine is taken, it is taken in large doses, or it is taken for a long period of time.
Source: Mayo Clinc
Drugs with potential for physical dependence include
•Morphine
•Pethidine
•Pentazocine (injectable narcotic pain killers)
•Dextropropoxyphene
•Tramadol (oral narcotic pain killers) Codeine (cough suppressant and narcotic pain killer)
•Diazepam
•Alprazolam
•Lorazepam and other Benzodiazepines (tranquillisers)
•Chlorpheniramine and Cyproheptidine (antiallergic and antihistaminics)
? Dr Piyush Jain, Escorts Heart Institute and Research Centre
