The easy availability of addictive prescription drugs magnifies this lethal mix. Over the past 20 years many doctors have become more aggressive in treating pain, making opium-based (and synthetic opioid) painkillers some of the most widely prescribed drugs in the United States. In 2009 alone, doctors wrote 128 million prescriptions for hydrocodone-acetaminophen combination products such as Vicodin.
These powerful painkillers spare legitimate patients a lot of agony. But many of these drugs also cause euphoria. And that makes them highly addictive.
For people in recovery, pain medication can be a rose with thorns. Consider Doug Bergon,* a 50-year-old information-systems specialist in Roanoke, Virginia. He has weathered addiction, alcoholism, and depression since age 14, attempted suicide several times, and been in and out of rehab for much of his life. In 1999, as a new husband and father, Doug had been clean for nearly four years when he developed a cyst from a knee injury. He was referred to a surgeon for surgery, after which the doctor prescribed oxycodone."I can't take that," Doug told the doctor. "I've had problems with substance abuse."
The physician dismissed his concerns. "You're gonna be in a lot of pain," he told Doug. "Just take it as I've prescribed."
But that can be tough for recovering addicts. "Oxycodone is heroin in a pill," Doug says. "It set off the craving, and I was back on heroin in, like, a minute."
Doug managed to conceal his heroin use from his wife, Melissa,* until one night shortly before Christmas. "I was getting ready for bed when I heard this weird buzzing sound, like a motor," she recalls. "I went outside and nearly tripped over the noise; it was Doug, lying by the pool, unconscious. I thought he'd had a heart attack."
When paramedics arrived, they said Doug "had come within about four heartbeats of dying." But not from a heart attack: "Your husband's had an overdose," they told her.
"I could feel my life change in that instant," says Melissa.
That it was heroin made it doubly horrifying: "I'd led such a straight-arrow life, I couldn't even say the word out loud."
With Melissa's help, Doug entered a Florida clinic run by Hazelden, where he completed a three-month stint in rehab. Good months were followed by relapses. In 2007, shortly after he was dropped by his sponsor — someone who commits to mentor an alcoholic through a 12-step program — Melissa found Doug passed out on the couch in their study at 3 a.m. after a drug-and-alcohol binge. That's when she asked him to move out. "I couldn't let our kids see him drunk or high," she reflects. "Thankfully, it never came to that."
Doug and Melissa have been separated for three years. A former government employee, Doug is having a hard time getting a security clearance — or finding a job of any kind. As 2010 came to a close, he had been clean for six months.
Doug was lucky that his wife found him — and saved his life — after his overdose. But many people who pop opioid painkillers at the same time they drink alcohol or take sedatives don't survive the toxic combinations, which can fatally depress breathing. And as the popularity of opioid painkillers has soared, so too have drug-overdose deaths. Overdoses are now the second leading cause of accidental death in the United States, topped only by car accidents. And look who's most likely to succumb: those ages 45 through 54, according to the Centers for Disease Control and Prevention.