When Friends star Matthew Perry, 31, checked into a rehab facility last month with an undisclosed addiction, some feared that he had once again become dependent on prescription painkillers, a problem for which he was treated in 1997. If so, he would hardly be alone. In addition to a long list of celebrities and athletes—from actress Melanie Griffith, 43, who entered a detox clinic last November after getting hooked on prescription medication, to Green Bay Packers quarterback Brett Favre, 31, who went public with his addiction to painkillers in 1996—an estimated 1 million Americans are dependent on medicines they have been prescribed to alleviate pain. "Probably every other individual has had some sort of pain problem in the last week," says Dr. Richard Frances, medical director of Silver Hill Hospital in New Canaan, Conn., which runs one of the country's top programs for treating substance abuse. "So dealing with pain issues is a major national problem." Frances, 55, spoke with PEOPLE's Lucia Greene.
How common is addiction to painkillers?
Only about 2 or 3 percent of the 34 million who have chronic pain develop a major addictive problem from pain medication. That's not a huge number, but there are many more people who are addicts—I would say several million—who abuse painkillers when they can get them for any reason.
Who's most likely to become addicted?
People with a biological, inherited tendency to addiction and those who come from families with histories of alcoholism or drug addiction should be concerned. But most people who need prescription pain medications should take them without fear that they're going to become addicted.
What are the danger signs?
If patients start increasing the dosage on their own or mixing pain medication with alcohol or other drugs not prescribed by a doctor, if they start having blackouts or if their drug taking is affecting their ability to work, get along with others or care for their children, there may be a problem. Stealing pain medication, going to different doctors to get more or wanting to buy drugs on the street are also tip-offs.
Are women more likely than men to become addicted to painkillers?
Men are more likely to become addicts, though they usually start out in bars or start abusing drugs recreationally. For women, doctor-induced addictions are more common. Also, due in part to physiology, women tend to develop addiction more rapidly and more severely than men.
How do people develop an addiction?
Highly addictive medications like Xanax, an antianxiety drug that's also fairly good for pain, are a lot easier to get on than to get off. Coming off Xanax, for example, often sparks an increase in anxiety. People with a predisposition to alcoholism may respond to the withdrawal with drinking.
How can people avoid addiction?
People should take pain medication exactly as it is prescribed, and they should make sure they get off it as quickly as they can. As soon as their pain ends, they should throw out anything they don't need. If they are worried they might be headed toward addiction, they ought to talk with their doctor.
How difficult is it to kick the dependency?
For truly addictive types, who may also have a panic disorder, depression, bipolar illness or an eating disorder, it's very difficult. As a doctor, you have to treat the psychiatric problem as well as the addiction, with a big emphasis on a 12-step program. On the other hand, the prognosis is very positive for people who have stable families and jobs, minimal family histories of addiction and less severe psychiatric problems. Addiction is about as treatable as most medical illnesses. Though some people will have chronic relapses, many of them will not start up again. It's a hopeful disease to treat I because when people turn addiction-around, they often turn their lives around as well.
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