I happened to be flipping through my TiVo guide earlier today and noticed the description of today's Oprah show – “Dr. Mehmet Oz holds an intervention for a mother and son addicted to prescription pain medication.” Needless to say, it piqued my interested so I recorded and later watched it.
The mother and son featured in the program did indeed have a genuine problem with addiction. Although the mother had started taking Vicodin for pain following a car accident, she began using them more as a stress reliever. Following her lead, when her son got a little older and began feeling stress in his own life, he stole pills from her. At this point, the two were sharing whatever medication they could get and using increasingly large doses. The mother described the search for more pills as “a full-time job.” Her utilities were shut off, then she was evicted from her home, yet she continued to spend everything she had for more of the drug.
That aspect of the show I didn't have a problem with. There were, however, several other things in the program that really disturbed me.
1. No distinction was made between physical dependence and addiction. In fact, Dr. Oz stated, “If you can't go a day without a medication, you're addicted to it.” With all due respect, that is just not true. There is a huge difference between having a physical dependence on a medication (meaning if you stop taking it suddenly, you will have withdrawal symptoms) and being addicted, which involves many things such as doing whatever it takes to get the drug, regardless of whether or not it destroys your life. For more detailed information about these differences, please read: Opioids: Addiction vs. Dependence
2. The dosage of the medication being discussed was misstated and never corrected. The mother repeatedly talked about taking two 500 mg Vicodin, which made it sound like she was taking 500 mg of the opioid (narcotic). In fact, Vicodin contains 5 mg of hydrocodone and 500 mg of acetaminophen. I suspect it was not explained nor corrected because 500 or 1,000 mg. sounds a lot worse and more dramatic than 5 or 10 mg. – and Oprah kept repeating and stressing the huge dosages. In my opinion, this kind of misrepresentation makes the credibility of the entire program questionable.
3. Viewers were left with the impression that all pain could eventually be resolved. Dr. Oz said, “If you can't get resolution of your pain in two weeks from the doctor caring for you, you need to get another doctor to help.” He later clarified that some people may need to be on pain medication for more than two weeks, but said if you are not on a treatment program that will lead to resolution of your pain, you need to find another doctor. I only wish that were possible for everyone. Unfortunately, there are many chronic pain conditions for which there is no known resolution. Statements like this do not help when you have doubting family members who are already questioning why you are still in pain.
4. Perhaps the most disturbing part of the entire show was Dr. Oz's admonition at the end of the program: “If someone that you love cannot go a day without pills, or gets annoyed when you raise the issue, or feels guilty about the whole issue of pills in their life, they're probably addicted. Get them help.” When I heard that, my heart ached. All I could think about was all of you who have written to me about family and friends who question your need for pain medication or have accused you of being addicted. I'm afraid a statement like that from someone as widely respected as Dr. Oz will only strengthen their belief and encourage them to renew their efforts to “help” you.
To be fair, the show did address a serious issue. Prescription drug abuse is a growing problem. And they did make some good points, like the fact that sometimes people confuse emotional pain with physical pain and use prescription pain killers as a way of numbing themselves and relieving the emotional pain. I just wish they could have made their points while still acknowledging that there are people who genuinely need opioid medications for serious chronic pain problems and who do not abuse the medications, but take them exactly as their physician prescribes. Not doing so was a great disservice to the chronic pain community.
Published On: September 29, 2009