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Pain and Consequences for Those Taking Too Much Pain Medication

April 30, 2013 at 12:00 AM EDT
At age 22, college football player Austin Box had suffered a slew of painful injuries. Two weeks after his graduation, he overdosed on a lethal cocktail of pain medications, none of which he had been prescribed. Health correspondent Betty Ann Bowser reports on the perils of painkillers and the difficulty of combating abuse.
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JUDY WOODRUFF: Next: the growing problem of prescription drug abuse and how it can lead to dangerous consequences.

Several states are now trying to tackle what they see as a serious public health concern. Oklahoma is one of the leading states on that front, as health correspondent Betty Ann Bowser reports.

CRAIG BOX, Father of Austin Box: He was U.S. Army All-American. Only 100 players in the country are picked for that.

BETTY ANN BOWSER: Austin Box seemed to have it all. He was a star linebacker for the University of Oklahoma Sooners. From childhood, his life was played out in the spotlight.

CRAIG BOX: This is after he caused a big fourth down stop against Baylor.

BETTY ANN BOWSER: So when Box died suddenly at age 22, it revealed a darker side of life few people knew about, one of pain and the consequences of taking too much pain medication.

In May of 2011, just two weeks after graduation, Box was found unresponsive at a friend’s home. His father, Craig Box, remembers the call like it was yesterday.

CRAIG BOX: I had a phone call from the office that there was a problem with Austin. He wasn’t breathing at times and his heart stopped, and they were reviving him. And that’s really all I knew until we got to the hospital.

BETTY ANN BOWSER: A toxicology report showed that Box, number 12, had taken a lethal combination of five different pain medications. None had been prescribed to him. Box had a long history of injuries, including a bad blow to his back that ruptured a disc.

CRAIG BOX: I knew at times he was in pain, but he never talked about pain. He never complained about pain, never. And when I mean — I’m not — I’m not being contrite. He never complained about anything.

BETTY ANN BOWSER: Box’s parents had no idea he was taking painkillers or where they came from.

CRAIG BOX: It was just a complete shock. It clearly was something I think he tried to keep from us. Well, I know he did.

BETTY ANN BOWSER: While Box’s death was a terrible shock, it was also an ending health officials in Oklahoma are too familiar with. The number one cause of overdose deaths here is misuse of prescription painkillers.

Terry Cline is Oklahoma’s commissioner of health.

TERRY CLINE, Oklahoma Commissioner of Health: Just over the last 10 years, or about 10 years, we have seen a 372 percent increase in the number of deaths from misuse of prescription drugs. It’s huge.

BETTY ANN BOWSER: In fact, in Oklahoma, more overdose deaths involve prescription painkillers than heroin, cocaine, and methamphetamine combined. The people dying from painkiller abuse don’t fit the profile of illegal drug users, people like Austin Box.

TERRY CLINE: I think he was the All-American boy who was struggling with an all-American issue that is prevalent in communities across our country.

BETTY ANN BOWSER: Nationally, deaths from abuse of prescription painkillers, or opiates, has quadrupled to more than 16,000 by 2010.

And Dr. Thomas Frieden, the director of the Centers for Disease Control, says things aren’t getting any better.

DR. THOMAS FRIEDEN, Centers for Disease Control and Prevention: We have had a huge increase in the amount of these drugs that are prescribed. And the more that they are prescribed, the more that are abused. That’s the bottom line.

BETTY ANN BOWSER: In fact, hydrocodone, found in the popular painkillers like Vicodin, is the most prescribed drug in the United States today.

Doctors say, taken as directed, painkillers can be a godsend for people who suffer. But national surveys show the majority of people who misuse prescription painkillers get them not from their doctor, but from a friend.

Whitney Box, Austin’s sister, believes that was true in her brother’s case.

WHITNEY BOX, Sister of Austin Box: I think he was getting them for free from people who just wanted to be in his life and live in his world. They wanted to get close to him, wanted to get close to all of the players.

BETTY ANN BOWSER: All too frequently, pills are lifted from the family medicine cabinet.

TERRY CLINE: They’re not getting it from drug dealers. They’re not getting it off the Internet. They’re not purchasing it from somebody down the street. They’re getting it right from our very own homes.

BETTY ANN BOWSER: That’s what Wayne Walker did after pain medications prescribed for a ruptured disc led him to addiction.

WAYNE WALKER, Suffered from Painkiller Addiction: When I was heavily into my addiction was asking people if I could use their bathroom. If I went into your house, I was going to ask you to use the bathroom, because I was going to go through your medicine cabinet.

BETTY ANN BOWSER: Walker has been clean for over a year now. His doctor, Hal Vorse, who specializes in addiction, says people have the mistaken sense that prescription pills are safe.

DR. HAL VORSE, Addiction Specialist: One of the first things out of their mouth is, well, I can’t see why it’s a problem because it’s legal. Well, you know, it doesn’t matter whether you buy your drugs in a liquor store, a pharmacy or on the street. You’re going to be just as dead at the end. You know, addiction doesn’t care where you get your drugs.

BETTY ANN BOWSER: Dr. Vorse says physicians don’t always see signs of dependency.

HAL VORSE: Many times, doctors haven’t been trained in addiction, and to recognize and understand when people start abusing their drugs and when they go cross that line into addiction.

THOMAS FRIEDEN: When I was in medical school, the one thing I was told was completely wrong. The one I was told was, if you give opiates to a patient who’s in pain, they will not get addicted. Completely wrong. Completely wrong. But a generation of doctors, a generation of us grew up being trained that these drugs aren’t risky. In fact, they are risky.

BETTY ANN BOWSER: Health officials also cite a cultural shift in the acceptance of taking prescription drugs in general.

TERRY CLINE: In our society, where we expect a pill to make our lives easier to manage, sometimes, we take the easy way out.

BETTY ANN BOWSER: Oklahoma is taking steps to tackle abuse. The governor has proposed $16 million dollars for treatment, public awareness, and education.

The legislature has debated several bills. One, sponsored by Sen. Rob Standridge, himself a pharmacist, would alert doctors with an electronic red flag on patient records if they’re already receiving painkillers.

SEN. ROB STANDRIDGE, R-Okla.: When a patient picks up hydrocodone, for instance, pharmacists are required to send that information in immediately. And so now we have all that data. What this bill does is take that data and proactively alert the physicians.

BETTY ANN BOWSER: Standridge is House sponsor of the legislation. Rep. Richard Morrissette says getting a bill passed aimed at prescription drug abuse was a political struggle.

REP. RICHARD MORRISSETTE, D-Okla.: Whether it’s the pharmaceuticals, the doctors, or manufacturers, everybody has a lobbyist and a special interest trying to protect what is. And they don’t want change, because they are very familiar with what is. People are making a lot of money at this, too. When you start pushing on those nerves, you’re going to get pushback, and that’s exactly what’s happened.

BETTY ANN BOWSER: Some physicians don’t think legislators should tell doctors how to practice medicine.

Dr. Daniel Morris is a specialist in pain management who treats patients in advanced stages of cancer. Morris says some physicians are so worried about patient abuse that they have stopped prescribing painkillers altogether.

DR. DANIEL MORRIS, Pain Management Specialist: And with all the pressure, legislative pressure, the law enforcement pressure, the press, media, it’s becoming more and more difficult for physicians to offer, you know, pain medications to people who really deserve it. And you’re seeing family doctors who put signs up in the waiting room: “We do not prescribe hydrocodone. We do not prescribe methadone.”

BETTY ANN BOWSER: Austin Box’s family would like others to remember his young life destroyed by drugs.

CRAIG BOX: He was a very sensitive, caring person. He was just friends with everybody. He treated everybody with a lot of respect.

BETTY ANN BOWSER: The family has started a foundation to educate doctors, patients, and policy-makers, so that other families will not have to live through a similar tragedy.

JUDY WOODRUFF: On our Health page, read the top 10 things the Centers for Disease Control says you should know about prescription drug abuse. If you still have questions, send them to us and a CDC official will answer them on our website in the days ahead.