A Brain Hijacked: The Story of Addiction and the Prescription Drug Abuse Epidemic in Tennessee

The grasp of opioid addiction is far-reaching and unbiased. It preys upon people of every socioeconomic status and race. Residents of Williamson County, which has one of the highest median household incomes in the nation, are not immune to the clutches of this addiction.

“Brentwood is definitely a bubble and that bubble fed into my addiction,” recovering addict Alex * said.

According to data from the Tennessee Department of Health, more Tennesseans died from drug overdoses than in car accidents in 2015. Statistics say 1,451 Tennesseans lost their lives to drug overdose, while 962 died in a vehicle accident.

“[1,451] is the highest annual number of overdose deaths recorded in state history and brings the five-year total for Tennessee to 6,036 lives lost,” according to a Tennessee Department of Health report.

“That figure is approximately the equivalent of every person on 40 mid-size jet liners dying.”

According to the same data, 25 people in Williamson County died from a drug overdose, an increase from 19 people who died in 2014.

Vanderbilt University Medical Center Professor Emeritus of Medicine and Psychiatry and nationally recognized addiction expert Dr. Anderson Spickard, who has spent more than three decades of his 45 year career learning about addiction, said that much of this sweeping opioid epidemic can be attributed to physicians overprescribing pain medication.

“The easiest thing in the world is to give a prescription ... It’s so easy to pull out the pen and write a prescription,” Spickard said.

“The problem has been that physicians have been giving refills and large amounts of addictive drugs without warnings and without limitations of how many [physicians] are going to give at one time.”

Spickard is a former director for the Center for Professional Health at Vanderbilt where physicians, who have been cited for overprescribing by the Tennessee Board of Medical Examiners, can participate in training.

Slowly moving toward addiction

Raised in Brentwood, Alex was the youngest of three children. The son of a successful sales representative, he said his family lived in a nice house.

Alex was well-liked in school and played sports but was constantly seeking a bad boy image. He first tried alcohol at age 13, marijuana at 14, and at age 16, he was arrested for possession of marijuana. During a period of court-ordered drug tests, Alex decided to try prescription painkillers.

“There wasn’t much information on addiction in 2002 and 2003,” he said, calling Oxycontin “legal heroin.”

“I didn’t go overboard [on prescription painkillers] because I felt I liked it too much.”

According to Alex, he never tried cocaine or heroin during high school, but it was available.

“If there was a pill, I probably tried it; Adderall, Valium, Xanax … ,” Alex said.

While Alex graduated high school and began college, many of his friends became addicted to Oxycontin. During Alex’s freshman year of college, his best friend from high school overdosed and died.

“[His death] hurt a lot,” Alex said.

“To see and hear about him being crazy … we think that can’t happen to us, and there are no worries.”

Two more of Alex’s friends died from causes relating to prescription painkillers and Alex’s life continued to spiral as his existence revolved around alcohol to cope with these losses.

After graduating college, Alex was reintroduced to painkillers.

“This was in 2009, which was one of the worst times to be looking for a job,” Alex said.

“I had lost touch with reality. I hadn’t interned in college for my marketing degree. I thought I’d be able to get a job with just a diploma. I had to move back in with my parents, which was a shot at my ego.”

Being the first in his family to graduate from college, Alex said he beat himself up for unachieved goals and unrealistic expectations he placed on himself.

After a DUI on his 21st birthday, Alex had begun to focus his addictive attentions on prescription painkillers.

“[While on painkillers], I could fully function and feel awesome,” Alex said.

Using money he received from graduation, Alex continued to feed his addiction.

“Within six months of using painkillers, I knew I was an opiate addict,” Alex said.

“I’m typically a chill dude, but while I was using, I was very on edge with hair-trigger emotions. I couldn’t hold down a job. I had 10 jobs in four years. I exhausted my expenses trying to stay high.”

According to Spickard, addiction is a brain disorder where the neurotransmitter dopamine “hijacks” the brain as a result of the use of chemicals like opioids.

“[Dopamine levels] make the brain so focused on craving, that the person cannot stop,” Spickard said.

“It’s not that they won’t stop, it’s that they can’t stop.”

Spickard described this finding as “the most important research result in the recent past from the National Institute of Drug Addiction.”

Correlation in genetics and addiction

Through his decades of research, Spickard found that not only is addiction a brain disorder, genetics can play a role in who is at risk to become an addict. Scientists are working to prove genetics are a factor in human addiction. According to Spickard, scientists have been able to breed mice who have a predilection for addictive substances such as alcohol. Through twin studies and tracing an addict’s family tree, scientists worldwide come closer to establishing genetics as a factor in addiction.

“It’s a difficult thing to prove a genetic illness ...,” Spickard said.

Through his research, Spickard found that the genetic disorder is predominantly passed from father to son.

“We do know that this is an inherited disorder,” Spickard said.

“The inheritance from father to son is much stronger than mother to daughter. If your grandfather or father is addicted, you should never drink because of that inheritance.”

In a blog post relating to his recent book The Craving Brain, Spickard told a story of a patient whose grandfather gave him moonshine to drink as a rite of passage into manhood. When Spickard first met him in the late 1980s, the man was in the Vanderbilt Emergency Room experiencing alcohol withdrawal seizures after developing a severe alcohol addiction. It was soon discovered that alcohol addiction was present in four generations of males in the man’s family.

“I thought how tragic this case was since his grandfather and other relatives were unaware of how they contributed to his near-death experience,” Spickard wrote.

“We explained this family inheritance pattern to the patient and hoped he would stop his drinking and warn his sons about their drinking, too.”

According to Spickard, the overprescribing of medications coupled with the rise of pain clinics has also led to a significant increase in opioid abuse and addiction.

“Tennessee has a large number of [pain clinics],” Spickard said.

“All you have to do is get a prescription, get it filled, and pay off your mortgage. People go from the doctor’s office to the pharmacy and get the pills. They then sell the pills to their friends in the parking lot who then sell the pills for different rates.”

Spickard said drugs like Oxycontin and Fentynal push a patient past an invisible line in which their brain is hijacked, desperate to maintain a high dopamine level.

Spickard said most pain clinics, which he describes as “prescription mills,” are run by “nefarious people,” who have no training in pain control.

In The Craving Brain, Spickard encouraged family members with a family history of addiction to be able to recognize the early stages of substance abuse and to maintain healthy communication.

“The behaviors that lead to addiction thrive in an atmosphere of silence and denial,” Spickard wrote.

“Parents, teachers, employees, and community leaders can keep the conversation alive by speaking honestly and openly about the effects of heavy drinking and the danger of developing an addiction.”

Road to recovery is possible

Alex said after years of carrying the weight of trying to maintain the secret of his addiction, he finally admitted his struggle to his family, during which time his mother opened up to him about her own struggle with addiction.

“It was hard to come clean to my family,” Alex said.

“I had built it up in my head, but my family ended up being great and so supportive.”

Now more than two years sober, Alex is married to a woman from Brentwood who he met in rehab. They recently bought their first house and had their first child.

“I enjoy saying ‘I’m on the other side of [addiction],’” Alex said.

“A lot of people can’t say that.”

*Name has been changed at the source’s request for anonymity.

This is Part 1 of a multi-part series on opioid addiction in Williamson County. Continue to read the Herald for future stories on this topic.

Much of the sweeping opiod epidemic has been attributed to over prescribing of pain medication, according to Vanderbilt University Medical Center Professor Emeritus of Medicine and Psychiatry and nationally recognized addiction expert Dr. Anderson Spickard.

http://m.williamsonherald.com/news/local_news/article_8a5f9da2-40f2-11e7-a353-2720c7abb38f.html?mode=jqm

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© 2016 by Tennessee Overdose Prevention.

If they're still alive, there's hope.