The story of Baltimore sportscaster Keith Mills is a reminder that we must draw a distinction between the drug addict and the person who develops a physical dependency on painkillers brought on by legitimate medical treatment for physical pain.
Mr. Mills was arrested last month on charges that he stole prescription painkillers from his next-door neighbor, who is suffering from cancer. The 48-year-old WMAR-TV sportscaster has battled a problem with painkillers for years. He is not alone in his drug dependency.
By 2002, nearly 30 million people had used prescription pain relievers nonmedically at some point in their life, and 1.5 million were dependent on them, according to the Substance Abuse and Mental Health Services Administration.
Physical dependency and drug addiction are not the same. Confusing the two - in this era of rapidly growing use of painkillers - is counterproductive.
The journey to physical dependence on painkillers for many people starts in their doctor's office, when they are prescribed medication to relieve the pain from something as basic as a toothache to the debilitating pain of bone cancer.
The biological processes involved in the relief of pain are precisely the same processes that lead to physical dependence. If someone is on a sufficient dose for long enough, that person is going to become physically dependent. There is nothing that science can do to avoid that. It is simply a side effect of the long-term use of narcotic drugs.
But that journey is poles apart from the one traveled by the stereotypical "junkie" who experiments with drugs to get high and gets caught up in a lifestyle of drug addiction.
It is counterproductive to label as a "drug addict" someone who develops a physical dependency on OxyContin while fighting cancer. That person's problem is pain, not addiction. Labeling him or her as a drug addict can ignite feelings of shame and guilt, a stigma unwarranted in these patients.
Meanwhile, physicians mistaking physical dependence for drug addiction - something they might not be prepared to deal with - might be more inclined to refer patients to drug rehabilitation environments and methadone clinics for treatment rather than to the pain management specialists who have the tools to make patients both pain-free and drug-free.
We have to make room in our understanding of drug abuse for the distinction between drug addiction and physical dependence. Several steps should be taken.
