Patti Geier, LCSW | Article

The Dark Side of Prescription Drugs: Part 4

What happened to Sylvia, Donna and Paul?


Sylvia began to go to NA but felt she couldn't relate because no one shared her addiction to pills. She found it difficult to connect with others who used street drugs. She found a PA meeting not far from her job and began to attend on occasion. She also decided to enter therapy to deal with memories that started to come up when she was no longer numbing herself with pills. In exploring her migraine headaches and what usually triggered them, Sylvia realized that the headaches often followed an argument with her husband or difficulty with her kids. She began to make the connection between anger and migraines. With time, when a headache came on, she no longer felt overwhelmed with feelings of anger, rather she just felt the pain of the headache.

Anger was not an acceptable emotion in Sylvia's family. As a result, she did not allow herself to feel it. She began to work on this issue in therapy and started to remember other times in her life when she had felt angry. After exploring this issue for some time, she began to open up about the sexual abuse she'd experienced from her uncle following her father's death. She'd been eleven when her father died of complications due to alcoholism. Her uncle "consoled" her for months. Sylvia had kept the secret of the sexual abuse inside her for years and, prior to therapy, she'd never told anyone about it. The pills had helped to keep the feelings, as well as the event, hidden.

Along with therapy, Sylvia began to use meditation and deep breathing to deal with the stress that generally preceded a migraine. Her migraines began to lessen and she was able to get sufficient relief from over-the-counter pain relievers.


After Donna left in-patient treatment, she continued with after-care. She attended group sessions three times a week. Her counselor stressed the importance of 12-step programs. Donna realized that she needed the support she could get from attending meetings regularly for those times in which her cravings began to surface. She liked the availability of AA and, by thinking of pills as dehydrated alcohol, could see the similarities between herself and the other members.

When her outpatient group ended, Donna sought out individual therapy. She focused on her anxiety and felt she needed to go back on medication. She went to see a new psychiatrist who specialized in substance abuse. Donna's new psychiatrist prescribed an anti-depressant that helped lessen her anxiety.

In therapy, Donna explored what might be at the root of her anxiety. In time, she discovered she had always felt anxious as a child and throughout adolescence. For example, as a teenager, Donna had experienced difficulty accepting her lesbianism and would often go on dates with boys so she would appear "normal."

After Donna came out and moved in with Beth, her anxiety returned. She did not understand the connection between the anxiety she felt as a teenager and what she felt once she made a commitment to Beth. Instead, she began to use Xanax to avoid facing any of the unsettling feelings that had begun surfacing and so, while on drugs, the anxiety-invoking feelings remained buried. Once off the drugs, they resurfaced and she began to deal with them in treatment.


Paul left inpatient treatment and felt lost. He went to a few NA meetings before he went back to work. When he returned to work a month later, he cut down on the number of meetings he attended.

After six months, Paul entered into another relationship. Feelings of fear and dependency started to arise and he found the feelings intolerable. He was terrified of losing this relationship by appearing too needy. After a couple of months, he had a relapse on Darvocet. He thought that if he switched medications he'd be safe. He believed that this time he could control it and resolved to only take pills on the weekends.

In just a month Paul was taking Darvocet everyday. He realized he needed help and went back to AA. Paul elected to re-enter the treatment facility and detoxed in a few days.

He returned to NA, found a sponsor and began to attend meetings regularly. He opened up to the other members and felt more comfortable accepting his addiction.

Paul went back into therapy to confront his deep feeling of emptiness. He knew that he needed to work on his feelings of dependency and neediness that seemed to push people away. He explored where these feelings came from and worked hard to keep his new relationship.

How do you know when someone needs treatment?

If you are unsure whether you or someone you know has a problem with prescription drugs, here are 20 questions that can help you become clearer about whether or not you'd benefit from help:

1. Has your doctor, spouse or anyone else expressed concern about your use of medications?
2. Have you ever decided to stop taking pills only to find yourself taking them again contrary to your previous decision?
3. Have you ever felt remorse or concern about taking pills?
4. Has your efficiency or ambition decreased since taking pills?5. Have you established a supply for purse or pocket or to hide away in case of emergency?6. Have you ever been treated by a physician or hospital for excessive use of pills (whether or not in combination with other substances)?7. Have you changed doctors or drug stores for the purpose of maintaining your supply?8. Have you received the same pill from two or more physicians or druggists at approximately the same time?
9. Have you ever been turned down for a refill?10. Have you taken the same mind- or mood-affecting medication for over a year only to find you still have the same symptoms?11. Have you ever informed your physician as to which pill works best at which dosage and had him adjust the prescription to your recommendations?12. Have you used a tranquilizer or a sleep medication for a period of months or years with no improvement in the problem?13. Have you increased the dosage, strength or frequency of your medication over the past months or years?
14. Is your medication quite important to you; e.g., do you worry about refills long before running out?
15. Do you become annoyed or uncomfortable when others talk about your use of medications?
16. Have you or anyone else noticed a change of personality when you take your medication, or when you stop taking it?
17. Have you ever taken your medication before you had the associated symptom?
18. Have you ever been embarrassed by your behavior when under the influence of your prescription drug?
19. Do you ever sneak or hide your pills?
20. Do you find it impossible to stop or to go for a prolonged period without your pills?
(Reprinted and slightly adapted from "There's More to Quitting Drinking than Quitting Drinking" by Dr. Paul O.)

If you have answered YES to three or more or these questions, you may be at serious risk of having a problem. The good news is that treatment is available.


There are many avenues for treatment. Inpatient treatment, under complete medical supervision is a safe and effective way to detox. This will cut down the risk of seizures and other health-related concerns.

Outpatient group therapy can be an effective way to transition back to a sober life.

Individual psychotherapy can be very helpful in dealing with all of the feelings involved in letting go of prescription drugs, not to mention discovering what led one to become addicted to them in the first place.


Not everyone succinctly stops using drugs, gets clean, and begins recovery. Getting past the denial and resistance common to most addicts is difficult. Some people need to "hit bottom" before they are willing to quit. Others may be more fortunate and embrace recovery before losing everything and everyone in their lives. Unfortunately, there are still many addicts that never make it back and die before they can ever get help.

*The examples used in this article are composites of several people. The names were changed to further protect their anonymity.