David Johnson is a licensed Marriage and Family Therapist who has been in the helping professions for thirty-five years. He has a unique perspective on prescription drug abuse. Not only was he the Treatment Director at a residential drug rehabilitation center that had a significant percentage of clients admitted due to prescription drug abuse, but he also experienced prescription drug abuse with his own children. He continues to work with patients in an outpatient setting treating prescription drug abuse. We were able to connect with David and ask him a few questions regarding prescription drug abuse, the family, and how to talk to our kids.
TestCountry: David, thanks for talking to us. To begin, could you give us a background on the dangers of prescription drug abuse?
David Johnson It is one of the fastest rising segments of drug abuse in America. Worth noting is that doctors in America prescribe more medications per capita than any other industrialized country. My take on that is that both doctors and consumers are to blame. More and more Americans have the mindset that a pill will cure all their ills, physical or mental. And doctors are often more interested in giving patients what they want rather than telling them no.
People are fooled into thinking that as long as a doctor prescribes it for me, it can't have any negative side effects like possible addiction. The typical patient who is dependent on opiates (e.g. hydrocodone, Percocet, etc.) is a person who had an injury and was placed, appropriately, on something for their pain. These people were not thrill-seeking or doing it recreationally.
TestCountry: Have you seen a rising trend of prescription drug abuse, or has it just been getting more attention in the news lately?
David Johnson I haven't seen statistics on this but it is my sense, based on my practice, that it is a tsunami that is building. I encourage people to read the history of our country at the turn of the 1900's and see how there were very real concerns that our country was going to collapse because of opium – opium that was in nearly every medicinal product sold! This gave rise to the FDA.
TestCountry: As a marriage and Family Therapist, how do you see prescription drug abuse affect the family?
David Johnson If a parent is abusing drugs, they are taking away time, money, and attention from their children. Their behavior is erratic which raises insecurity and anxiety in children.
When a child is abusing drugs it can create a wedge between the caregivers as to how they should deal with the problem. Usually one wants to be the bad cop and the other the good cop.
Parents are usually guilt-ridden about what has happened to their child. They blame themselves for not having been a better parent.
TestCountry: Is there anything that differentiates prescription drug abuse from other substances of abuse? For example, does it affect the family differently, or have different negative effects?
David Johnson Different drugs affect the brain in different ways. Full recovery from the effects of benzodiazepines (e.g. Xanax, Valium, Klonopin, etc.) can take up to two years to recover. Opiates don't take nearly that long for the brain to recover from. Many people forget that alcohol is a drug and can take an extended of the period for the body to recover from its effects. Methamphetamine, because it is the modern version of moonshine, can have any number of toxic ingredients mixed with it. PET scans of people's brains that have been damaged by meth are not very promising of a full recovery.
TestCountry: Are there any predisposing factors to prescription drug abuse? What are the reasons why a person would abuse prescription drugs?
David Johnson Predisposing factors can include a number of things, like genetic predisposition (having a relative with an addiction or a history of addiction). Reasons? I suppose one of the reasons connected to prescription drug abuse that sets it apart from illicit drugs is that people are so used to taking medicine other than the way it is prescribed. How many of us have had an ailment and a family member says, "I took such-and-such and it really helped? I think I have some of it left I could give to you." Or perhaps you've been the one to offer an office worker one pill from your prescription for your headache. It's only one pill, right? First of all, it is illegal. Yes, illegal. But secondly, it diminishes in our minds the power that medicines hold, both for the good and the bad. The ibuprofen you buy at the drug store says to take two at a time. But your headache is really, really bad so you take three. What's the harm, right? Again, it is a mindset that is a potential pitfall for drug abuse.
TestCountry: Do you find that teens are the most vulnerable population, or are adults at risk as well?
David Johnson I would say that adults are more at risk than teens because teens are not prescribed medication without parental involvement. Now that doesn't mean that teens can't procure them in other ways. I had a teenage boy who played high school football who told me he had received hydrocodone that was passed around by the coach like candy prior to going onto the field.
TestCountry: What should a parent look for if they suspect their child is abusing prescription drugs?
David Johnson First of all you should know exactly how many pills you have at all times in each of your medications. Count them every week. If any are missing, you need to start keeping them locked up. Secondly, the things you look for are the same things you look for if your child is abusing prescription drugs: dramatic changes in behavior, grades, appearance, or group of friends.
TestCountry: In your opinion, what is the best way to approach kids about possible drug abuse? Can you provide some insight as a parent to our readers who are going through the same problem?
David Johnson Screaming, yelling, crying, and pleading will all fall on deaf ears. If you must use those tactics, do it in your closet when you are home alone. Have a reasoned conversation supported by facts. If you have sufficient evidence to warrant it, drug screen your teen. Then lay out what behaviors you will tolerate and what behaviors you won't tolerate and what the consequences will be for your child if they violate rules. As you might expect, I would encourage parents to enlist a therapist to aid the family. Never, never, never say to yourself, "My child would never – " Yes, your child would and may, in fact, be doing right now. No family is immune.
TestCountry: Are there any words of hope you can give to our readers who may have children with substance abuse?
David Johnson Don't lay all of the blame for your teen's drug abuse at your feet. Should you bear some of the blame? Probably. Have you made mistakes as a parent? If you're human, you have! Our children don't come with an owner's manual. But here's the truth that we forget: I've known children who grew up in deplorable conditions with parents who were both abusive and neglectful. Yet these children grew up to be some of the most incredible people I've ever met. And on the opposite side of the fence, I've known children who, as best as I could see, were raised by wonderful, loving parents. Yet those children turned out to be lazy, irresponsible, drug-seeking adults. At some point in their lives, children are responsible for the choices they make, not their parents.
TestCountry: For you, what is the bottom line regarding prescription drug abuse?
David Johnson The bottom line is that help is available for those who want to receive help. Drug abuse doesn't have to be an albatross that someone carries for their entire life. I know many, many people who are life-giving, people-enriching, compassionate adults who at one time were being destroyed by their addiction.
David Johnson maintains a blog at www.thefrontwindow.wordpress.com.