THEY'RE behind a string of celebrity deaths, but prescription drugs also blight thousands of more ordinary lives.
As friends and relatives of actor Corey Haim gathered at his funeral in Toronto last month, one could only imagine the anguish that comes with losing someone close at the relatively tender age of 38. The former child star was declared dead at 2.15am on Wednesday March 10 at the Providence Saint Joseph Medical Centre in Burbank, California, having collapsed at the nearby home of his mother. A full explanation won't be available until the results of a toxicology report are disclosed, yet it's strongly believed the Lost Boys star died as a result of his long-standing abuse of prescription drugs.
According to LA's assistant chief coroner, four prescription bottles bearing Haim's name were found in his mother's apartment. The coroner would not name the drugs, yet they're believed to be: Vicodin (a strong painkiller containing paracetamol and hydrocodone); Valium (an anti-anxiety medication containing diazepam); Haldol (an antipsychotic medication containing haloperidol); and Soma (a muscle relaxant containing carisoprodol) — drugs that have also been linked to the high-profile fatalities of Heath Ledger, Brittany Murphy, Anna Nicole Smith and Michael Jackson.
They're also central to a tale of addiction that stretches from Hollywood to the east coast of the US. "The accessibility to those drugs is no worse in Hollywood than anywhere else," says drugs interventionist Jeff VanVonderen. "It's just more newsworthy when it goes wrong." The figures back this up. According to the US Drug Enforcement Administration, opioid painkillers such as Vicodin cause more overdose deaths in America than cocaine and heroin combined. Prescription drugs are also responsible for 25 per cent of drug-related emergency department visits.
At the same time, the US National Survey on Drug Use and Health (NSDUH) claims 52 million Americans aged over 12 — or 20.8 per cent of the population group — use prescription pain relievers, tranquilisers, stimulants or sedatives in a non-medicinal fashion. "In the States, it's reaching epidemic proportions," says Dr Marvin Seppala, chief medical officer of the Hazelden addiction treatment centres. "These medications are now the fourth-most abused substance behind tobacco, alcohol and marijuana. Yet they're so much more dangerous. The risk of death from overdosing is extreme."
But it's not just cashed-up kids on the streets of Hollywood who develop such addictions. According to Professor John Saunders, from the Centre for Youth Substance Abuse Research at the University of Queensland, Australia has one of the world's highest rates of prescription drug abuse. Of greatest concern is the fact we know so little about the scope of the problem.
"The true scale of the issue is not very well known, because there's been more concern about the abuse of illicit drugs over the past 20 years and, more recently, about binge drinking," he says. "Prescription drug abuse and dependence has been off the radar, which is a serious problem."
Saunders says that, a few years ago, it was estimated 300,000 Australians were dependent on benzodiazepines (tranquilisers or sleeping pills) and somewhere between 75,000 and 100,000 had an addiction to opioids. That's compared to just 75,000 users of heroin at the same time.
"One of the new phenomena in Australia is that fewer people are taking heroin, but they're taking prescription drugs, instead. Some people crush them up, filter them or inject them. Addicts are even doing it with codeine-containing drugs such as Panadeine and Panadeine Forte."
And don't expect local prescription drug addicts to look like strung-out junkies and hang out on street corners. Many of them are housewives, parents and professionals whose addiction developed after first going to their doctors with an honest health issue.
"At least half the people with a dependence started receiving the drugs legitimately to help with pain, tension, anxiety, stress or sleep, before their use of these drugs got out of control," Saunders reveals. "We know that prescription drug addicts in Australia are more likely to be female than male, and are usually over the age of 30."
Many of those who rely on prescription drugs feel that, since they aren't illegal, they must be safe. But Saunders offers a grave warning: "People abusing these drugs should be very concerned about dying. Usually, that will be from a combination of drugs that depress the brain and the central nervous system and work in combination with each other.
For example, if you take an opioid and a benzodiazepine, you're putting yourself at risk of having your breathing suppressed or dying of asphyxiation after vomiting in your sleep."
Just as damaging is the control such a dependence can have over an addict's life. Saunders says some patients spend up to six hours a day going to various doctors in order to secure prescriptions, before visiting multiple pharmacies to have the drugs dispensed.
"Their lives become impossibly complicated," he says. "The user's life starts being dominated by their addiction, and that turns into a neglect of other responsibilities to their family and their work, which represents another very damaging side of these drugs."
What, then, can be done to curb this surge of prescription drug abuse in Australia? Gino Vumbaca, executive director of the Australian National Council on Drugs, says federal and state governments are currently working with various groups and organisations to come up with new ways to combat the problem.
One such method is The Pharmacy Guild of Australia's 'Project Stop', which aims to prevent pharmacies selling excessive amounts of pseudoephedrine-based products, which can be adapted by abusers to manufacture methamphetamines.
"Chemists are able to know, in real time, if you've already purchased pseudoephedrine at another pharmacy up the road," Vumbaca says. "So, that sort of technology exists. If doctors were involved in a similar system, that would be an opportunity. But it's easier said than done. There are costs, there are IT requirements, there are serious privacy issues. It's hard to develop a public system of governance > over people's medical health and pharmaceutical requirements and to maintain privacy for people at the same time."
In Dr Marvin Seppala's rural home state of Oregon, you're three times more likely to die from an overdose of prescription opioids than you are to be murdered. Some of the cases he's dealt with would be laughable were the issue not so serious. "It used to be the case that teenagers suffering pain from a sprained ankle or sore shoulder would be advised to take ibuprofen or paracetemol. But, these days, physicians are increasingly prescribing opioids," says Seppala.
"We had one case where a 12-year-old boy was caught dealing Vicodin at school. When his local physician asked where he was getting the drugs, the boy replied, 'Here, in your practice.' The young guy was able to go in repeatedly and gain opioids to sell to his friends in the schoolyard, no questions asked."
In another case, a female addict drew a month's supply of Vicodin from five separate doctors. Thanks to the way the US health system is organised, there was no way for the doctors to check her usage. As she looked clean, respectable and in good health, she was never suspected of being addicted. Things only came to light when she started to suffer financial problems because of her addiction and walked into a Hazelden clinic. "It's similar to the 1800s, when there was little state control on opium," claims Seppala.
Sadly, the likes of Haim and Ledger were at the tip of this addiction iceberg. Unlike everyday users, they had the advantage of fame and money, which, in Hollywood, translates into a virtually limitless ability to secure prescription drugs and neatly sidestep the seediness and risk associated with buying illegal or street drugs.
Yet this doesn't mean prescription drug users are completely isolated from the criminal world, either, as Haim's death has now been linked to what California's Attorney General Jerry Brown describes as a "an illegal and massive prescription drug ring" handling more than 5000 fraudulent prescriptions. "They get prescription pads, get illegal drugs, then sell them on the street," says Brown. "You have doctors doing wrong, people pretending to be doctors, and all the criminal intermediaries making the process work."
Meanwhile, although authorities are taking steps to make it harder to gain access to drugs, in the world of the internet, that's a fiendishly tough nut to crack. The primary issue to be tackled remains that of perception, so people who reach for a codeine-carrying flu remedy understand they're essentially taking a stripped-down component of heroin poppies, and those swallowing Valium, Vicodin, OxyContin and pills that can form dependencies fully appreciate the risks.
"Vicodin is a synthetic opiate. It's just heroin in pill form," adds VanVonderen. "Yet there's some kind of legitimisation in people's minds about using that kind of heroin, rather than robbing your local convenience store and shooting up with street drugs. But, whether you're addicted to heroin or OxyContin, you can lose your sanity. Once you've crossed that line, you have a sickness and you need help fast." 
