Pubdate: Tue, 26 Jul 2005 Source: Chronicle Herald (CN NS) Copyright: 2005 The Halifax Herald Limited Contact: http://www.herald.ns.ca/ Details: http://www.mapinc.org/media/180 Author: John Gillis, Health Reporter WHEN 'THE DRAGON' BITES BACK Chasing A High First Step On Road To Addiction, Experts Say Drug addiction begins in many ways: a one-time pursuit of pleasure, the desire for a pick-me-up or maybe just to fit in socially. But the quest to regain the high can turn a user's life upside down, says the man in charge of combating addiction in metro Halifax. "You're always trying to chase the dragon," said Tom Payette, director of addiction prevention and treatment services for Capital Health. "In many ways, what people are trying to do is to get back to normal. Just so that they can continue to use without losing a job, losing a friendship, losing their loved ones, getting into trouble, stealing and cheating." But Mr. Payette said that balance falls apart when users get addicted. Pretty soon, an addict's life starts to revolve around finding and buying the daily fix and where, with whom and how often the drug is used. The people he and his staff treat at the Nova Scotia Hospital and through Choices, an adolescent treatment program, span every segment of society. More than half are men. Their average age is 37. Mr. Payette said most patients have trouble with multiple drugs, usually including alcohol and cannabis. "It's seldom a person comes in here to withdraw from one drug only," he said. Pharmacologist Shaun Black said drug addicts lose the ability to manage consumption and they also lose perspective on what they're doing to themselves. He compared addiction to people's feelings about car crashes: that it won't happen to them. Users think they have control, that it won't become a problem. "I think you go beyond that line before you realize it," he said. "Not only is your body but also your mind is dependent upon the drug. You're not going to function normally or feel well unless the drug is there." Mr. Black said people with addictions aren't criminals by nature. But often they don't have the resources to get the drugs their bodies need and that gets them in trouble. It can start with simply borrowing money - money a user can't always pay back, Mr. Payette said. "A person can at that time, needing to continue their habit but also to keep the wolves at bay, begin to steal, to commit some type of crime to actually pay for the acquisition of their drug," he said. "When you start to look at the illicit drugs like cocaine, some of the opiates that are prescription but sold on the street, now you're starting to get involved with another part of society that's dealing with drugs illegally." The need to get a drug, or the money to buy a drug, can override a person's sense of morality, Mr. Payette said. They'll do dirty business for others, lean on a supplier's other debtors, even do sexual favours to get drugs. "As it becomes more a centre of your life, you're willing to sacrifice other things in your life, like relationships, like jobs, like income, in order to maintain the primary relationship of your life, which is with drugs," Mr. Payette said. He said family doctors may not recognize underlying factors pointing to a drug problem. "I'm not sure physicians are well-trained in the whole issue of addictions and the world that that creates," Mr. Payette said. "They're not aware of the lying, cheating, deceitfulness that sometimes can happen to acquire the drug that you want." Doctors need to be especially vigilant about writing prescriptions for narcotics. "Our physicians need to be involved more in understanding opiates and their use," he said. "You give somebody 100 pills. They may divert 50 of those to the street and use the other 50 and they're making a good profit margin on that. It creates that underworld." Mr. Payette said having enough cash of one's own to buy drugs doesn't always mean a user can stay out of trouble. "That's helpful in some sense if you want to continue to use the drug," he said. "But on the other hand, the problems that one might see associated with an abuse of the drug wouldn't be caught as quickly. Sometimes that can hide the fact that an addiction exists." - --- MAP posted-by: Beth