These days, cocaine is passe. Ecstasy is for kids. The hot new drugs are numbing blasts from the past, the ones with which such burnished icons as Elvis and Liz made headlines in their heydays of excess. Young superstar actors, rappers and chart-topping singers are popping pain pills. It's chic, it's mellowing, and some think it's funny. During January's Golden Globe awards, Just Shoot Me star David Spade joked, "I found 10 Vicodin in my gift basket." Michael Jackson and Anna Nicole Smith, Chevy Chase and quarterback Brett Favre have been addicted to prescription drugs. Friends' Matthew Perry, who has admitted that he was hooked on Vicodin, last month returned to rehab for unspecified reasons. "An addiction to prescribed pain pills can happen to anyone," says Melanie Griffith in her online "Recovery Journal," "and you have to be careful."
The trend has quickly spread from Hollywood to the heartland. According to the latest Department of Health and Human Services survey on drug abuse, about 1.5 million people started taking prescription painkillers for "nonmedical" purposes in 1998--nearly three times the number who started in 1990. "There are two reasons that people are abusing prescription pain medications," says David Rolston, a program director at Santa Monica's Clare Foundation rehab center. "They can be used as supplements to street opiates like heroin, and there isn't the same stigma associated with them."
To obtain Vicodin and other painkillers, you needn't slink off to the rough side of town for a date with your dealer--although you could. Last month Ventura County, Calif., issued a grand jury indictment alleging that the Hell's Angels used a youth gang called the Outfit to sell more than 700,000 Valium and Vicodin tablets throughout the region--all supplied, according to the charge, by an Air Force clinic employee. But you can also ask your doctor for the pills, and he may not scrutinize too carefully the validity of your request.
Opioid painkillers, which include morphine and heroin as well as prescription products like Percocet, Percodan and Vicodin, are so dangerous because they are so seductive. They work by throwing up roadblocks all along the pain pathway from the nerve endings in the skin to the spinal cord to the brain. In the brain these drugs open the floodgates for the chemical dopamine, which triggers sensations of well-being. Dopamine rewires the brain to become accustomed to those benign feelings. When an addicted person stops taking the drug, the body craves the dopamine again.
This lure is particularly strong for "people who have had sobriety problems before," says Richard Rogg, founder and owner of the fashionable Promises Malibu--a rehab clinic where the high-profile addict can try to kick the habit. "He'll have an operation, and the doctor will give out Vicodin like they're M&M's. Soon, he's addicted. I'm hearing the same old story: 'I had five or 10 years' sobriety, but I got loaded on Vicodin, and I went out.'"
Not everyone who uses painkillers for more than a few weeks at a time will become an addict, says Dr. Alan Leshner, director of the National Institute on Drug Abuse. He suspects that most of those abusing Vicodin obtained the drug illegally. Says Leshner: "It's important to separate when the substance is a medicine and when it is abused." Just ask Eminem, who in Under the Influence declares, "I'm like a mummy at night/fightin' with bright lightning/frightened with five little white Vicodin pills bitin' him."