It’s 6 p.m. on Nov. 9.
Dr. Anna Lembke’s voice crackles through the telephone. Although she’s the director of the Stanford Addiction Medicine Clinic, she started off her training as a psychiatrist. But as she discovered that her patients tended to suffer from both mental problems and substance abuse simultaneously, she realized that if she couldn’t help them tackle their drug and alcohol problems, then she wouldn’t be able to help them tackle their anxiety or depression. In Oct., Lembke published a book about doctor shopping and the prescription drug epidemic titled “Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop.”
In Lembke’s opinion, it isn’t that prescription drugs are more addictive than other substances; the issue is that they oftentimes come from doctors – an alarming thought that Lembke believes undermines the intended therapeutic benefit of getting medications.
“When they get their medical degree and they take the Hippocratic Oath that they will first ‘do no harm,’” Lembke said. “But if I as a physician, prescribe a medication to a patient who then becomes addicted to that medication, I’ve essentially indirectly and inadvertently harmed that individual.”
Lembke believes that to some extent, the psychology behind addiction is the same – the initial use, the withdrawals, and the dependence on the drug – are all somewhat similar across all drugs. But what makes an addiction to prescription drugs worse is the additional layer of complication that comes with a well-intended doctor unconsciously hurting an individual.
Lembke says that a gateway drug isn’t always the expected cigarette – in her eyes, whatever substance is easiest to acquire is the most likely candidate to be a gateway drug. And since prescription drugs are more readily available to teens, Lembke believes that they can serve as a gateway drug towards other drugs.
“Oftentimes prescription drugs serve as a gateway to other drugs because teens are readily prescribed stimulants for attention deficit disorder or opioids for wisdom tooth removal and in many instances, that can lead the individual to then want to experiment with other drugs,” Lembke said.
Yet regardless of whether a substance is a prescription drug, Lembke acknowledges that the general gist of addiction is the same across all substances.
“To put it in simpler terms, what goes up must come down,” Lembke said. “There’s a price to be paid for using substances so often times… people experience a high when using [drugs and] when the drug wears off, they end up lower than where they started.”