"Some people are more prone to addiction," said Joseph A. Califano Jr., chairman and president of the National Center on Addiction and Substance Abuse at Columbia University. "People who are depressed, prone to anxiety or alcoholics are more likely to develop an addiction to prescription drugs."
Doctors, he said, have to know their patients' histories with substance abuse and remain involved in their treatment while taking potentially addictive painkillers.
"Part of any physician's responsibility is to carefully watch their patients. … It is vital they question their patients enough to determine if they might become addicted. If a doctor focuses on an alcoholic's pain, or anxiety, or sleeplessness, and ignores his alcoholism, there is an increased chance of developing a prescription drug addiction," he said.
Unlike Hess, the majority of teenagers who become addicted to painkillers were never prescribed medication by a doctor. These kids instead find the drugs in their parents' medicine cabinets, get them off friends or purchase them off the Internet.
"There has been an explosion of prescription drug abuse among teens," Califano said. "They see their parents using these drugs and they think they are using a clean pill approved by the FDA [Food and Drug Administration]. They think the drugs are safe because they're not buying it from dirty drug dealers on dirty corners. The increase in prescription drug abuse has wiped out any of the modest decreases among teen users of marijuana."
Teenagers looking to get high often crush and snort pills, quickly releasing the drug intended to be spread throughout the body during 12 to 24 hours. Users report a high similar to other opiates like heroin that can "really affect their functioning," said Berger.
The visible effects on a typical painkiller abuser, however, are subtle and family members of addicts sometimes rarely know.
"There is very little medical damage that goes along with opioid addiction," Berger said. "It's destructive because it gets you by the throat in terms of addiction potential. Your life becomes consumed with worrying about how to get the medication. It is an ongoing process centered on getting drugs, maintaining your supply and worrying little about the other important aspects of your life."