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by Abigail Van Buren

DEAR ABBY: Several years ago, I was in a car accident and was prescribed the painkiller Vicodin. Because of some bad personal relationships and terrible choices, I became addicted.

During the years I was addicted, I became involved with a patient in the medical office where I was working as a secretary. He seemed sincere and caring. I thought he was "the one." My addiction grew to the point where, at times, I was afraid I wouldn't wake up in the morning. I felt guilty and ashamed. I wanted to tell "Mr. Perfect," but I was afraid I'd lose him.

To feed my addiction, I resorted to forging a prescription. I was caught and arrested. Mr. Perfect assured me he understood and would be supportive. That lasted two days. When he was teased by his co-workers, who read about my arrest in the newspaper, he broke up with me.

To my surprise, the doctor I worked for and his wife were compassionate and forgiving. They got me into treatment. It saved my life.

Abby, please assure your readers who may have drug problems that it may not be easy, but they can live drug-free. They shouldn't keep their drug addiction a secret for fear of embarrassment. Prescription drugs can be as dangerous as street drugs. People must educate themselves before taking anything. Those who have never experienced addiction shouldn't look down on people who have one. Addiction can happen to anyone. –- RECOVERING IN A SMALL TOWN, U.S.A.

DEAR RECOVERING: Pain is a huge public health problem. While the medical establishment is keenly aware of the need for pain management, there is also concern about media reports of misuse of pain medications such as OxyContin.

I learned from Tom Strouse, M.D., psychiatrist and director of pain management at Cedars-Sinai Comprehensive Cancer Center in Los Angeles:

"People at greatest risk for misusing prescription pain medications tend to have a prior history of substance abuse, but they, too, deserve -– and can receive -– pain relief without reactivation of their addiction. There is scientific evidence that patients with pain problems do better when the pain is recognized and treated effectively early on in an illness.

"Although opioid pain relievers (morphine, codeine, etc.) are considered the mainstay for serious pain problems, many nonhabit-forming medications can be as effective or more effective than opioids for particular kinds of pain, such as nerve, bone and soft tissue pains. There are also a host of proven nonmedication techniques, including physical therapies, chiropractic, massage and acupuncture, hypnosis, relaxation and other psychological treatments."

Finding pain management experts and communicating openly and honestly with them is the crucial strategy. For information on services available locally, consult the American Pain Society at www.ampainsoc.org or the American Alliance of Cancer Pain Initiatives at www.aacpi.org.

CONFIDENTIAL TO "THE MIDDLE-SCHOOL MISFIT": Don't lose hope. The great entertainer Bette Midler also felt she was a misfit when she was a child. Fortunately, she finally realized that being different wasn't the problem she thought it was. As she put it: "I didn't belong as a kid and that always bothered me. If only I'd known that one day my differences would be an asset, then my early life would have been much easier."

Dear Abby is written by Pauline Phillips and daughter Jeanne Phillips.

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