Manhattan Psychiatrist on Prescription Pill Addiction

March 7, 2014 Updated: April 28, 2016

Many people take prescription pills without becoming addicted at all while others find themselves heavily addicted, not realizing it was even possible to become dependent on pills their doctors prescribed.

Manhattan-based psychiatrist Dr. Ankur Saraiya, who works with patients dependent on a variety of substances, including prescription medications, explains what addiction is and some misconceptions about prescription pill addiction.

Epoch Times: Why do some people become addicted to prescription drugs while others don’t?
Dr. Ankur Saraiya: This is a complicated question and the most honest answer would be “No one knows.” You could substitute just about any substance of abuse in place of “prescription drugs” with the same kind of unknowability.
Some possible factors are, people have different responses to prescription drugs. In other words, some people feel a pleasurably high and others don’t or they feel it to different degrees. Also, different people have different abilities to avoid temptation and make healthy choices. Others are more prone to listen to authority figures (i.e. take the medications as indicated by their doctor) while others are more prone to be rule breakers. Some people don’t have a problem breaking the law by obtaining the drugs illegally while others will not do this. Some patients will have doctors that are more attuned to the risks of addiction so will have better oversight. There are many reasons for the variability but there is no way to boil it down to any one thing.

Epoch Times: What does it mean to be addicted?
Dr. Saraiya: The concept of addiction is imprecise. In other words, different people mean different things when they talk about addiction. It’s important to define what you are talking about in a particular context.
For physicians, addiction generally refers to a substance that creates a physical or psychological dependence, meaning that stopping is specifically dangerous or problematic for specific health reasons.
There is also a constellation of behaviors related to the substance use in those addicted or dependent.

Epoch Times: So can addiction be either physical or mental, or is it always both?
Dr. Saraiya: Again, this comes down to definition, a distinction between dependence and addiction. You can have either physical or psychological dependence or both. I would say that for what most people think of when they think of addiction, it is largely going to be a combination of physical and psychological factors. Apart from knowing the physical risks of taking and stopping a substance I don’t think this distinction is all that important. If use of a substance is creating problems in someone’s life and they are having difficulty stopping, it doesn’t really matter how we categorize the addiction.

Epoch Times: What kind of prescription drugs most commonly become addicting?
Dr. Saraiya: There are a variety of classes of drugs that are prone to be abused, but the most common class is probably prescription opioid painkillers (Percocet, Vicodin, Oxycontin, and the like).

Epoch Times: What are misconceptions about prescription drug addiction?
Dr. Saraiya: [Some common misconceptions are] that addicts are stereotypical low-class criminals, that only certain people are prone to addiction. People have misconceptions about what drugs are addictive, for example, antidepressants are not addictive, but many people believe that they are.

Epoch Times: What are the most successful techniques you’ve found to help people quit?
Dr. Saraiya: The specific approaches depend on the substance, but for painkillers, we use substitution therapy with Suboxone. Some kind of therapy in conjunction with medications is most effective.
Therapy can include both individual and group therapy as well as support groups and Alcoholics Anonymous and Narcotics Anonymous.

Epoch Times: What are common challenges to overcoming prescription drug addiction?
Dr. Saraiya: Stigma is a major concern. People are afraid to seek treatment for fear of being treated like an “addict” and also for being found out by others that they have a problem. Unfortunately, people often leave treatment too early and are susceptible to relapse.

Epoch Times: What role do you recommend family and friends play in helping their loved one quit?
Dr. Saraiya: Helping to get people to appropriate treatment and offering general support are the best things loved ones can do.

Epoch Times: There has been a lot of controversy over the upcoming release of the painkiller Zohydro because it has such serious side effects. What do you think readers should know about this issue?
Dr. Saraiya: From my understanding, it is not anything specific about the drug itself that has fueled the controversy, it is the fact that it is going to be available in relatively large doses because it is a long-acting drug. The fear is that people will tamper with the drug so that the full dose is released immediately and that this high dose could be more toxic than what is currently available.
For people who use the drug as directed, I don’t think there is anything specific to worry about. Opioids have been used by prescription for many years and this is just another variation. For people who are going to choose to use the drug recreationally, they will be taking a risk that may be higher than usual because the available dose is higher than what is available now. Bottom line, just use your medications as directed and be in contact with your prescriber about any unexpected effects. If you are going to abuse any substance, you are taking risks possibly with your life.

Dr. Saraiya has offices on the Upper West Side and in Murray Hill.

If you or someone you know is dealing with drug addiction, call the Drug Detox Helpline (646) 583-2301 or visit