The problem started in 1992, when Eddie Hamill sustained a shoulder and back injury during his training with the Army Reserves.
"The Army's favorite thing—no matter what, if you break a bone, stub a toe or get an ingrown toenail—is Tylenol and codeine," he says.
Those "T3s" were Hamill's first experience with prescription painkillers, and for a while, they worked. He took them regularly. He rested his shoulder. His back more or less recovered.
But while the pain subsided, the lure of that sweet codeine high only grew. Soon, Hamill was looking for something different, and he found it in oxycontin, and in xanax. This being the pre-drug-database '90s, the Florida resident had no trouble going from doctor to doctor, getting one prescription filled after another.
It was the beginning of an addiction he kept hidden—from his wife, from his four kids, from his father and business partner—for close to 20 years.
There are, of course, multiple factors that cause a person with addiction to keep their substance use a secret. "Two major ones are the legality of the substance and how socially acceptable it is to use the substance at all," explains Daniel Bradford, a researcher in the Addiction Research Center at the University of Wisconsin–Madison. On the legal side, Bradford cites tobacco as an example. Few cigarette smokers bother to hide their use, whereas most people with a cocaine addiction choose to use privately. And some substance abuse disorders are easier to hide simply because the drugs aren't as impairing as others.
That was the case for Hamill, who had no trouble compartmentalizing. At work, xannies made him the happy-go-lucky sales guy. He spent a lot of time alone on the road, driving state to state to visit vendors and customers, which made it easy to pop pills privately. And because he was working such long hours, it seemed like standard dad stuff to his wife and four kids when he'd stay stuck to his recliner each weekend; they didn't know it was because he'd over-indulged on painkillers. Come Monday morning, he'd wake up and do it all over again.
"You can smell when someone's an alcoholic," Hamill says. "You can't smell when someone's high on oxycontin. And if you don't know what you're looking for… people just saw me as a funny guy with a quick wit, always up for a joke."
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"And for the majority of that, my insurance covered it," he adds. "I thought, in my mind, if there was a problem the insurance company would say something, or the doctors would say something."
Bradford explains that this is the particularly tricky thing about addictions to prescription pills: Because the drug is perfectly legal for those who have been prescribed it, family and friends may be less likely to see their use as an addiction. The addicted person doesn't seem to be doing anything they aren't supposed to.
That's the case for Brian, who was diagnosed with ADHD at 21 and prescribed Vyvanse, a stimulant similar to Adderall. He took the medication as prescribed for about two years, until, exhausted during a night out with friends, he popped an extra one. "It gives you a burst of energy—it's almost an indescribable feeling," says Brian (who prefers to use his first name only). He compares the sensation to being in "hyper-speed mode"—and he quickly realized that his prescription would come in handy for more than just making him a tireless drinking buddy.
"I'm a 26-year-old and I run my own company," he explains. "I like having the extra energy; I like being motivated. It's given me a huge advantage over other people, because I can pull all-nighters if I have to. I can get things done super quickly and with super attention to detail."
Brian's family knows that he's on ADHD meds—though he says they don't really understand how Vyvanse works or what it does—but they have no idea he's using it any any way other than how it was prescribed. And while a few friends have questioned his behavior—especially at the end of each month, when his prescription runs out and he becomes withdrawn and "a bit off emotionally"—he's not exactly forthcoming with them, even if he does know plenty of other people who have a similar habit when it comes to their stimulants.
"I don't know if all addicts share the same mindset, but your first instinct is to deny it and say, 'No, like, I take an extra every once in awhile, but it's not a problem,'" he explains.
This is where the "social acceptability" component of substance abuse comes in. Our acceptance of alcohol isn't just about the fact that it's legal, but that it's part of the fabric of our culture, says Ashwini Nadkarni, a psychiatrist at Brigham and Women's Hospital in Boston. A night out drinking means a night spent socializing with friends and family. Similarly, while it's still illegal in plenty of places, marijuana is widely accepted, which is why you won't find too many closet potheads.
Opiate addictions, on the other hand, tend to be kept hidden, and Nadkarni says they're often under-diagnosed because of the stigma that continues to be associated with them. "For example, people link opiate addiction symbolically with a range of other stigmatized health conditions, such as Hepatitis C and mental illness, as well as social problems such as poverty and criminality," she says. "People hide such addictions because they feel a sense of shame about their usage."
Nadkarni says the best way to help someone who you think may be struggling with substances is to have an open dialogue about what's going on. She recommends approaching it in a way that's both non-judgmental and curious, making it clear that you're there to lend support. Fatigue and emotional fluctuations are one of a number of behavioral changes that can indicate a secret addiction, and people may spend more time alone or engage in more risk taking behaviors. Often, relationship and financial problems or disrupted sleep patterns can be an indicator, and those who are using in secret may become defensive or irritable. Many lose interest in their usual activities or miss important events.
But whether you know the signs or not, a secret addiction is, almost by definition, difficult to spot. Christine (who used a pseudonym for this article) works for a company that makes a non-opioid alternative used to manage post-surgical pain. She's well versed in the signs and statistics associated with opioid abuse; she spends the first hour of each workday researching the epidemic. So the 25-year-old was "completely blindsided" when, this past April, her boyfriend was arrested for heroin possession. She learned he'd been hiding a heroin addiction for the entirety of their eight-month relationship.
"He completely lied to me for months, but we were good, everything else in our relationship felt so good," she says. They'd had candid conversations about her job and about drug use in the past, and while her partner was occasionally irritable or tired, who wasn't? Besides, he didn't even really like drinking—how could he be addicted to heroin?
Christine's read countless stories from people who say they never knew about a friend or family member's use until it was too late, about how surprisingly easy it is to hide a heroin addiction. And it's not that she didn't believe those people, per se… it's just that she always thought she'd see the signs, especially since it was her line of work. "I had no reason to doubt him," she insists. "There was no reason for me to believe anything was different."
Of course, it's not like she could have made him quit; recovery is a something a person with addiction has to decide on themselves. For Eddie Hamill, that moment only came about last fall. In his search for something stronger, he'd stumbled upon fentanyl a few months prior. Things quickly got out of hand, and during a days-long bender, he got in a car wreck after failing to yield. Later, looking back at photos from the crash, he saw there was a kid sitting in the other car. "That was when I made the decision. I sat my wife down and I filled her in on everything," he says.
Hamill wishes he hadn't kept it a secret for so long. It let him rack up close to $30,000 in credit card debt, which he and his wife are working together to pay off. Today, he says he texts her if he's planning to take an ibuprofen. He's been brutally honest about the situation with his kids (except the youngest, who's 11), and they're allowed, at any time, to ask him to take a drug test. He's working to repair their trust—the family just got back from a weekend getaway to Disney World—and with their support, he's nine months sober.
"The people I hid it from were the ones that were going to help me the most," Hamill says. "That was what I didn't realize."
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