‘I took 20 pills every four hours’
At the peak of her dependency, Simonette Nikole was taking a potent cocktail of 20 prescription painkillers every four hours.
The Melbourne woman felt constantly ill as a result. Her hair began to fall out, the strength of the opioid medications severely damaged her digestive tract and she could barely function.
But every single one of the incredibly strong and dangerous pills, which are essentially pharmaceutical heroin, was prescribed by a doctor, obtained legally and taken as directed.
"I had never taken illegal drugs in my life but I might as well have been on them," Ms Nikole said.
"The ridiculous amount of painkillers I had been giving were ruining my life. It was scary and it became an addiction, yeah. I was totally dependent on them."
Ms Nikole was in a serious car accident in 2010 and what initially seemed to be general pain from the impact turned out to be a lower back injury.
"I saw numerous doctors, starting with my GP and then from there numerous specialists - osteos, chiros, physios, surgeons," Ms Nikole said.
"No one could help me though. I had scans done that clearly showed there was a problem. It was so hard to even get an appointment with a surgeon and when I did, no one was willing to operate."
Instead, she was prescribed several kinds of prescription pain killers and told that this would be her new reality.
"The more time that went by, they just increased the dose of the medication, the time that I was taking it, adding more in," Ms Nikole said.
"I was taking a ridiculous amount of medication and not getting any relief. I thought, surely this can't be the answer. It wasn't right.
"For more than 12 months I was on high doses of really strong painkillers, every four hours."
It didn't take long for the 32-year-old to became one of the 750,000 people who experts say are hooked on the legal drugs, which are as potent as heroin and now kill more people than the infamous illicit substance.
As the prescriptions piled up, Ms Nikole bought a plastic container divided into days so she could keep track of the various pills she had been directed to take.
She eventually ran out of room. At the worst of it, she was taking 20 pills every four hours that had enormous side effects.
"The pills ruined my digestive tract. My face was swollen. A lot of my hair had fallen out. I looked like such a different person. I was really ill.
"I became depressed. I experienced hallucinations. The pain was still there and I had to take more and more pills.
"One night, things got really bad and I went to the hospital. A doctor at an emergency department told me there was nothing they could do, that a lot of people have back problems, and that I'd just have to manage for the rest of my life.
"I was 25. That wasn't what I wanted. Another neurosurgeon I saw told me to go back to my GP and work out a pain management plan to take medicine for the rest of my life."
While at a pharmacy one day in 2013 having yet another prescription filled, after almost 18 months on a heavy dose of multiple pills, Ms Nikole collapsed.
"I was so drained - I wasn't eating because of the pills, I wasn't drinking enough water. They called an ambulance and the paramedic asked me what I was taking. I gave her the booklet and she was like, you must be joking.
"The physical and mental toll the medication took … it was awful. Those medications aren't made for long-term use, I know now."
The number of powerful opioid medications prescribed by doctors in Australia has boomed in recent years, and so have deaths from the legally available pills, which have more than doubled in a decade.
Turning Point clinical director and addiction treatment doctor Mathew Frei said prescription opioid deaths in Australia had now "equalled, if not surpassed the heroin crisis" of the late 1990s.
"The number of people dying in Australia is quite significant," Dr Frei told news.com.au.
Medications like oxycodone, endone, morphine, codeine, fentanyl, tramadol and pethidine are being prescribed for pain conditions in huge numbers, often at high doses and for extended periods of time.
Desperate and at the end of her tether, Ms Nikole eventually met Melbourne neurosurgeon and spinal specialist Michael Wong in 2014 who reviewed her MRI scans and decided that he could help.
She underwent a surgery that fused her L4 and L5 discs. In recovery, she began the six-week process of being weaned off the opioids.
"You can't be taken straight off it because it's so dangerous," Ms Nikole said.
Last year, she re-injured her back and returned for another surgery and after nine months of recovery is "feeling good" and pain-free.
And, more importantly for Ms Nikole, she does not need pain medication.
"It's probably never going to be 100 per cent. But I'm at 90 per cent. And I'm not dependent on all those pills."
A staggering 14 million scripts for powerful pain killers were written by doctors in 2017.
Of those taking them, the organisation Addiction Centre estimates that one-in-10 could become addicted to their medication.
A coronial inquest in Sydney last year heard alarming evidence that some 750,000 people are currently dependent on prescribed opioids across the country.
And research by Monash University estimated that of the 1.9 million people who start taking them each year, 50,000 new addicts become long-term users.
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