Banker hopes to help others get off drugs

Kristi Metzger had it all: a job she loved as a bank vice president, loving family and friends, community activities, a house to shelter her at the end of a productive day.

And a secret.

Metzger was addicted to the prescription pain reliever Vicodin.

After 10 surgeries in 15 years in a fruitless effort to relieve chronic pain caused by endometriosis, Metzger had almost quadrupled the maximum number of Vicodin she was allowed. And to keep her secret, she had turned into a liar.

Now, after two stays in chemical dependency treatment centers, Metzger, 31, has decided to keep that secret no longer. She has begun talking to civic groups about her addiction to painkillers and the resources available.

“My point is, addiction knows no boundaries,” Metzger said. “It doesn’t matter what you do or where you come from or how smart you are. It’s a very real problem, people are struggling with it, and I want to help.”

An estimated 4.7 million Americans used prescription drugs nonmedically for the first time in 2002, according to the 2003 National Survey on Drug Use and Health. The number who used pain relievers was estimated at 2.5 million.

Studies also suggest that women are more likely than men to be prescribed an abusable prescription drug, particularly narcotics and anti-anxiety drugs.

“More women come to me for prescription drug use than men do, but I think the drug of choice has changed,” said Janell Christenson, a registered nurse and a certified chemical dependency counselor with Avera McKennan Hospital.

“I can remember when it was Demerol that was most abused, then Percodan and Percocet. I don’t know the top one now, probably oxycodone or Vicodin.”

First there’s pain

Most addictions start out innocently, Christenson said. Generally people have an accident, injury, surgery or medical problem that causes pain and requires prescribed medication.

Three things are required for someone to become an addict, said Dr. John Hansen, supervisor of Sioux Valley Hospital’s Pain Clinic. First is a psychological or biologic predisposition; second is a substance that can produce addiction or chemical dependency, such as the painkillers known as opiates, and third is an unrestricted access to the drug.

That is why his clinic provides a highly structured environment in which the patient has no discretion in deciding to increase the dosage of their drug, Hansen said. In addition, the clinic offers a multidisciplinary approach providing physical therapy, psychology and associated physician services.

Professionals can easily recognize the difference between a person with chronic pain who is properly using opiates and one who is abusing them, Hansen said.

“People who have chronic pain who get opiates look better, their mood improves, they function more, and they look better when their pain is controlled. People who are chemically dependent, when they have unrestricted access to the meds they’re dependent on, they look worse, their behavior deteriorates, their mood can deteriorate.”

That happened to Metzger, who cut herself off from family and friends as her dependency worsened.

“My life was just constantly filled with, ‘When am I going to take my next pill?’ It got so incredibly bad (but) I thought I was hiding it well,” she said.

At a high cost

No local physician would have prescribed the number of pills she needed, but Metzger recalled something she had heard the first time she entered a substance-abuse center: Pills could be purchased online, after a quick chat with a physician.

She was amazed at how easy it was to get her Vicodin that way.

How costly was Metzger’s addiction? She has never totaled it up, but it easily cost her thousands of dollars to buy the pills online, she said.

For example, the Web site my247md.com offers 120 tablets of Vicodin for $145. For Metzger, that was a four-day supply. That’s $1,015 for a four-week supply.

When she was taking eight painkillers a day, she ended up at Keystone Treatment Center. On 30 pills a day, she frantically tried to hide her problem.

But her family, particularly her uncle Ken Ness, president of the bank that employed her, knew something was wrong. He contacted Metzger’s parents and three brothers, and they staged an intervention after Thanksgiving 2005.

“They had planned for me to go to Hazelden in Center City, Minn., and I just started crying as soon as I saw them all sitting at this table, and I knew that everybody knew and I had lied to them,” she said.

After a sleepless night, Metzger’s parents drove their daughter to Hazelden.

Metzger knew what was awaiting her, since she had been through withdrawal once before. This time, with her body’s greater reliance on drugs, it was much worse.

“It was pure torture, the physical agony I went through,” Metzger said. “I was so sick, with flu-like symptoms. I was dry heaving; eventually I threw up the pills I’d taken that hadn’t gone into my system. The anxiety was worse than anything, and they couldn’t give anything until the pills were out of my system.”

Metzger lay in a bed at the clinic, her body convulsed with tremors. Staff changed her sweat-soaked sheets several times. Doctors and nurses closely monitored her that first week.

“I looked like ‘dead girl walking,’ ” Metzger says. “I was pasty white. I didn’t look like I was alive.”

Slowly, helped by a drug that reduced withdrawal symptoms, Metzger began to feel better.

Just before Christmas, she returned home. But the battle wasn’t over.

All in the attitude

Metzger’s pain had started years earlier. As a 15-year-old student at Hills-Beaver Creek High School, she was in a car accident. About the same time, she learned she had endometriosis, a painful condition in which the uterus’ lining invades the abdominal cavity.

The condition worsened during college. Eventually, an ovary and part of her fallopian tubes were removed. As the pain persisted, and it became less likely Metzger would ever be able to become pregnant, depression surfaced.

But she persisted in maintaining a positive front. She became a trust officer and vice president at First National Dakota Bank. She played piano, tennis and golf. She volunteered with Sioux Empire United Way, the Sioux Falls Community Foundation’s investment board and Kiwanis Club.

And she kept swallowing painkillers.

“I took these pills to get up, I took them during the day at work, and I took them to go to sleep, so now my life revolved around these drugs,” Metzger says.

She realized she was addicted in July 2004, after undergoing surgery. She entered the chemical dependency program at Keystone Treatment Center in Canton in October 2004.

But her attitude was wrong.

“I went there very naïve, not knowing anything about addiction, thinking that this is really a fluke that happened to me, I’m not really the addict type, I shouldn’t be here, and when I was with other alcoholics and drug addicts, there was really arrogance on my part,” she said.

That arrogance is gone. Metzger attends two Alcoholics Anonymous meetings a week, and she volunteers at a halfway house.

Jane Pugh of Yankton serves as Metzger’s AA sponsor.

“She has her ups and downs,” said Pugh, who agreed to let her name be used. “It’s a new lifestyle she’s learning. She’s also discovering who Kristi is.”

To help in that discovery, Metzger has left the bank. She lives with her parents, who now reside in Brandon. She can return to a career when she knows she is healthy, Metzger says. It may be in law or chemical dependency counseling.

Whatever it is, it won’t involve secrets.

“I just don’t want people to worry and be scared that this could be the end for them,” Metzger said. “There are treatment centers, there’s doctors willing to help you, there’s pastors at your church. There’s resources.”

BY JILL CALLISON
PUBLISHED: October 6, 2006