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HOUSING an OPIOID DEPENDENCE

AARYAN SANWAL

HOUSE, a critically acclaimed award-winning television series portrays a brilliant but rather unsociable diagnostician named Gregory House. He is the head of the Department of Diagnostic Medicine and deals with cases that other doctors and clinicians are unable to diagnose. While undergoing a surgical procedure, an infarction in his right legs’ quadriceps resulted in him having severe pain in his leg and rendered him unable to walk without a stick. To manage the severe and increasing pain, he started taking Vicodin. Over time his tolerance towards the drug started building up and at a certain point in the series, he consumed –Vicodin – pills that were supposed to last a month in less than a week.  This blog post will look at the accuracy of the depiction of opioid dependence and its effects in the show.
Gregory House’s dependence on Vicodin starts small and then slowly becomes a full-blown problem. While dealing with a hypochondriac patient who comes into the clinic, House prescribes him Vicodin and gets the same from the pharmacy but switches out the drug for mint pills and keeps it for himself. Even though he is a doctor and has a prescription for the drug itself, the fact that he engages in such behavior shows very early on in the show that his need for the drug is high.
In a later episode, House’s colleague, Dr. Cuddy bets him that he cannot go a week without Vicodin and it is important to note that during this time a lot of his colleagues and juniors have told him that he abuses Vicodin and should stop but House denies all of it. House accepts the bet and does well for the first three days but on the fourth day after a lot of work and being under intense pain House breaks the bones in his hands with a large paperweight to release endorphins in his body and also as a way to divert the pain from his leg. The next day, he starts vomiting and when questioned about it lies and says that it was from the pain and not the withdrawal. Finally, at the end of the week, House agrees that he abuses Vicodin and goes back on the medicine but says that it allows him to be a better doctor and that is worth it. Opioid dependence, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), is characterized by physical dependence on opioids and loss of control over opioid use. This can be clearly seen in House when in order to get his dose of Vicodin tablets he forges the signature of his colleague despite knowing that prescription fraud is a punishable offence. This behaviour goes to show that he is severely dependent on Vicodin and cannot function without it.
House is seen popping pills like candy and this earns him a reputation of being an addict and subsequently gets him in trouble with the police and only after he is put in jail, he agrees to go to rehab. While this works for him for a while, he soon relapses into his old dependency and is right back where he started and only worse this time. This goes to show that opioid dependency can affect anyone and even people in the healthcare industry who are supposed to know the effects of certain drugs.
The use of certain opioids such as OxyContin and Vicodin in the U.S. health industry came in the 1990’s after receiving approval from the Food and Drug Administration (FDA). Pharmaceutical companies assured people in the healthcare services to prescribe opioids and led them to believe that there were no disadvantages of the same. Initial adverts for OxyContin – an opioid – said that, “It’s not hypnotic, and there’s no danger of acquiring a habit.” (Miroff, 2019). These claims in hindsight were absolutely false and were made by the sales representatives to promote the usage of these drugs. “In a settlement reached on 22 December, Purdue Pharma, maker of OxyContin agreed to pay $24m to settle a lawsuit by the state (Kentucky) that alleged that the company had concealed the highly addictive nature of the opioid and encouraged doctors who were not trained in pain management to prescribe its formulation”. (McCarthy, 2015).
The depiction of opioid dependency in HOUSE is shown very well and more than that, it is accurate. It shows the various stages, the effects, the treatment methods available and does a good job of showcasing a problem that was and still is prevalent in many U.S. states due to foolish and rash decisions taken by the FDA and the pharmaceutical companies.


REFERENCES
Miroff, N. (2019, April 1). From Teddy Roosevelt to Trump: How drug companies triggered an opioid crisis a century ago. Retrieved October 30, 2019, from https://www.washingtonpost.com/news/retropolis/wp/2017/09/29/the-greatest-drug-fiends-in-the-world-an-american-opioid-crisis-in-1908/.
McCarthy, M. (2015). Companies to pay $39.5m in OxyContin and Risperdal cases. British Medical Journal, 351. doi: 10.1136/bmj.h7018

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