Prescription for Trouble

BusinessWest, Apr 02, 2007 by Bednar, Joseph

While to research this story rise of prescription abuse among teenagers, BusinessWest visited Google to call up some statistics from the U.S. government and health care agencies.

They were eye-opening. For instance, the Partnership for a Drug Free America estimates that 20% of teens have abused a prescription pain medication, 20% have abused prescription stimulants and tranquilizers, and 10% have abused cough medicine. The numbers aren't difficult to find.

But here's the interesting thing: neither are the drugs. On the right side of the Google search page, in a list of sponsored links, were a series of attention-getting blurbs: "Online pharmacy sale." "Purchase Vicodin, Xanax, and Soma. " "Buy discount drugs now." "Order drugs online. Don't wait for doctors. " And so on.

With the Internet now an extension of the medicine cabinet, such links shed considerable light on how prescription drugs are winding up in the hands of people without prescriptions an increasing number of them teenagers.

"Nationally, prescription drugs are second only to marijuana as drugs people are trying for the first time, surpassing even alcohol and older drugs," said Roberto Agrait, licensed mental health counselor at Holyoke Medical Center. "And the big factor now is that they're available. In the past 15 to 20 years, the use of painkillers, especially the opiates, has risen."

The National Survey on Drug Use and Health identifies four commonly abused types of prescription medications: pain relievers, stimulants, sedatives, and tranquilizers. Among those groups, painkillers - the powerful Oxycontin among them are the most commonly abused, with girls more likely than boys to report use during the past month, 4.3% to 3.6%.

Substance-abuse counselors speculate that part of the appeal of pharmaceuticals is the perception that they are safer than street drugs, since they are professionally manufactured and can often be found in the household medicine cabinet - or in the pockets of school peers. Simply put, many teens who can't see themselves buying street drugs may feel safer trying out Oxycontin.

"These drugs don't have the stigma of heroin and cocaine when a young person can go to the medicine cabinet at home and they're available," Agrait said. "There's a rationalization that, if it was prescribed by a doctor, it must be OK. And when they're used as prescribed, they can be very safe and helpful. The problem arises when people take more than they were prescribed or use it for other reasons."

And it's a significant problem, he added, when the National Institute of Drug Use reports that 48 million Americans more than 16% of the population have used prescription drugs for nonmedical reasons.

This month, BusinessWest examines this trend as it relates to teens - and what some concerned adults are doing about it.

Making the Score

James Leyden, program manager of inpatient substance abuse services at Providence Hospital in Holyoke said teens, after. developing a taste for sedatives or stimulants, are savvy about obtaining more.

"A lot of these drugs are prescribed," Leyden said. "Addicts have their own network, and they're very clever when it comes to finding out what stories they have to tell to get the drugs they seek. Doctors are in the business of helping people, and if someone says, 'I'm in terrible pain,' the tendency is to help them. They might not look like addicts when they come into the office. They might look like an 18year-old with a sciatic nerve problem."

Even for those who aren't able to obtain drugs in that way, or on the Internet, Leyden said they have a way of finding what they need.

"It's easier for kids to get marijuana than it is to get alcohol," he said. "That's not to say that everyone who sells marijuana sells Oxycontin, but when you travel in illegal circles, illegal things become available to you."

Leyden said some teens who experiment with prescription drugs don't dig too deep a hole, while others transition quickly into other, more potent drugs that are readily available on the street.

"It becomes cheaper to buy heroin than Oxycontin," he explained, adding that both have a sedating, contenting effect on the user. "They have to make an economic decision, and they find it's cheaper to use the street drug."

Before becoming addicted to what is effectively a prescription alternative to heroin, many teenagers - often suburban kids somewhat insulated from urban street life would have been afraid to enter that world. In addition, Leyden said, many teens associate street drugs with eventual IV use, which delivers the most potency but is associated with the deepest addiction.

Once hooked, though, many of those stigmas fall by the wayside.

"There has always been the same opportunity for addiction in Wilbraham as there is in Holyoke; the thing that's different is the opiate," he said, explaining that painkiller abuse is more associated with the suburbs, while heroin has a reputation as a "city drug."

The transition between the two drugs is all too common, however. "They can get addicted in the suburbs, but they end up in the city eventually."