Trouble in the Medicine Chest (I): Rx Drug Abuse Growing

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Students in big cities are "pharming" these days- "pharming" being new lexicon for grabbing "a handful" of prescription drugs and ingesting some or all of them. Young people steal grandma's pills and distribute them at school. Senior citizens falsify their prescriptions for more pain medication. Babysitters take pills from cabinets. An Ohio real estate agent loses her license for pilfering pills from bathrooms at "Open Houses." Eminem, the rapper, is reported to have had the painkiller Vicodin tattoed on his bicep.

These are all scenes from the latest drug frenzy-getting high (or low) from prescription drugs. The appeal is obvious-the drugs can be legally obtained, the stigma of going to a street pusher can be avoided, and the price isn't steep. There are an estimated 800,000 web sites which sell prescription drugs on the Internet and will ship them to households no questions asked. Today, about one-third of all U.S. drug abuse is prescription drug abuse.

What drives it?

Experts and students themselves point to many things spurring prescription drug abuse by youth. There's the extreme competition for college entrance, including competition for Advanced Placement and Honors courses in high school. Students talk of "dying down the pressure" with excess painkillers, sedatives, or stimulants. The abuse of the stimulant Ritalin, a drug used for attention deficit hyperactivity disorder (ADHD), is rising. Harm is not often associated with prescription drugs until it is too late. Others note that this is a culture which doesn't easily tolerate pain. Also, an obsession with physical appearance stokes the use of diet pills. One such pill containing ephedra recently contributed to the death of a Baltimore Orioles pitcher during spring training.

Often, people don't realize that prescription drugs, if used outside a doctor's orders, can pack a very hard-sometimes lethal-punch.

ER and mortality stats

• In 2000, 43 percent of those who ended up in hospital emergency rooms from drug overdoses-nearly a half million people-were there because of misusing prescription drugs.
• In seven cities in 2000 (Atlanta, Chicago, Los Angeles, Miami, New York, Seattle, and Washington, DC) 626 people died from overdose of painkillers and tranquilizers. By 2001, such deaths had increased in Miami and Chicago by 20 percent.
• From 1998 to 2000, the number of people entering an emergency room because of misusing hydrocodone (Vicodin) rose 48 percent, oxycodone (OxyContin) 108 percent, and methadone 63 percent. The rates are intensifying: from mid-2000 to mid-2001, oxycodone went up in emergency room visits 44 percent.

Disturbing trends

While most illicit drug abuse, particularly for middle and high school teens, began to slow or actually decline in 2002 after a half a decade increase, abuse of prescription drugs continues to climb:

• Over the past decade-and-a-half, the number of teen and young adult (ages 12 to 25) new abusers of prescription painkillers such as oxycodone (OxyContin) or hydrocodone (Vicodin) has grown five-fold (from 400,000 in the mid-eighties to 2 million in 2000).
• New misusers of tranquilizers such as diazepam (Valium) or alprazolam (Xanax, called "zanies" by youth)-medicine normally used to treat anxiety or tension-went up nearly 50 percent in one year (700,000 in 1999 to 1 million in 2000).
• More than 17 percent of adults over 60, wittingly or not, abuse prescription drugs.
• In 2000, more than 19 million prescriptions for ADHD drugs were filled, a 72 percent increase since 1995. An estimated 3 to 5 percent of school-age children have ADHD. A study of students in Wisconsin and Minnesota showed 34 percent of ADHD youth age 11 to 18 report being approached to sell or trade their medicines, such as Ritalin.
• Among 12- to 17-year-olds, girls are more likely than boys to use psychotherapeutic drugs nonmedically.

Sources:

Results from the 2001 National Household Survey on Drug Abuse, SAMHSA, 2002. Emergency Department Trends from the Drug Abuse Warning Network, Preliminary Estimates January to June 2001, with Revised Estimates 1994-2000, SAMHSA, 2002.
Prescription Drug Abuse and Addiction, National Institute on Drug Abuse, 2001.
Prescription Drug Abuse Prevention: Where Do We Go from Here? (Strategizer), Community Anti-Drug Coalitions of America (CADCA), 2003. Final Report, CADCA's Prescription Drug Abuse Initiative Community Forums, 2002-2003. "Stealing and Dealing Ritalin," Karen Thomas, USA Today, November 27, 2000. Moline and Frankenberger, "Use of Stimulant Medication for Treatment of ADHD: A Survey of Middle and High School Students' Attitude," Psychology in the Schools, Vol. 38, No. 6:1-16.