Pubdate: Tue, 13 Jun 2006
Source: USA Today (US)
Copyright: 2006 USA TODAY, a division of Gannett Co. Inc
Contact:  http://www.usatoday.com/printedition/news/index.htm
Details: http://www.mapinc.org/media/466
Author: Donna Leinwand, USA TODAY

PRESCRIPTION DRUGS FIND PLACE IN TEEN CULTURE

'Pharm Parties' Reflect New World of Drug Abuse -- and Introduce a 
Dangerous Misperception: Pharmaceuticals Are 'Safer'

When a teenager in Jan Sigerson's office mentioned a "pharm party" in 
February, Sigerson thought the youth was talking about a keg party 
out on a farm.

"Pharm," it turned out, was short for pharmaceuticals, such as the 
powerful painkillers Vicodin and OxyContin. Sigerson, program 
director for Journeys, a teen drug treatment program in Omaha, soon 
learned that area youths were organizing parties to down fistfuls of 
prescription drugs. Since February, several more youths at Journeys 
have mentioned that they attended pharm parties, Sigerson says.

"When you start to see a pattern, you know it's becoming pretty 
widespread," she says. "I expect it to get worse before it gets better."

Drug counselors across the USA are beginning to hear about similar 
pill-popping parties, which are part of a rapidly developing 
underground culture that surrounds the rising abuse of prescription 
drugs by teens and young adults.

It's a culture with its own lingo: Bowls and baggies of random pills 
often are called "trail mix," and on Internet chat sites, collecting 
pills from the family medicine cabinet is called "pharming."

Carol Falkowski, director of research communications for the Hazelden 
Foundation, says young abusers of prescription drugs also have begun 
using the Internet to share "recipes" for getting high. Some websites 
are so simplistic, she says, that they refer to pills by color, 
rather than their brand names, content or potency.

That, Falkowski says, could help explain why emergency rooms are 
reporting that teens and young adults increasingly are showing up 
overdosed on bizarre and potentially lethal combinations of pills.

Overdoses of prescription and over-the-counter drugs accounted for 
about one-quarter of the 1.3 million drug-related emergency room 
admissions in 2004, the federal Substance Abuse and Mental Health 
Services Administration reported last month.

The abuse of prescription and over-the-counter drugs -- which barely 
registered a blip in drug-use surveys a decade ago -- is escalating 
at what Falkowski and other analysts say is an alarming rate.

In a 2005 survey by the Partnership for a Drug-Free America, 19% of 
U.S. teenagers -- roughly 4.5 million youths -- reported having taken 
prescription painkillers such as Vicodin or OxyContin or stimulants 
such as Ritalin or Adderall to get high.

Vicodin has been particularly popular in recent years; a study by the 
University of Michigan in 2005 found that nearly 10% of 12th-graders 
had used it in the previous year. About 5.5% said they had used 
OxyContin. Both drugs are now more popular among high school seniors 
than Ecstasy and cocaine.

Marijuana is still the most popular drug by far; about one-third of 
the 12th-graders surveyed said they had used it in the previous year.

Falkowski, whose foundation is a treatment center based in Center 
City, Minn., says prescription pills have become popular among youths 
because they are easy to get and represent a more socially acceptable 
way of getting high than taking street drugs.

Some kids, she says, are self-medicating undiagnosed depression or 
anxiety, while others are using stimulants to try to get an edge on 
tests and studying.

Falkowski says prescription drugs are familiar mood-altering 
substances for a generation that grew up as prescriptions soared for 
Ritalin and other stimulants to treat maladies such as 
attention-deficit disorder. "Five million kids take prescription 
drugs every day for behavior disorders," she says.

"It's not unusual for kids to share pills with their friends. There 
have been incidents where kids bring a Ziploc baggie full of pills to 
school and share them with other kids."

Pharm parties, she says, are "simply everyone pooling whatever pills 
they have together and having a good time on a Saturday night. Kids 
.. don't think about the consequences."

Lisa Cappiello, 39, of Brooklyn, N.Y., says that seemed to be the 
case with her son, Eddie. She says she knew that he had tried 
marijuana at 15 and sneaked beers at school.

But it wasn't until after he graduated from high school and took a 
year off before college that Cappiello realized the extent of her 
son's drug use -- and the hold prescription drugs had on him.

"In what seemed like the blink of an eye, it went from marijuana and 
an occasional beer to so much Xanax that (one day) my husband had to 
pick him up when he feel asleep on a street corner waiting for some 
friends," she said. "He hid his drug use from me so well."

The next day, Eddie Cappiello admitted to his parents that he had 
taken 15 pills of Xanax, a brand name for benzodiazepine that acts as 
a sedative. He told his parents Xanax helped him deal with anxiety 
and depression.

Eddie rejected professional help and vowed to stop taking pills, his 
mother says. He was clean for 10 months, she says, before he was 
hospitalized in July 2005 after overdosing.

Two months later, he entered a 28-day treatment program, his mother 
says. After he was discharged, he stayed clean for about two months 
- -- then relapsed into weekend binging: 40 to 50 pills and a quart of 
Jack Daniel's, sometimes by himself, sometimes with friends, Lisa 
Cappiello says.

Eddie Cappiello, 22, died in his bed on Feb. 17 after overdosing on a 
mix of pharmaceuticals. He left behind a girlfriend and two young children.

A toxicology report said he had 134 milligrams of Xanax -- the 
equivalent of 67 pills -- and an opioid derivative in his system, his 
mother says.

"Before four years ago, I never even heard the word Xanax," Lisa 
Cappiello says. "Now ... I know kids as young as 12 are using it. 
Then I found out that Vicodin was a very big party drug. Before 
school, after school, at parties. Kids mixed them with alcohol and 
Ecstasy. It was baffling to me."

Cappiello says police, teachers and parents are so fixated on street 
drugs such as marijuana, cocaine and Ecstasy that they are missing 
the start of an epidemic.

"Eddie was not the first kid to die in this neighborhood from 
prescription drugs," she says.

In recent months, federal anti-drug officials have acknowledged that 
they didn't anticipate the quick escalation of prescription-drug 
abuse. Most government-sponsored drug prevention programs focus on 
marijuana, tobacco, alcohol and methamphetamine.

"We were taken by surprise when we started to see a high instance of 
abuse of prescription drugs," says Nora Volkow, director of the 
National Institute of Drug Abuse (NIDA), which is collecting 
information about how teens perceive, get and use prescription drugs 
so it can try to craft an effective prevention campaign.

In a bulletin last year, NIDA called the increase in pharmaceutical 
drug abuse among teens "disturbing" and said pharm parties were a 
"troubling trend."

The increasing availability of prescription drugs is a big reason for 
the rise in their abuse, Volkow and other drug specialists say.

Pharmaceutical companies' production of two often-abused prescription 
drugs -- hydrocodone and oxycodone, the active ingredients in drugs 
such as Vicodin and OxyContin -- has risen dramatically as the drugs' 
popularity for legitimate uses has increased. Drug companies made 29 
million doses of oxycodone in 2004, up from 15 million four years 
earlier. Hydrocodone doses rose from 14 million in 2000 to 24 million in 2004.

The 2005 Partnership survey found that more than three in five teens 
can easily get prescription painkillers from their parents' medicine 
cabinets. And as Falkowski says, the rising number of youths being 
treated with stimulants has made it easier for kids to use such drugs 
illicitly. About 3% of children are treated with a stimulant such as 
Adderall or Ritalin, up from less than 1% in 1987.

Almost all of the 13 youths at Phoenix House's intensive outpatient 
treatment program on New York City's Upper West Side have dabbled in 
prescription drugs, director Tessa Vining says.

"There's definitely easy access," she says. "Maybe a parent had some 
surgery and took one or two painkillers from a bottle of 10, and the 
rest are just hanging out in the medicine cabinet."

After her son died, Cappiello says she wondered how kids in her area 
were getting pills. She says she learned from police that one local 
dealer got Xanax from his mother, who had been given a prescription 
for the drug. Instead of taking the pills, she gave them to her son 
to sell for $2 to $3 each.

Paul Michaud, 18, of Boston, says he got his first taste of OxyContin 
pills -- he calls them OCs -- from a friend during his freshman year 
in high school.

Until then, Michaud says, he had smoked marijuana daily and taken a 
Percocet pill occasionally. Michaud's father had recently died of 
cancer, and Michaud says he was depressed and feeling like an 
outsider at school. The prescription painkiller made him feel like 
nothing could faze him, he recalls.

"The first time I did it, I was hooked," says Michaud, who is four 
months into a yearlong drug treatment program at Phoenix House in 
Springfield, Mass. He says he quickly became a daily OxyContin user, 
breaking apart the time-release capsules, crushing pills and snorting 
the powder from five 80-milligram pills a day.

"They're not very hard to get. I could find OCs easier than I could 
find pot," Michaud says. "There were plenty of people who sold them," 
including some dealers who got pills illicitly by mail order.

To try to reduce the supply of prescription drugs on the black 
market, authorities have shut down several "pill mills" -- where 
doctors prescribe inordinate amounts of narcotics -- as well as 
Internet pharmacies that ship drugs with little medical consultation, 
says Catherine Harnett, chief of demand reduction for the Drug 
Enforcement Administration (DEA).

Last September, DEA agents arrested 18 people allegedly responsible 
for 4,600 such pharmacies.

A tricky part of the prescription-drug problem, Harnett says, is 
addressing the perception among youths that pills are safe because 
they are "medicine." Many teens don't equate taking such pills with 
using drugs such as heroin or cocaine, she says.

"If you start with pills, it seems fairly sanitary and legitimate," 
she says. "Kids have been lulled into believing that good medicine 
can be used recreationally."

Two in five teens in the Partnership study said prescription 
medicines, even if they are not prescribed by a doctor, are "much 
safer" to use than illegal drugs.

Phil Bauer of York, Pa., believes his son, Mark, 18, an avid weight 
lifter, started using prescription drugs to relieve chronic back pain 
and didn't appreciate the potential risks of taking the drugs.

Bauer says his son never behaved as he imagined a drug addict would. 
"He wasn't hanging out all night. He had parents who wouldn't let him do that."

Mark Bauer died of an overdose on May 28, 2004. The toxicology report 
found morphine, oxycodone and acetaminophen -- the active ingredient 
in Tylenol but also an ingredient in Vicodin -- in his system, Phil Bauer says.

Before his son's death, "we didn't see a bleary-eyed guy. He wasn't 
slurring his words," the father says. "He seemed to have a lot to 
live for. I did not know prescription-drug abuse was a problem. 
There's so much guilt in that. I don't know if I stuck my head in the 
ground. I did not see this coming."

Michaud says he didn't equate his OxyContin addiction with hard-core 
drug abuse. "Where I come from, OC is a rich boys' drug," he says. "I 
thought, heroin abuse, that's pretty low. I'd never stick a needle in my arm."

However, Michaud says he eventually switched to heroin. "I sniffed it 
and a week later, I was shooting," he says. "I thought I wasn't like 
other people doing heroin. I wasn't that low. Come to figure out, it 
all leads to the same place."
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