I Was Sure I Had More Pills Left

Part Two: Protecting You Family from Teen Pharmaceutical Swap-Meet

Part One >>

A New Culture of Abuse
The risks of teen prescription drug abuse are momentous, yet few adults in a position to take action against them have realistic grip on this new frontier of teen crime.
Pharmaceutical companies and even some doctors are not the clear allies they could be.
A New York Times article, dated May 10th 2007, reported the guilty plea of OxiContin maker Purdue Pharma to marketing the drug, “with the intent to defraud or mislead,” the FDA, doctors, and consumers, as to its immense potential for abuse and addiction. The drug maker agreed to pay over $600 million in fines and punitive damages, the largest settlement ever made a by a drug company, for its misconduct regarding the drug that once accounted for over 90% of its profits. The article reported that, “both experienced drug abusers and novices, including teenagers, soon discovered that chewing an OxyContin tablet or crushing one and then snorting the powder or injecting it with a needle produced a high as powerful as heroin.”

Not only do pharmaceutical companies deceive the public to make a buck, but they influence the judgment of many doctors, paying them well to give speeches and sales pitches promoting their drugs to other doctors. In a separate New York Times article, published the same day, it was revealed that “From 2000 to 2005, drug maker payments to Minnesota psychiatrists rose more than sixfold, to $1.6 million. During those same years, prescriptions of antipsychotics for children in Minnesota’s Medicaid program rose more than ninefold.” It is sad yet self-evident that the politics of money have long infiltrated the offices of many of those who should be defending teens from prescription drug abuse. The fact is that whether people use their drugs legally or not the company still makes money on every pill.

The culture growing between young people who abuse prescription drugs is poignantly different from that around other narcotics. First, know that these drugs are much cheaper than most other narcotics, and many teens get them for free, from medicine cabinets, friends, or their own prescriptions to them. The price for a pill of the most commonly abused pharmaceutical drugs ranges from three to six dollars, with prices getting cheaper in bulk. OxyContin and other stronger drugs can be a little more. Prices vary based on availability and on how many milligrams are in the dose. What this means is that not only can young people often afford to take them every day, but also teens do not have to buy them to try them since the low cost makes many happy to share.

With other narcotics, like marijuana and cocaine, teens often have to look around quite a bit to find a dealer, who also routinely sells prescription drugs, often importing them in quantity from countries like Mexico that allow you to buy anything you like over the counter. Yet the primary means of trafficking prescription drugs, especially for younger teens, is through social networks-friends and classmates. The effect of teen’s sharing and trading prescriptions at little or no increased price, is that drug dealers often can not make as much money on these drugs as they can on others for which they completely control the supply.

A typical teen conversation about pills between classes might sound something like the following:

M: “I am so not ready for this math test. Do you have some more of that skippy (Ritalin) that your brother gets? I’ll trade you two bars (Xanax) for four of them.”

J: “No, he sold them all, but I need some study pills for that stupid test, too. I’ll ask around and see. If you want to trade those bars for something before school gets out, and if we can’t find anything, we can go over to that girl Patti’s house.”
M: “Totally, she has a prescription and she hasn’t been able to get any killer (OxyContin). I bet she would trade for any strong nose candy by now.”
The zeal with which many teens experiment with these drugs means that they are always curious to try new prescriptions and combinations. Having “pharm parties,” in which everyone puts whatever pills they have around in a bowl of “trail mix” for party goers to “graze” have been a popular craze in the last few years. Especially considering that teens probably can not identify different medications or dosage amounts reaching into a bowl of pills, the potential for drug interactions and overdoses to kill such reckless teens is horrific. But of course that is the point of pharm parties; one does not have to know what it is to take it, and it is a different high every time.

The cornucopia of ways teens take prescription drugs and mix them with other narcotics making “cocktails” demonstrates how their abuses lead straight to even more destructive drug habits. All three major categories of abused medications can be easily crushed and snorted, making the sensation more instant and overwhelming, and very often leading teens to seek out cocaine and speed. Opiates and CNS depressants are frequently crushed and smoked, often with marijuana. The injection of Opiates and CNS depressants among teens, by crushing them and mixing the powder with water, is also growing. The trend is especially alarming given some of these drugs similarity to heroin, especially OxyContin.

The reality of the ongoing prescription swap-meet between teens has long-term implications for the mental health of many young people, who may grow up without learning how to make themselves feel healthy without illegal drugs. Another alarming trend with prescription drugs is that girls are more likely to abuse them than boys. The National Survey on Drug Use and Health reported in 2002 that 4.3% of female teens reported abusing prescription drugs in the last month in comparison to 3.6% of male teens. The disparity is likely due in part to the propensity of many teens to pop pills to lose weight. The effect prescription drugs have on one’s judgment can interact with eating disorders to raise a host of fresh health threats. What many parents find most painful about teen prescription drug abuse is that, because most teens are always willing to sell off a few pills, many more children are in effect becoming drug dealers.

Listening and Acting

The universe of available prescription drugs is too great for almost anyone to keep close track, especially with the astronomical number of new drugs and generics introduced every year. Yet a practical understanding of the pills most often popped is vital for parents to fight back. A concise listing of these medications, their effects and common slang names can be found online in a one page chart at:
www.drugfree.org/Files/Table_of_Commonly_Abused_Drugs An empowering first step for parents is to print, study, share, and reference, this chart.

Putting prescriptions under lock and key seems obvious, yet abuse usually gets started because parents don’t. In addition to this practice, count your pills, keeping a sticky note on the bottle where you can initial and write the number of pills left every time you take some. This practice may sound like a lot of paperwork, but it is a clear signal to teens that you are constantly vigilant on the issue, and it should help provide a deterrent. Ask your doctor if your prescriptions are often abused and how, so that you know the symptoms. Most medications will not get you high or serve teens’ perceived self-medication needs. If this is the case with your meds, you should be open with your teen about it, joking “you would not get a rush from taking my heart medication — I sure don’t.”

Once you have taken the initial steps to become more informed, and to secure the medications in your home, considering how to discuss the issue with your family is the next move. Begin by listening. Just starting a general conversation on prescription drugs can illuminate your teen’s tendencies before you clam them up with warnings and rules. Once you have learned your teen’s honest opinions on the issue, set clear expectations with your teen, letting them know that under no circumstances should they ever take medications without your knowledge. Let them know that if they ever feel curious about whether they would benefit from taking medications that you would love to discuss it with them and the family doctor or therapist. Your children tune you out when you lecture them so use teachable moments to get the message across instead, such as organizing the bathroom or swinging by the pharmacy.

Prescription drug abuse has been played down for so long that reaching out to the community for support is even more critical than with other narcotics and alcohol. If you are the only person in their life concerned about it, it is much easier for teens to discount your warnings. Making sure that your teen’s doctor is actively addressing the issue when he or she talks with your teen is vital. Next, meet with the teen’s school counselor, nurse, and principal, to hear what they have to say about the issue in your teen’s peer group. Make sure that the most current information is included in your teen’s health class and that all parents are being asked to lock up and count their pills.

The issue is terribly worrisome, yet a solution requires thinking critically to find the solution uniquely suitable to your family. It is highly unlikely that you can prevent your teens from being exposed to prescription drug abuse. The question is how you can help them think critically and respond confidently. If your teens are showing a special curiosity about prescription drugs it usually means that they at least have friends who are abusing them. When you observe this curiosity, satisfy it with the facts. Let them know that taking a pill one cannot identify or were not prescribed is like playing Russian roulette.