Youths' drug of choice? Prescription

Youths' drug of choice? Prescription

Baby boomers made marijuana their 'gateway' -- and some still can't let go,
a report says -- but a younger generation finds prescription drugs are an
easier score.

By Melissa Healy
Los Angeles Times Staff Writer

September 15, 2008

It's been four decades since the dawning of the Age of Aquarius, but aging
baby boomers haven't stopped turning on. The federal government's National
Survey on Drug Use and Health, released earlier this month, finds that as
boomers move into their 50s in large numbers, drug use among older adults in
the United States has hit its highest point ever.

In the government's latest report -- reflecting drug use in 2007 -- 1 in 20
Americans ages 50 to 59 told researchers they had taken illicit drugs in the
last month.

More than half of these older users still like their street drugs, including
marijuana and cocaine. But as they contend with the aches and pains of
aging, boomer drug users are adding prescription drug use to their mix of
vices, according to the report from the Substance Abuse and Mental Health
Services Administration.

A new generation of drug users, by contrast, isn't waiting to reach middle
age to add prescription drugs to its portfolio of abuse, the report says.
Among teens and young adults 12 to 25, one-third of those who use illicit
drugs say they recently have abused prescription drugs -- including
painkillers, tranquilizers and stimulants. Among kids 12 to 17, 3.3% had
abused prescription psychotherapeutic drugs in the last month. Among 17- to
25-year-olds, 6% had abused prescription drugs in the last month.

Those generational trends are driving a significant change on the landscape
of American drug abuse. After years of declining American use of street
drugs -- cocaine, hallucinogens and even marijuana -- prescription
medications have begun moving front and center as the nation's drug of
choice.

The result, according to the latest federal drug-use survey: Last year,
Americans who began abusing prescription drugs outnumbered those who took up
smoking marijuana -- traditionally the nation's "gateway drug."

Dr. Nora Volkow, director of the National Institutes of Health's National
Institute on Drug Abuse, says the report underscores a "paradigm shift" in
drug abuse -- and hence, in its likely treatment. Though addiction to
prescription drugs is not new, the current generation of teens and young
adults has grown up around unprecedented widespread medical use of
prescription drugs, Volkow says, and is inclined to view them as safe
because they are prescribed by doctors.

"That comfort level," Volkow says, "facilitates the abuse" of these
medications. Add to that the high from such drugs as narcotic pain
relievers, she adds, and young users are at high risk of becoming addicted.

Reaching for Mom and Dad's pills

Peter S., a 26-year-old recovering addict from New Jersey, says the ubiquity
of prescription drugs in American homes is reassuring to kids eager to take
a controlled risk or dull the emotional challenges of being a teenager.

"You don't have to go to the drug dealer, or even leave the house," says
Peter, who spoke on condition that his last name not be used. "You can just
go upstairs to Mom's medicine chest and boom! You're locked and loaded. . .
. People feel like, 'Wow, how bad could it be? It came from our doctor. And
I'm not doing street drugs -- cocaine or mushrooms. I'm doing what Mom has
in her medicine cabinet.' "

Many adults, whose images of drug abuse may be dominated by street drugs,
"just don't realize," Peter says, that the leftover pain pills from Mom's
back spasm or the unused anti-anxiety pills prescribed for Dad during a
rough patch at work may furnish a kid's first chance to experiment with
drugs. Parents "take one and feel better and put the rest up there in the
medicine chest," Peter says. "They just don't know."

Volkow adds that a shift toward prescription drug abuse also may make it
harder for the new generation's drug users to "age out" of their habit, as
many baby boomers -- though clearly not all -- have done. Users of street
drugs, Volkow says, frequently quit as they find that unpleasant side
effects become more pronounced with age and prolonged use.

Users of prescription medications, by contrast, tend to build tolerance to
the effects over time, prompting them in some cases to use more, not less,
and more often, Volkow says.

Researchers with the federal substance abuse agency said they remain
uncertain if baby-boomer drug users had continued to take illicit substances
through mid-adulthood or, rather, returned to a youthful habit as they aged.
John P. Walters, the nation's drug czar, expressed surprise that although
young Americans are turning away from cocaine and methamphetamine, use of
such street drugs continues among their elders.

Jim Steinhagen, executive director of the Hazelden Center for Youth and
Families in suburban St. Paul, Minn., says that for young people,
experimentation with prescription drugs only seems safer than their parents'
drug forays.

"We're seeing kids coming to the treatment center more acutely addicted than
we ever have before, so the degree of detox we need is more extensive and
takes a longer period of time," says Steinhagen, a 32-year practitioner of
addiction treatment. "The kind of substance use that goes on today is like
extreme sports for this generation -- quicker, faster, a more dangerous
thrill-seeking experience."

Easy access

Studies suggest that for the current generation, as for past drug users,
efforts to thwart distribution of some drugs shift thrill-seekers to others
that are easier to score -- a dynamic that helps explain the move toward
prescription drugs.

The recent government report comes on the heels of a study by the National
Center on Addiction and Substance Abuse at Columbia University, showing that
19% of 12- to 17-year-olds believed prescription drugs were easier to lay
hands on than cigarettes, beer and street drugs. The new report also
underscores the ease with which abusers of prescription drugs can get these
controlled substances. More than half who reported they had recently taken
prescription drugs for nonmedical uses said they got the drugs from a friend
or relative for free, and almost 20% got them from a physician. About 1 in
10 who took prescription pain relievers said they bought or stole them from
a friend or relative.

Drug enforcement officials have long noted that teens and young adults
widely trade, sell and steal stimulant medications, heavily prescribed among
student populations to treat symptoms of attention deficit hyperactivity
disorder.

Fewer than 5% told interviewers that they had had to resort to a
drug-dealing stranger to acquire prescription drugs, or even to log onto an
Internet site selling prescription drugs.

Peter S. says his initiation to prescription drugs came from the medicine
chests of his -- and a friend's -- parents.

"I had found Vicodin and Percocet and had heard about them and Xanax and
Valium -- the benzodiazepams -- and took a couple," Peter says. "I reached
up in that medicine chest and took a couple and thought, 'Oh this is fun.'
It made me feel floaty . . . . It was fun in the beginning."

The government report, which also tallies Americans' mental health status,
makes clear that illicit drug use is frequently a form of self-medication.
It found that among 12- to 17-year-olds, roughly 2 million had experienced a
major depressive episode in 2007 -- about 8.2% of that age group's
population. Illicit drug use was roughly twice as high -- 35% -- among those
youths who had experienced depression than among those who had not.

melissa.healy@latimes.com

http://www.latimes.com/features/printedition/health/la-he-drugs15-2008sep15,0,4105950.story

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