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The enrollment at Fossil Ridge High School in Keller, Texas, stands at 2,147. It should be 2,148. That's because freshman Tyler Bailey, a promising athlete who dreamed of attending college on a football scholarship, died of a drug overdose and was buried in his black No. 86 jersey. The culprit wasn't cocaine or heroin. Tyler died from oxycodone intoxication after he and some friends raided a parent's stash of prescription drugs.

A growing number of families are discovering what that loss feels like.

"This is an entirely new category of substance abuse, and we're only seeing the tip of the iceberg," said Steve Pasierb, president and CEO of the Partnership for a Drug-Free America. "Ease of access is the number-one reason kids are abusing prescription drugs. They don't have to go to a scary street dealer, because the drugs are right there in Mom's or Grandma's medicine cabinet."

Illicit drug use among teens has dropped radically since 2001. There's also been a slight decline in alcohol and tobacco use. Yet several studies concur that the number of adolescents abusing prescription drugs has tripled since 1992. According to Columbia University's National Center on Addiction and Substance Abuse, 75 percent of them are "polysubstance abusers" who combine prescription meds with other drugs or alcohol. A Monitoring the Future study released in December found that 14 percent of high school seniors, 11 percent of 10th graders and 7 percent of 8th graders said they had used tranquilizers, barbiturates or sedatives for nonmedical purposes within the past year.

Donald Hauser serves as medical director with The Right Step, a drug and alcohol treatment clinic in Houston. He noted, "By far, the most common trend I think we're seeing are sedative hypnotics, particularly Xanax—'bars' is what they call 'em—and the opiates, the hydrocodone derivatives, the Vicodins, the Loracets. Almost every adolescent that comes in this program has used some of them."

Teenagers think that, because these products are FDA approved, popping pills from a pharmacy is safer than buying marijuana or Ecstasy from an unknown source. They don't realize the potential dangers and addictive qualities of depressants, anti-depressants, stimulants, muscle relaxants, anti-anxiety medications, tranquilizers and opiate pain relievers—all modern drugs of choice. In fact, USA Today reported recently that only 48 percent of teens see "great risk" in experimenting with prescription medication.

Wendy is a 17-year-old who experimented mightily. One day she took Xanax and remembers nothing more than regaining consciousness in a garage, clearly a victim of sexual assault. "I don't even know who it was," said the young woman, now in a treatment program. "You have to hit your bottom. For me it was almost dying."

This problem is pervasive enough to have inspired Rx, a new teen novel by Tracy Lynn. Written from a teenager's point of view, it's the story of an overachieving 17-year-old who sneaks Ritalin to help her focus. Soon she finds herself trading and dealing a wide assortment of prescription drugs, both to fuel her own habit and to "help" peers facing similar challenges.

Pharm Country
How do teens score these drugs? They rummage through their parents' medicine cabinets or beat the system by phoning in prescriptions, forging signatures or duping the online questionnaires of Internet pharmacies. Ryan Haight got caught in that web. After faking his age and concocting an ailment to get drugs online, the 17-year-old died from an overdose of prescription pain meds.

Teens also purchase pills in school hallways (a single Vicodin tablet can fetch $4 or $5) and take advantage of relatives' existing prescriptions. "My mom was prescribed alprazolam, which is Xanax's generic name," a rehabbing teen told ABC's Nightline. "All I had to do was find the pill bottle and call CVS and type in the prescription number. And then maybe an hour later, you go pick it up and say, 'I'm picking up Blair's prescription.' That's how I got a lot of mine."

One of the trendiest, most social ways to get a pharmaceutical high is at "pharming parties," pot luck-style gatherings where teens contribute to a chemical "trail mix." Even those who would never do crack or cocaine think nothing of grabbing fistfuls of these diverse, colorful drugs and washing them down with alcohol. Ernest Patterson, a recovering addict, recalls, "They'll just reach their hands in there, take a handful and just take them. It could be anything."

Pharming parties also let users swap pills as if they were Yu-Gi-Oh! cards. "If I have something good, like OxyContin, it might be worth two or three Xanax," a girl told Time. "We rejoice when someone has a medical thing, like, gets their wisdom teeth out or has back pain, because we know we'll get pills. Last year I had gum surgery and I thought, Well, at least I'll get painkillers."

OxyContin seems to be the most popular … and deadly. Depending on the dose taken, OxyContin can slow or even halt breathing, especially when consumed with alcohol or other sedatives. Dubbed by one doctor "one of the strongest opiates and potentially addictive painkillers ever created," it was approved for round-the-clock pain, such as that experienced by patients with advanced stages of cancer. Its recreational use has increased 26 percent among 8th, 9th and 12th graders since 2002.

Dr. Nora Volkow, director of the National Institute on Drug Abuse, explained, "Some abusers bypass the time-release system by crushing or chewing the pills. That way, they get all of the drug in their system at one time, and the body responds very differently. The risk of overdose then becomes huge. And an overdose of OxyContin can kill you."

That's precisely what happened to 17-year-old Julie. Julie's mother told Family Circle, "[Parents] are looking for alcohol and pot, not prescription drugs. It's like we got suited up for the game but were dressed for the wrong sport."

What Parents Can Do
With the medical community continuing to create stronger, more efficient drugs, the potential for this type of abuse will only get worse. Still, parents can take steps to keep teenagers from becoming statistics:

1. As part of an ongoing dialogue, give children a healthy respect for prescription medication. Express your strong disapproval of abuse. Silent or wishy-washy parents can be a teen's worst enemy.

2. Know which prescription drugs are in your home and keep them locked up. Even if your teens aren't tempted, guests could be. A New Jersey youth declared, "The best part about going to a new house was rifling through the medicine cabinet."

3. Be aware of how many pills remain in partially used prescriptions so you'll know if any are missing, and be sure to discard medications you're no longer taking.

4. Know which drugs are prone to be abused, including over-the-counter cough medicines containing dextromethorphan (or DXM), such as Robitussin DM and three of the four forms of Coricidin HPB.

5. Familiarize yourself with the warning signs of prescription drug abuse in teens so you can intervene before it's too late: missing prescription drugs, slurred speech, lack of concentration or coordination, glassy eyes or frequent use of eye drops, rapid weight loss, secretiveness or dishonesty, truancy or a drop in grades, an unexplained change in eating or sleeping habits, a constant need to borrow money, less concern about hygiene or appearance, waning interest in favorite sports or hobbies, unusual emotional outbursts, and a sudden change in friends.

6. Explain the diminishing returns of drug abuse, which releases unnaturally large amounts of dopamine into the brain. Over time the brain gets used to it, and the addict ceases to enjoy life's normal pleasures without the dopamine flood that only the drugs can deliver.

Our overmedicated culture has a pill for just about everything. Ads for prescription drugs outnumber toothpaste commercials. So for many young people it's second nature to manage moods and stimulate performance with capsules that come in amber-colored plastic bottles. Members of Generation Rx need to know that, if not taken as intended, prescription drugs could land them in the emergency room … or the morgue.

Published April 2006

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