Cory, 21, says the idea of "hard" illicit drugs scared him.
"I knew as a kid that I would never try heroin or coke or crack, because it sounded so bad," he says.
But his experience with the prescription pain pill OxyContin rivals that of most any hard-core addiction. In less than one year, Cory had progressed from casual experimentation with the painkiller to a $50-a-day habit that cost him two jobs and sent him to the Scripps McDonald Center for alcohol and substance abuse treatment.
"People think it's harmless because it's a prescription pill," he says. "You look at it, and it looks harmless."
Now, an increasing number of teens may be using "harmless" prescription and over-the-counter drugs to get high. And with growing availability and recreational use, health experts fear the worst is yet to come.
A study released today by the National Institute on Drug Abuse shows a 23.2 percent decline in the use of illicit drugs like cocaine, marijuana and crack among eighth, 10th and 12th graders over the past five years.
That's the good news.
But a new threat in the form of legal drugs could be putting the health of millions of teens at risk.
Worse yet, a growing counterculture, fueled by the Internet, may be encouraging teens to experiment with legal drugs in increasing numbers.
"It clearly allows people to communicate information much more readily," says Dr. Fred Berger, medical director of the McDonald Center. "People look on the Internet for what they want to find, and they find it.
"Teens can say they are adults, and they can have Vicadin mailed to them. All they need is a credit card or debit card, and they will mail it to you."
"I think we've created a culture rooted in computer smarts and drug not-so-smarts," says Dr. Joel Saper, director of the Michigan Headache and Neurological Institute in Ann Arbor. "It's a culture of awareness and access."
For example, browse the home page of erowid.org, and you'll see a number of clickable photos of drugs and supplements. Entries include such illegal substances as LSD. But nestled between ecstasy and the veterinary tranquilizer ketamine is zopiclone -- a prescription sleep aid commonly known by the brand name Lunesta.
Click on this link, and you will find an informational page about the drug -- as well as testimonials from those who have used the drug recreationally.
The entries of each drug list common names, as well as any street names. Many come complete with a summary of positive effects, side effects and hangover/day after information listed in easy-to-reference tables.
Erowid isn't the only site of its kind out there. And though any explicit encouragement to abuse these drugs is absent from many of these sites, many see Internet resources like these as evidence of a growing culture of prescription and OTC drug abuse.
"Sites like these are a veritable how-to for people who are interested in using just about any drug imaginable," says Paul Doering, co-director of the Drug Information and Pharmacy Resource Center at Shands at the University of Florida. "These Web sites are downright frightening, and word spreads quickly."
"They just get it. It's just out there," Saper says. "These kids are self-medicating with the drugs that are available to them."
The Internet also makes it easier for would-be abusers to get their hands on these medications.
"This is all part of the liberalization and the availability of the drugs offered by the Internet," Saper says. "And who uses the Internet? Well, for sure, kids do."
Further evidence of the culture can be seen in the evolution of street monikers for prescription and even OTC medicines. Coricidin Cough and Cold, for example, becomes "Triple C" or "Skittles."
Doering, who delivers lectures on the subject of OTC drugs, says the net result is that teens are becoming more familiar with the drugs in general.
"Five or six years ago, I would mention the names Vicodin, Lortabs, Xanax and Valium, and nobody would know what I was talking about," he says. "But what I do now is tell them to nod if they know what I'm talking about, and when you ask questions about these you'd think it was bobblehead night at Yankee Stadium.
"All of them have at least heard of, if not had a personal experience with these drugs."
Growing Prescription and OTC Threat
The study reports that 4.2 percent of eighth graders, 5.3 percent of 10th graders, and 6.9 percent of 12th graders reported taking cold or cough medicines with dextromethorphan (DXM) during the past years to get high.
The NIDA study found that recreational use of the prescription painkiller Vicadin remained high among all three groups of teens studied, with nearly one in 10 high school seniors admitting to using excessive dosages of the prescription pain killer. The abuse of OxyContin, another prescription pain reliever has dropped only among 12th graders and remained constant in the younger groups.
And Cory estimates that in his high school at any given time, about 10 percent to 15 percent of his schoolmates abused OxyContin.
"This is something that we have been aware of in the substance abuse field for some time," says Dr. Gregory Collins, section head of the Alcohol and Drug Recovery Center at the Cleveland Clinic Foundation. "The survey confirms this trend."
And there is cause for concern, as teens are dying from overdoses. One California teen died in September from taking 20 pills of Coricidin decongestant, which contains DXM. And in February 2005, two 19-year-olds in Cape Coral, Fla., died after overdosing on a purified form of DXM.
DXM is just part of the problem, as many other OTC and prescription drugs can be harmful or fatal if improperly used.
"These are potentially lethal drugs," Collins says. "Some of these drugs, like OxyContin, are extremely strong.
"One or two of these pills can kill a kid."
"People tend to associate over-the-counter drugs with safety, and only illegal drugs are seen as dangerous," Doering says. "But people who are drinking a whole bottle of cough syrup are putting themselves at infinitely more danger than someone who is taking a trip on LSD.
"I'm not saying LSD is a good drug, but the notion that if something over-the-counter is virtually harmless in any dose and in any way one chooses to use it is total folly."
Companies Perhaps Partially to Blame
Arguably, the major problem in controlling the abuse of prescription and OTC drugs by teens is the fact that these drugs are easy to obtain and often cheap.
"There has been a huge increase in the amounts of these drugs available," Collins says. "These things are becoming more commonly seen, and they are finding themselves in more home medicine cabinets than ever before."
"The major instigator of the OTC problem is that they are so readily available," says Doering. "Unlike pseudoepinephrine [another cough mixture drug], which has been moved behind the pharmacy counter, DXM can be purchased at gas stations, grocery stores and wherever else it is sold."
In light of this, much of the blame, Collins says, lies with the pharmaceutical companies themselves.
"Some responsibility falls back on the drug companies for putting these things on the market," Collins says. "I think the drug companies need to be much more responsible."
The medical community may also share in the blame, Saper says.
"In the past five years, we have seen kids coming in who are on narcotics for mild headaches, and many times they are taking relatively huge amounts of OxyContin," Saper says. "It was actually unheard of 10 to 15 years ago for a doctor to put anyone on narcotics for headaches, much less kids.
"The medical community has to get a grip on the amount of opiates it is giving out uncontrolled," Saper says. "The medical community has got to respond to this threat, and it is hard because most of medical education is supported by drug companies."
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