Pubdate: Mon, 11 Feb 2002
Source: Time Magazine (US)
Copyright: 2002 Time Inc
Contact:  http://www.time.com/time/
Details: http://www.mapinc.org/media/451
Author: Sanjay Gupta, M.D.

WHAT DID SHE WANT WITH XANAX?

The arrest of Governor Jeb Bush's daughter on charges of prescription fraud 
put a strange light on a familiar drug

Like most doctors, I've watched with concern the growing use of so- called 
club drugs--psychotropic substances that catch on from time to time among 
teenagers and young adults and become the rage at dance clubs and all-night 
raves. I know about ecstasy, Rohypnol and ketamine. But I was taken by 
surprise last week when Noelle Bush, daughter of Florida Governor Jeb Bush 
(and the President's niece), was arrested in Tallahassee trying to buy 
Xanax, having allegedly borrowed the name of a retired doctor and called in 
a bogus prescription. Xanax, after all, is a widely prescribed antianxiety 
medication--a cousin of Valium--and hardly fits the profile of a Gen X 
party drug.

Xanax is usually used to relieve panic and anxiety, which may be why Noelle 
wanted it. But though it ranks low on the scale of drugs most likely to be 
abused (heroin is termed a Schedule I drug; Xanax is a Schedule IV), the 
Drug Enforcement Administration has been keeping a close eye on it for 
years. Like other benzodiazepines, it acts on the neurotransmitter 
gamma-aminobutyric acid, decreasing brain activity and producing a drowsy 
or calming effect. "It's like being drunk, without the toxicity of 
alcohol," reports a helpful chat-room participant.

It's also quite addictive. "Xanax is extremely potent," says Dr. Steven 
Juergens of Virginia Mason University, who was the first to write about 
Xanax addiction, in 1988. "It acts quickly on the brain and has a short 
half-life." Users of such drugs tend to come back for more and more. Xanax 
is also used by partygoers as a "parachute" drug to bring them down from 
the effects of stimulants such as ecstasy. It's this combination of drugs, 
suggests Dr. Herbert Kleber, a professor of psychiatry at Columbia 
University, that may account for the current interest in Xanax.

Benzodiazepine abuse is on the rise, according to the Health and Human 
Service's Drug Abuse Warning Network. But so is prescription-drug abuse 
generally. From 1990 to '98, National Institute on Drug Abuse statistics 
show, the number of Americans who started misusing sedatives nearly 
doubled, while abuse of pain relievers rose 180%.

We don't really know what Noelle Bush planned to do with those 40 Xanax 
pills in the prescription or even whether she was getting them for herself. 
Her parents issued a terse statement acknowledging that the family is 
"deeply saddened" and reminding Americans that "substance abuse is an issue 
confronting many families across our nation." Noelle's mother Columba 
should know. As a board member of the Center on Addiction and Substance 
Abuse at Columbia University, she has helped raise awareness about the 
problem. Sadly, nothing she's done over the years has attracted nearly as 
much attention as her daughter's arrest.

Dr. Gupta is a neurosurgeon and CNN medical correspondent

With Reporting by Jonathan D. Lynch
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