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Pubdate: Sun, 29 Apr 2001 Source: Florida Today (FL) Copyright: 2001 FLORIDA TODAY Contact: http://www.mapinc.org/media/532 Website: http://www.flatoday.com/ Author: Sara Paulson-Camodeca Note: Staff writer Zenaida A. Gonzalez contributed to this report. Bookmark: http://www.mapinc.org/find?186 (Oxycontin) PRESCRIPTION PILL ABUSE A GROWING, DEADLY HABIT Last Decade Has Seen A Steady Rise In Problem Popping prescription pills is becoming a more popular, and sometimes deadly, way to get high. And experts say anyone can get hooked. A patient taking painkillers to ease the anguish of an injured knee can build up a tolerance quickly, causing his body to require larger and larger doses to attain the same level of relief. Soon, he can't function socially without a handful of pills. A frightened flier who wants to ease her nerves before getting on an airplane swallows a Valium and discovers she likes the sleepy, uncoordinated feeling. Soon, she takes Valium each night to "relax." A college student who thinks he'll have the energy and brain power to ace an exam crushes a Ritalin pill and snorts it up his nose minutes before heading to class. All of them face risks - breathing difficulties, brain seizures and heart failure - depending on the drug. The National Institute on Drug Abuse reported earlier this month that in 1999, an estimated four million people over age 12 used prescription drugs for non-medical reasons. It's a trend especially among adolescents, older adults, and women, the institute reported. Statewide, 152 deaths last year were blamed on oxycodone and hydrocodone - - narcotic ingredients in the popular painkillers OxyContin and Vicodan, the Florida Department of Law Enforcement reported. And 93 deaths were attributed to benzodiazepine, a central nervous system depressant found in Valium and Xanax, which are commonly used to relieve tension or help people sleep. "Prescription drug abuse has always been around, but there's been a gradual rise in the past 10 years," said Cindy Miner, chief of science policy for the institute. Evidence of pharmaceutical abuse is apparent on the Space Coast. Addicts are forging doctors' signatures to get their prescription drug fix. And local pharmacies have been broken into and robbed for their potent pills. Last week, a man and woman from Merritt Island were arrested near a Palm Bay pharmacy. Police found a green duffel bag stuffed with nearly 30 bottles of OxyContin in the couple's car. The Medicine Shoppe, 2200 Port Malabar Blvd., had already been broken into four times before this year for its drugs. Sgt. Vic DeSantis of the Brevard County Sheriff's Office said prescription drug abuse is scattered throughout the county. "Users run the entire spectrum," DeSantis said. "There is no one location in Brevard where the drug is seen" the most. Painkiller Problem Problems with painkillers have drawn a lot of news media attention lately, but "they've been around for a long time," Miner said. "And they've been abused for a long time." But the numbers show the nonmedical use of opioids - the classification for those narcotics - has increased threefold, Miner said. Nationally in the mid-1980s, fewer than 500,000 reported they used painkillers for nonmedical reasons; in 1998, 1.6 million people were abusing them, Miner said. Research also shows adolescent girls are abusing prescriptions more than ever, and are using more than their male counterparts, Miner said. While opioids appear to be the prescription drugs most abused, central nervous system (CNS) depressants, such as Valium and Xanax, and stimulants, one of which is Ritalin, are also being used more nonmedically. Some of the institute's research suggests that: * More than 17 percent of people older than 60 may be abusing prescription drugs. * People between the ages of 12 and 25 are abusing medications more and more; in a 1999 survey, 12- to 14-year-olds said they are more frequently picking painkillers, sedatives and stimulants to get high. * Women, who are two to three times more likely to be diagnosed with depression and treated with psychotherapeutic drugs, may be more likely to abuse narcotics and anti-anxiety drugs. Miner said teen prescription drug abuse could be attributed to a few things. "It could be easy access," Miner said, adding that teens in particular can swipe such drugs from their parents' cabinets or buy them on the street. "It may be that some drugs are harder to get." Norm Tomaka, a consultant pharmacist in Melbourne, points to a combination of factors for "a dramatic rise in the utilization of pain medication" during the past decade. Medical care is improving, and people are living longer. They're surviving cancer, congestive heart failure and other conditions more than they used to, he said. With that comes making those patients more comfortable with pharmaceuticals. Tomaka said it's hard to state a percentage for the increase of addictive prescriptions available, but his "gut instinct" tells him there's 50 percent more of these narcotics around. And higher volumes of prescription drugs mean more opportunity for abuse, Tomaka said, adding that popping a prescription pill is "socially more acceptable" than using other illicit drugs. Massive Abuse Earlier this year, Dr. Heidar Heshmati received an unexpected phone call from a Melbourne pharmacist. The pharmacist asked Heshmati, director of the Brevard County Health Department, about the 2,160 Lortab pills he had prescribed for a 57-year-old Indian Harbour Beach man within a year. The man was one of Heshmati's patients. But the doctor hadn't written the prescription. The man, who had brought fraudulent prescriptions to the pharmacy 14 times between January 2000 and January 2001, was charged with obtaining a controlled substance by fraud and trafficking in hydrocodone. Heshmati said there is a lot of prescription drug abuse in Brevard County, but it's hard to pin down an accurate number. "How big is the issue?" he said. "I don't know. . . . Most of the people (who are prescribed painkillers) need the medication, since they have some chronic problem or pain." Long-term abuse usually has two dimensions, Heshmati said. People become addicted to the pills and build up a tolerance for them. That's often where the problem starts, he added. Someone suffers from a bad knee or a chronically aching back and gets started on the pills to manage the pain. Soon, one or two pills aren't enough to ease the discomfort, Heshmati said. "After a month or two, depending on the type of medication, it won't work for you," Heshmati said. That's when some people start consuming as much medication as they can. Bruce Goldberger, director of toxicology at the University of Florida, said prescription drugs are giving illicit street drugs some competition in deadliness. "They can be just as dangerous if they're misused," Goldberger said. Each prescription pill is different, but generically speaking, opioids and central nervous system depressants can slow the respiratory system and cause heart problems, even seizures. Stimulants can cause irregular heartbeat, cardiovascular failure and seizures. Experts advise addicts get professional treatment tailored to their situation. The institute reported that cutting down or stopping heavy depressant use can lead to seizures. But for the most part, "withdrawal is not life-threatening, it's just terribly uncomfortable," Goldberger said. No. 1 Addiction Chris Sanok, director of information and referral for PREVENT! of Brevard Inc., said prescription painkillers are the number one medication addiction she sees. The agency has both inpatient and outpatient help for people struggling with drug addictions. "Most recently, it's OxyContin," Sanok said. "That, right now, is the prescription we see most abused." Sanok estimated fewer than a quarter of people who come through PREVENT's treatment program are battling prescription drug abuse. Heroin, crack cocaine and marijuana still have a firm hold on most addicts, she said. Other painkillers that are gaining popularity with abusers are Lortab and Vicodin, Sanok said. Many abusers are buying them off the street in large quantities, she said. Some addicts are impatient and don't appreciate the time-release coating, Sanok said. So they scrape it off. "People that are buying them off of the streets are crushing them and snorting it or (mixing it with water) and injecting it," Sanok said. Ritalin - prescribed to people with Attention Deficit Disorder - used to be the rage, but Sanok said she hasn't gotten a call about it in six months. For a short time, some children had had their Ritalin stolen from them on their way to school or the kids were selling it. "There's fads of things," Sanok said. Coping, Prevention Pharmacist Tomaka tries to intervene if he believes someone is abusing prescription drugs. "I really try to talk to people," he said. "I try to be empathetic. I'm there to help them, I'm not there to judge them." At that point, the real abusers either "open up, come clean or leave," Tomaka said. Paula Ferrell, the project manager for Safe and Drug Free Schools for Brevard Public Schools, said the district has no specific awareness or outreach program for parents or students that targets prescription drugs. "Some research indicates that when you tell kids about drugs they may be more apt to try them," Ferrell said. "Our programs focus more on giving them alternative positive activities." But there have been rumors that some children in Brevard may be passing out Ritalin to friends and classmates, Ferrell said. School district policy bans students from carrying any kind of drug, including prescription medication. Prescription drugs must be brought to the school office, where they are kept under lock and key and given only at specific times by the school nurse. "As illegal drugs are harder to get, children will look for things they can easily access, such as prescription drugs in medicine cabinets or even inhalants," she said, suggesting parents keep an eye on their medicine cabinets - especially when their children's friends visit. State Sen. Charlie Bronson, R-Melbourne, said he hasn't seen any planned legislative action to combat the problem yet, but "I know we're willing to take a look at it." Bronson, who sponsored a bill passed last year that made it illegal to possess nitrous oxide - laughing gas - for recreational use, said a closer look needs to be taken by the health care committee, the pharmaceutical community, hospitals and others. Educating children in the schools is also a necessity to curb the misuse of prescription drugs, Bronson said. Annie, a former OxyContin addict who nearly died after abusing the drug, said she wishes oxycodone would be removed from drug stores. "I think they should take it off the market," she said. "It's the devil's drug." - --- MAP posted-by: Doc-Hawk