Terra Sigillata

From USA Today, some interesting and sad news:

When a teenager in Jan Sigerson’s office mentioned a “pharm party” in February, Sigerson thought the youth was talking about a keg party out on a farm.

“Pharm,” it turned out, was short for pharmaceuticals, such as the powerful painkillers Vicodin and OxyContin. Sigerson, program director for Journeys, a teen drug treatment program in Omaha, soon learned that area youths were organizing parties to down fistfuls of prescription drugs.

I am now officially old. I thought I’d never say, “I remember when…”

Well, I remember when drinking PBR as a teenager was living on the edge – and I’m not talking about the plasmid.

In recent months, federal anti-drug officials have acknowledged that they didn’t anticipate the quick escalation of prescription-drug abuse. Most government-sponsored drug prevention programs focus on marijuana, tobacco, alcohol and methamphetamine.

“We were taken by surprise when we started to see a high instance of abuse of prescription drugs,” says Nora Volkow, director of the National Institute of Drug Abuse (NIDA), which is collecting information about how teens perceive, get and use prescription drugs so it can try to craft an effective prevention campaign.

In a bulletin last year, NIDA called the increase in pharmaceutical drug abuse among teens “disturbing” and said pharm parties were a “troubling trend.”

The increasing availability of prescription drugs is a big reason for the rise in their abuse, Volkow and other drug specialists say.

Pharmaceutical companies’ production of two often-abused prescription drugs — hydrocodone and oxycodone, the active ingredients in drugs such as Vicodin and OxyContin — has risen dramatically as the drugs’ popularity for legitimate uses has increased. Drug companies made 29 million doses of oxycodone in 2004, up from 15 million four years earlier. Hydrocodone doses rose from 14 million in 2000 to 24 million in 2004.

The 2005 Partnership survey found that more than three in five teens can easily get prescription painkillers from their parents’ medicine cabinets. And as Falkowski says, the rising number of youths being treated with stimulants has made it easier for kids to use such drugs illicitly. About 3% of children are treated with a stimulant such as Adderall or Ritalin, up from less than 1% in 1987.

Again, the full article by Donna Leinwand is here.

Comments

#1 Mike the Mad Biologist
June 13, 2006

The 2005 Partnership survey found that more than three in five teens can easily get prescription painkillers from their parents’ medicine cabinets.

3 in 5? Just how many adults are being prescribed painkillers?
#2 anjou
June 13, 2006

Is this raiding of parents’ med chests so new? In my day, the late 60′s 70′s, kids were raiding their parents medicine chests for quaaludes (they were very popular and always available for those interested-…) codeine, or valium etc…. While I didnt indulge, being the kid who didnt do drugs, did ended up driving a kid od’d on quaaludes to the ER which, really upset my parents (understandably).

These days kids are selling their adderall and ritalin-and definately an increase in availability there.
#3 qetzal
June 13, 2006

Well, I remember when drinking PBR as a teenager was living on the edge – and I’m not talking about the plasmid.

Snork.
#4 Rick @ shrimp and grits
June 14, 2006

Well, I remember when drinking PBR as a teenager was living on the edge

Wasn’t it not too long ago that all the outrage was focused on inhaling spray can aerosols and other volatile organics?

What i’d be interested in finding out, and it wasn’t apparent from a skim of the linked article, is how the increase in illegal prescription drug use compares to the advertising dollars spent by drug companies to promote the drugs in the first place. It’d also be interesting to see how teenage illegal drug use parallels legal adult usage (if it does).
#5 Joe
June 14, 2006

Sorry but, what is PBR?
#6 Rick @ shrimp and grits
June 14, 2006

Joe: Pabst Blue Ribbon

Looking at it again, the article does note that abuse of these drugs parallels increasing legal use – but still there’s no mention of the advertising angle.

My next burning question is – why is anyone surprised by this? Kids and adults are bombarded with “drug” ads (not usually for the drugs cited above, but many folks seem to think that if legal “drugs” weren’t safe, then why would they be advertised on TV?). The availability of these drugs is high.

Given these conditions, I’d be surprised only if abuse went down.
#7 Doc Bushwell
June 14, 2006

This topic came as an off the cuff quip by the facilitator at our managerial development lovefest this afternoon. No one knew what he was talking about so he gave us the nutshelled essence of that article. Like anjou, I recall Rx drugs being freely abused back in the day (1970′s) so I am not so certain these latter day pharm parties can be attributed to the plethora of smarmy phamry ads on TV and in glossy print.

For the record, I despise direct-to-consumer drug ads. Given that many of the general public cannot even define what a molecule is would seem to indicate that the DTCs are not reaching well-informed consumers.
#8 anjou
June 14, 2006

And, during the 80′s was working with adolescents as a counselor– would routinely catch them abusing Mummy and Daddy’s percocet– much to their amazement… little did they know that there tongues turned a tell-tale yellowish brown!!
#9 Abel Pharmboy
June 14, 2006

I also had another piece of info for Joe about the pBR322 plasmid named after two postdocs in Herb Boyer’s lab at UCSF.

As for the discussion, my ever-so-slightly-senior women readers remember a time on which I came in on the tail end. My rogue compatriots in the late 70s/early 80s were mostly beer and weed enthusiasts. Perhaps it’s because my folks were children of the 50s, not the 60s. Where I got interested in this area is when I read of kids staking out mail order pharmacy shipments to senior neighbors – a string of baclofen ODs raised my awareness of kids using Rx drugs for fun.

Rick, I guess I am somewhat surprised about Rx drug abuse among kids that lead to deaths (P.S. thanks for posting the family recipe for shrimp and grits!). Volatile inhalants are definitely a huge risk for irreversible brain damage but I was unaware that Rx drug access by teenagers was so widespread. I did some searching and haven’t found a link between DTC advertising and teenage diversion of narcotic analgesics, etc., but I appreciate the input of Doc Bushwell.

The reason I posted this was to see if people thought this was odd or not surprising. I guess I’m living under a rock.
#10 Doc Bushwell
June 15, 2006

Heh. You’re not the only one living under a rock, Abel. When the facilitator explained that kids were raiding their ‘rents’ medicine cabinets, I turned to the rest of my fellow middling managers and quipped, “Lipitor and Caduet are fun? Who knew!?”
#11 anjou
June 15, 2006

As a psychologist who’s worked with adolescents its hard to live under a rock as parental medicine cabinet raiding in kids dragged to therapy by their parents is likely to be considerably higher than the norm–biased sample I suppose!! And, likely biased in the amount of “fun” meds to be found as all too often crazy parents beget crazy kids….(all too often when confronted with a kid with problems Ive imagined parentectomy as the only viable solution…sometimes when the kids cross their arms and say…its not me, its my parents that are nuts, they are really on the mark)
#12 Rick @ shrimp and grits
June 15, 2006

A tricky part of the prescription-drug problem, Harnett says, is addressing the perception among youths that pills are safe because they are “medicine.”

I mentioned it briefly before in the context of ads, but this is another point in the article that’s worth bringing out. We know it’s not rational, but there is this attitude that things are safe because they are medicine. (It’s similar to the attitude I face a lot as a chemistry teacher – things are bad because they are chemicals.)

… but how do you combat this attitude?
#13 Joseph j7uy5
June 17, 2006

I can’t remember where I saw it, but I am fairly sure that I did see a study (probably out of ISR at University of Michigan) that showed that quite a large proportion of the kids taking opiates were taking them because of pain. Therefore, one has to be careful about the definition of the term drug abuse. SUre, you can define the act of taking a prescription drug that was prescribed for someone else as being abuse, but you miss an important point if you fail to account for the fact that pain is widely undertreated.
#14 Doug
June 17, 2006

Ditto on the ‘not a new phenom’ posts. The most popular version where I lived (middle-o-nowhere MO ’68-’72) was for lots of kids to snag small quantities of whatever was in the medicine chest then dump everything into a big salad bowl that everyone would then just dip into and grab a handful of random meds.

No, not new just different meds.
#15 Abel Pharmboy
June 17, 2006

Joseph: Yes, you certainly want to be sure that hypervigilance against drug abuse doesn’t result in people not getting opiates for pathophysiologic severe pain. This remains a problem in oncology in some areas.

Rick: You point to an issue that we often deal with as well on the herbal supplement side of natural products. Just because a chemical is natural (and I emphasize that natural products ARE chemicals) doesn’t confer any inherent safety. To the contrary, some of our most potent poisons are natural: tubocurarine, batrachotoxins, ricin, and others.

To present the drug issue to your students, I’d note that drugs are chemicals that mimic normal chemicals in your body, but usually act for a much longer time. The beta2-adrenergic agonist in my asthma inhaler binds the same receptors as norepinerphrine to cause bronchodilation, but does so much longer than NE, which is released from nerve terminals, acts, and is then taken up and/or degraded.

Even drugs like opiates (morphine, oxycodone, fentanyl) mimic the effects of endogenous opiate peptides to act as analgesics. The problem is that, in addition to their presence in pain transmission pathways, we also have opiate receptors in our brainstem that regulate respiration – supra-analgesic concentrations can kill by shutting off the central stimulus for breathing.

We do a terrible job in this country of educating the public that medicines should be respected and used with caution regardless of whether they are prescription or over-the-counter. FDA approval and sale of OTC drugs means simply that the benefits of a given drug outweigh its risks – it does NOT mean that safety is absolute, but rather relative in the context of the disease/disorder being treated.