PRESCRIPTION DRUGS FIND PLACE IN TEEN CULTURE

'Pharm Parties' Reflect New World of Drug Abuse -- and Introduce a
Dangerous Misperception: Pharmaceuticals Are 'Safer'

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. Since February, several more youths at Journeys
have mentioned that they attended pharm parties, Sigerson says.

"When you start to see a pattern, you know it's becoming pretty
widespread," she says. "I expect it to get worse before it gets better."

Drug counselors across the USA are beginning to hear about similar
pill-popping parties, which are part of a rapidly developing
underground culture that surrounds the rising abuse of prescription
drugs by teens and young adults.

It's a culture with its own lingo: Bowls and baggies of random pills
often are called "trail mix," and on Internet chat sites, collecting
pills from the family medicine cabinet is called "pharming."

Carol Falkowski, director of research communications for the Hazelden
Foundation, says young abusers of prescription drugs also have begun
using the Internet to share "recipes" for getting high. Some websites
are so simplistic, she says, that they refer to pills by color,
rather than their brand names, content or potency.

That, Falkowski says, could help explain why emergency rooms are
reporting that teens and young adults increasingly are showing up
overdosed on bizarre and potentially lethal combinations of pills.

Overdoses of prescription and over-the-counter drugs accounted for
about one-quarter of the 1.3 million drug-related emergency room
admissions in 2004, the federal Substance Abuse and Mental Health
Services Administration reported last month.

The abuse of prescription and over-the-counter drugs -- which barely
registered a blip in drug-use surveys a decade ago -- is escalating
at what Falkowski and other analysts say is an alarming rate.

In a 2005 survey by the Partnership for a Drug-Free America, 19% of
U.S. teenagers -- roughly 4.5 million youths -- reported having taken
prescription painkillers such as Vicodin or OxyContin or stimulants
such as Ritalin or Adderall to get high.

Vicodin has been particularly popular in recent years; a study by the
University of Michigan in 2005 found that nearly 10% of 12th-graders
had used it in the previous year. About 5.5% said they had used
OxyContin. Both drugs are now more popular among high school seniors
than Ecstasy and cocaine.

Marijuana is still the most popular drug by far; about one-third of
the 12th-graders surveyed said they had used it in the previous year.

Falkowski, whose foundation is a treatment center based in Center
City, Minn., says prescription pills have become popular among youths
because they are easy to get and represent a more socially acceptable
way of getting high than taking street drugs.

Some kids, she says, are self-medicating undiagnosed depression or
anxiety, while others are using stimulants to try to get an edge on
tests and studying.

Falkowski says prescription drugs are familiar mood-altering
substances for a generation that grew up as prescriptions soared for
Ritalin and other stimulants to treat maladies such as
attention-deficit disorder. "Five million kids take prescription
drugs every day for behavior disorders," she says.

"It's not unusual for kids to share pills with their friends. There
have been incidents where kids bring a Ziploc baggie full of pills to
school and share them with other kids."

Pharm parties, she says, are "simply everyone pooling whatever pills
they have together and having a good time on a Saturday night. Kids
.. don't think about the consequences."

Lisa Cappiello, 39, of Brooklyn, N.Y., says that seemed to be the
case with her son, Eddie. She says she knew that he had tried
marijuana at 15 and sneaked beers at school.

But it wasn't until after he graduated from high school and took a
year off before college that Cappiello realized the extent of her
son's drug use -- and the hold prescription drugs had on him.

"In what seemed like the blink of an eye, it went from marijuana and
an occasional beer to so much Xanax that (one day) my husband had to
pick him up when he feel asleep on a street corner waiting for some
friends," she said. "He hid his drug use from me so well."

The next day, Eddie Cappiello admitted to his parents that he had
taken 15 pills of Xanax, a brand name for benzodiazepine that acts as
a sedative. He told his parents Xanax helped him deal with anxiety
and depression.

Eddie rejected professional help and vowed to stop taking pills, his
mother says. He was clean for 10 months, she says, before he was
hospitalized in July 2005 after overdosing.

Two months later, he entered a 28-day treatment program, his mother
says. After he was discharged, he stayed clean for about two months
- -- then relapsed into weekend binging: 40 to 50 pills and a quart of
Jack Daniel's, sometimes by himself, sometimes with friends, Lisa
Cappiello says.

Eddie Cappiello, 22, died in his bed on Feb. 17 after overdosing on a
mix of pharmaceuticals. He left behind a girlfriend and two young children.

A toxicology report said he had 134 milligrams of Xanax -- the
equivalent of 67 pills -- and an opioid derivative in his system, his
mother says.

"Before four years ago, I never even heard the word Xanax," Lisa
Cappiello says. "Now ... I know kids as young as 12 are using it.
Then I found out that Vicodin was a very big party drug. Before
school, after school, at parties. Kids mixed them with alcohol and
Ecstasy. It was baffling to me."

Cappiello says police, teachers and parents are so fixated on street
drugs such as marijuana, cocaine and Ecstasy that they are missing
the start of an epidemic.

"Eddie was not the first kid to die in this neighborhood from
prescription drugs," she says.

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.

Almost all of the 13 youths at Phoenix House's intensive outpatient
treatment program on New York City's Upper West Side have dabbled in
prescription drugs, director Tessa Vining says.

"There's definitely easy access," she says. "Maybe a parent had some
surgery and took one or two painkillers from a bottle of 10, and the
rest are just hanging out in the medicine cabinet."

After her son died, Cappiello says she wondered how kids in her area
were getting pills. She says she learned from police that one local
dealer got Xanax from his mother, who had been given a prescription
for the drug. Instead of taking the pills, she gave them to her son
to sell for $2 to $3 each.

Paul Michaud, 18, of Boston, says he got his first taste of OxyContin
pills -- he calls them OCs -- from a friend during his freshman year
in high school.

Until then, Michaud says, he had smoked marijuana daily and taken a
Percocet pill occasionally. Michaud's father had recently died of
cancer, and Michaud says he was depressed and feeling like an
outsider at school. The prescription painkiller made him feel like
nothing could faze him, he recalls.

"The first time I did it, I was hooked," says Michaud, who is four
months into a yearlong drug treatment program at Phoenix House in
Springfield, Mass. He says he quickly became a daily OxyContin user,
breaking apart the time-release capsules, crushing pills and snorting
the powder from five 80-milligram pills a day.

"They're not very hard to get. I could find OCs easier than I could
find pot," Michaud says. "There were plenty of people who sold them,"
including some dealers who got pills illicitly by mail order.

To try to reduce the supply of prescription drugs on the black
market, authorities have shut down several "pill mills" -- where
doctors prescribe inordinate amounts of narcotics -- as well as
Internet pharmacies that ship drugs with little medical consultation,
says Catherine Harnett, chief of demand reduction for the Drug
Enforcement Administration (DEA).

Last September, DEA agents arrested 18 people allegedly responsible
for 4,600 such pharmacies.

A tricky part of the prescription-drug problem, Harnett says, is
addressing the perception among youths that pills are safe because
they are "medicine." Many teens don't equate taking such pills with
using drugs such as heroin or cocaine, she says.

"If you start with pills, it seems fairly sanitary and legitimate,"
she says. "Kids have been lulled into believing that good medicine
can be used recreationally."

Two in five teens in the Partnership study said prescription
medicines, even if they are not prescribed by a doctor, are "much
safer" to use than illegal drugs.

Phil Bauer of York, Pa., believes his son, Mark, 18, an avid weight
lifter, started using prescription drugs to relieve chronic back pain
and didn't appreciate the potential risks of taking the drugs.

Bauer says his son never behaved as he imagined a drug addict would.
"He wasn't hanging out all night. He had parents who wouldn't let him do that."

Mark Bauer died of an overdose on May 28, 2004. The toxicology report
found morphine, oxycodone and acetaminophen -- the active ingredient
in Tylenol but also an ingredient in Vicodin -- in his system, Phil Bauer says.

Before his son's death, "we didn't see a bleary-eyed guy. He wasn't
slurring his words," the father says. "He seemed to have a lot to
live for. I did not know prescription-drug abuse was a problem.
There's so much guilt in that. I don't know if I stuck my head in the
ground. I did not see this coming."

Michaud says he didn't equate his OxyContin addiction with hard-core
drug abuse. "Where I come from, OC is a rich boys' drug," he says. "I
thought, heroin abuse, that's pretty low. I'd never stick a needle in my arm."

However, Michaud says he eventually switched to heroin. "I sniffed it
and a week later, I was shooting," he says. "I thought I wasn't like
other people doing heroin. I wasn't that low. Come to figure out, it
all leads to the same place."