PRESCRIPTION DRUG ABUSE RISING IN AMERICA

CHICAGO - At colleges across the country, students are taking pills they've
sneaked from home, tossing them into bowls and swallowing handfuls with a
chug of beer or a sip of a margarita.

It's called "pharming," for the pharmaceuticals ingested.

In office towers, workers sitting at computers are barraged by spam e-mails
offering prescription drugs at low prices, no prescription required.

"No physical exam," promised one message widely circulated last week,
touting painkillers, stimulants, tranquilizers and anti-depressants.

The face of drug addiction is changing in America, from cocaine or heroin
addicts snorting or shooting up to teenagers and grandmothers popping pills
purchased at the local pharmacy or delivered through the mail in plain
packages.

Rush Limbaugh turned a spotlight on the epidemic this month when he
admitted being hooked on prescription painkillers and told his radio
audience he intended to get help.

Prescription drug abuse is the fastest-growing type of substance abuse in
the United States, a phenomenon fed by aggressive drug marketing,
Americans' habit of taking pills for any ailment, physicians' tendency to
over-prescribe and the Internet, which is expanding the availability of
drugs exponentially.

About 6.2 million Americans, including disproportionately high numbers of
young people and the elderly, abuse prescription drugs, according to
government data released in September. More than 14.5 million people report
they've taken such drugs for non-medical purposes during the past year.

Meanwhile, 2.4 million people in 2001 started abusing pain relievers - the
drugs Limbaugh allegedly asked his housekeeper to buy for him - almost a
four-fold increase over the 628,000 reported as abusers in 1990, according
to the U.S. Substance Abuse and Mental Health Services Administration.

The problem of prescription-drug misuse is so acute that parents may need
to start locking their medicine cabinets, just as liquor cabinets were
locked decades ago to keep children away from booze, said Joseph Califano,
president of the National Center on Addiction and Substance Abuse at
Columbia University.

For many people, popping pills may appear to be a more sanitized, less
stigmatized way to get relief from the stress of daily life. Instead of
dealers on mean streets, frequent sources are doctors duped by patients or
pharmacies responding to call-ins for fake prescription refills.

Califano, a former U.S. Cabinet secretary, cites 2002 figures for legal
prescriptions in the U.S: 153 million for narcotics, such as Vicodin,
Percocet or OxyContin; 53 million for tranquilizers such as Xanax or
Valium; 23.5 million for stimulants such as Adderal or Ritalin; and 5
million for sedatives such as Soma.

On top of that is an unknown quantity of counterfeit prescription drugs
streaming into the country through the Internet and other sources, often of
unknown quality and diverted to the underground market.

Officials from the Food and Drug Administration, Secret Service, Justice
Department, pharmacy groups and others met last week in Washington to
develop strategies for keeping counterfeit pills out of the country.

But the rise of the Internet as a source of illegal prescription drugs
presents new challenges. At least 2,000 Web sites now sell prescription
drugs, the FDA estimates.

Traditionally, investigators have looked for geographic "clusters" of
drug-related problems - whether admissions to emergency rooms or to jails -
to identify physicians who may be overprescribing, buyers who may be
doctor-shopping and other drug scams. With the Internet, though, clusters
aren't readily detectable.

In the past several months, authorities have seen "a new and troubling
evolution of this business," from the Internet sale of lifestyle drugs such
as Viagra and diet aids to the pervasive marketing of all kinds of
prescription drugs, said William Hubbard, assistant commissioner at the FDA.

The FDA and the Drug Enforcement Administration last week teamed to form a
task force, Operation Gray Lord, that will aggressively pursue outfits that
market prescription drugs illegally over the Internet. Doctors who
prescribe drugs over the Internet based only on customers' answers to
e-mail questionnaires also may be targeted.

While some Web-based outfits are legitimate - filling prescriptions written
by patients' doctors online for a reduced price - many are rogue
pharmacies, offering to be both doctor and drug salesman to anyone with a
credit card. They're typically secretive, rarely listing their full
corporate names, business addresses or the names of doctors and pharmacists
they employ.

Many are based in foreign countries. Most require only that the shopper
fill out a short online questionnaire and provide no oversight of the often
dangerously addictive drugs they so easily distribute.

"Basically, you can get as much as you want of anything if you know how to
do it," said Dr. Daniel Angres, director of Rush Behavioral Health, a
treatment program with several sites in the Chicago area. "It's so
frightening. None of us wants to think about it in terms of where it might go."