PRESCRIPTION DRUGS USED ILLEGALLY ARE GETTING MORE ATTENTION

Last month the 24-year-old daughter of Florida Gov. Jeb Bush and a niece of
the president of the United States was arrested for trying to buy the
anti-anxiety drug Xanax on a fraudulent prescription.

The same day, five Houston middle school students, ages 12-14, were rushed
to a hospital after taking the prescription sleeping medication Ambien.

Different states, different drugs, different situations and far different
degrees of public attention. But the same problem.

"There is no connection between Jeb Bush's daughter attempting to get Xanax
and these (students)," says Mel Taylor, president of the Council on Alcohol
and Drugs, Houston, "except a problem coming to light."

Xanax and Ambien are two of dozens of prescription drugs working their way
from pharmacy shelves to the mouths of millions of Americans who are taking
them illegally. The situation is causing alarm in the medical, legal and
law enforcement communities, adding new complications and expense to the
national war on drugs.

"Where it's really costing us is in (long-term) health effects," says John
E. Gartland, special agent in charge for the Houston office of the Drug
Enforcement Administration.

A National Institute on Drug Abuse report estimates 9 million people age 12
and older used prescription drugs for nonmedical reasons in 1999. Perhaps
more alarming, a quarter of those people were first-time users the previous
year, indicating a rapid growth in the problem.

Those figures are for teens and adults, but even younger children are part
of the growing problem. A 1999 NIDA report says that the most dramatic
increase in new users of prescription drugs for non-medical reasons is in
12- to 17-year-olds and 18- to 25-year-olds. It also said
psychotherapeutics -- painkillers and stimulants -- were one of two primary
drug groups used by children ages 12-14.

"Every junior high school I go to, they know as much about these drugs as I
do," Gartland says.

Illegal drugs, from marijuana to "club drugs" such as ecstacy, continue to
be more common, but prescription medications used illegally -- which means
in any way not prescribed for the specific user by an authorized health
care professional -- are getting more attention.

"Every day we are hearing more and more from our counterparts (in other law
enforcement agencies) or from high schools and junior high schools about
the abuse of Xanax or some other depressant," says Gartland, who closely
ties the growing use of prescription drugs by young people to illegal
drugs. "My guess is that (the illegal 'club' drug) ecstasy is becoming so
prevalent that kids need to self-medicate. In order to come down, they need
some kind of depressant."

Some people abuse prescription drugs because they're easier to get than
illegal drugs.

"You see a lot of poly-drug use," Taylor says. "A heroin addict who can't
get heroin will substitute something else to keep him calm to avoid the
effects of withdrawal from heroin. So you'd see Valium or something else
along those lines."

The most commonly abused prescription drugs are depressants such as Xanax,
Valium or Ambien; painkillers such as morphine, codeine, Vicodin,
oxy-codone, Percocet, Darvon, Demerol and Tylenol III; or stimulants such
as Ritalin or Dexedrine.

Reasons for abuse of prescription drugs are many -- some obvious, some not.

Often an ordinary, legal user -- someone who needed the drug for a medical
problem -- becomes dependent simply through extended use of the drug.

Other users just want to get high, but want drugs that are "safer" than
narcotics bought on the street.

"One of the things that turns people to pharmaceutical drugs is that street
drugs (are often cut) and the strength goes down," says task force officer
Sam T. Searcy of the Houston Police Narcotics Division. "You don't know
what you're getting.

"But when you go to Randalls, Eckerd, Albertson's, Wal-Mart (to get a
prescription), you know what it is. It's pure. And it's cheap, because you
are using that (insurance) co-pay."

Some well-meaning people assist others on the road to addiction by giving
them their own prescriptions. It seems innocent enough: just a Valium for a
friend worried about a job interview, perhaps.

"It's a violation of federal law the minute you do something illegal with
the drugs," Gartland says.

The stereotype of a drug user applies even less to prescription drug
abusers. "It covers the broadest spectrum I've ever seen, everyone from the
street person all the way up to whoever you want to think of," Searcy says.

At special risk are health-care professionals -- the doctors, dentists,
nurses and others who prescribe, or work around, drugs.

"It's a huge problem to health-care professionals because of access," says
Scott Basinger, chair of the substance abuse assistance council at Baylor
College of Medicine. Basinger says the incidence of prescription-drug abuse
among health-care workers is slightly higher than the general population.
"We constantly have clinic people and nurses who are caught much like
(Noelle) Bush was, phoning in or stealing pads. It's way too frequent.

"Access and stress are thought to be the reasons. Long hours, lots of
responsibility, and they work in the candy store," Basinger says.

Prescription medicines reach illegal users in numerous ways. One of the
most common, Searcy says, is for a person to go to a doctor or dentist,
claiming to be in pain.

"A lot of times they (claim) some kind of pain that is really hard to
diagnose, other than the patient's word for it," he says.

If the first doctor doesn't provide a prescription, the person may try a
second, third or fourth doctor.

"You can doctor-shop, which is what we call it," Searcy says. "Say you get
back surgery and become addicted to one of the hydro-codone products. You
prostitute that back surgery from doctor to doctor to doctor."

The person might even find a "script doctor" -- someone willing to write a
prescription he knows is not needed, for a fee or a share of the drugs.

"Script doctors used to be a lot more common," Basinger says. "They were
called 'Dr. Feel Good.' The system is such now that those people usually
get caught."

When getting a prescription through "safer" channels fails, users often get
more daring.

"You can call a pharmacy and act like a doctor or a doctor's aide and say
you are calling the prescription," says Carol Fisher, director of
enforcement with the Texas State Board of Pharmacy. "If they don't call it
in very well, the pharmacist will check it and get the person arrested.

"Then you've got the written order where somebody may steal a prescription
blank from a doctor's office. An alert pharmacy will catch those, as well,
because they are not written like a doctor writes."

Basinger says many prescription drugs sold on the streets come from
diverted pharmaceutical shipments, hijacked delivery trucks and pharmacy
break-ins.

In the case of very young people with illegal prescription drugs, the
acquisition is often much more basic.

"Somebody gets those drugs out of somebody's medicine cabinet," Taylor
says. "An older child hears that 'Hey, Mom's got Valium.' They bring it to
school. Mom doesn't know about it until it's too late."

The Internet doesn't just supply information . State and federal
governments are increasingly concerned by the proliferation of Internet
prescription sites, not all of which are legitimate.

There have been several recent instances of the prosecution or attempted
curtailment of both domestic and foreign prescription medicine services,
some of which routinely prescribe controlled drugs with little or no real
diagnosis. Two weeks ago an Oklahoma doctor was convicted for making
illegal Internet prescriptions.

Part of the problem of prescription drugs is a lack of understanding about
their danger. A person takes a painkiller to feel better, thinking "what's
the harm?"

It's obvious, really: The drugs pose a danger if not administered correctly.

"One of the consequences is that too much of a certain drug can affect the
organs of the heart, the liver, the kidneys, and when it's mixed with
alcohol, it just exacerbates the effect," Taylor says. "A Valium, say,
needs to be carefully monitored by a physician, not only physically, but
also looking at the dependency level, to tell when it's time to really shut
it down."