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."