THE LATEST TREND: MIXING PRESCRIPTION DRUGS WITH OTHER SUBSTANCES

Coming soon to a campus near you: Ritalin mixed with alcohol or
heroin.

If the mixing of prescription drugs with alcohol or illegal drugs
isn't already occurring on your campus, the odds are good that before
long it will be, according to some college health officials and
high-school drug counselors. Such concoctions have already caused the
deaths of at least two college students in the last few years.

As prescription drugs like Ritalin, a stimulant typically used to
treat attention-deficit disorder, and Valium, often used for anxiety,
become more prevalent, more and more high-school students seem to be
getting high by mixing them with each other, with alcohol, or with
narcotics.

Health officials and counselors acknowledge that they have no hard
facts to back up their observations, but they point out that what
happens in the high schools usually finds its way to the colleges.

"Kids are more and more likely these days to combine substances in a
careless way and to not pay much attention to the risks," says Thomas
W. Clark, an associate with Health and Addictions Research, a
nonprofit research organization in Boston.

Jennifer Kairis, a sophomore at Rollins College, in Winter Park, Fla.,
died in March 1998 after taking a lethal mixture of Inderal, a heart
medication sometimes prescribed to control migraines, and two
different antidepressants before a fraternity party. According to city
police, Ms. Kairis had prescriptions for the two antidepressants, but
not for Inderal. The coroner's report showed that her blood contained
more than twice the toxic amount of Inderal.

Police who investigated the death say that the combination that killed
Ms. Kairis was unusual. Students are more likely to combine Valium or
Ritalin with other drugs.

One such concoction killed Joshua H. Duroff, a senior at Trinity
College, in Hartford, Conn., in March. He died after sniffing a
mixture of Valium and Xanax, which also relieves anxiety, as well as
anti-migraine medication and sleeping pills. According to news
reports, none of the medications had been prescribed to Mr. Duroff. He
also had been drinking alcohol and using heroin.

The roommates, one of whom was hospitalized for three days before
regaining consciousness, were arrested on felony drug-possession
charges. They have been expelled from Trinity.

After Mr. Duroff's death, some students charged that Trinity has long
had a drug problem. An editorial in The Trincoll Journal, an online
weekly magazine produced by Trinity students, pointed out that four
months earlier, an editorial in the student newspaper read: "We have
an environment on campus that is incredibly conducive to drug
addiction. Drugs are available and seem to be acceptable."

Mary D. Thomas, Trinity's dean of students, says that drug use is
difficult to track, since students typically are not forthcoming about
it, and that mixing prescription drugs had not come to light on the
campus before the incident. But since then, she has received
"anecdotal reports" of such experimentation by other students at
Trinity. Ms. Thomas says she doesn't know to what extent the activity
is a problem, but believes that what the four students were doing is
not common.

"The students were abusing drugs in a way that most students wouldn't
contemplate," she says.

Officials on other campuses agree. "That is so rare," says Nancy
Schulte, coordinator for drug-education services at George Mason
University in Virginia. "It was just a bunch of students who were
sitting around, saying, 'Hey, we're bored. Let's try this.'"

Health officials at the University of Wisconsin at Madison, however,
say the abuse of prescription drugs, especially Ritalin, has become
disturbingly common.

Ritalin is registered as a controlled substance by the U.S. Drug
Enforcement Administration, and possessing or distributing the
medication without a doctor's prescription is a felony. The drug is
finding its way into more and more of America's medicine cabinets as
doctors increasingly diagnose youngsters and teens with
attention-deficit disorder.

According to the D.E.A., the number of prescriptions for such drugs as
Ritalin and Dexedrine has increased about 60 percent over the past
five years. From January 1990 to May 1995, Ritalin ranked in the
top-10 controlled substances most frequently reported stolen from
those authorized to have them.

When prescribed, Ritalin tablets typically cost 25 to 50 cents each,
but they fetch $3 to $15 each on the black market, according to the
Indiana Prevention Resource Center at Indiana University.

Some who misuse the drug don't take it in pill form. Instead, they
crush and inhale the drug, or dissolve it in water and inject it. Many
students opt to get high on prescription drugs because they seem more
innocent than illicit drugs.

"It's a minor-league experience compared to cocaine," says Eric
Heiligenstein, the Madison campus's clinical director of psychiatry.
"For some students, it's a way to protect your resume while still
getting stoned."

At Wisconsin last year, some students with Ritalin prescriptions told
health-center officials that classmates were either stealing the drug
from them, or trying to buy it. So the center began its own informal
survey of students who visited the center.

Dr. Heiligenstein acknowledges that the survey was more anecdotal than
scientific, but says it revealed a "substantial" problem. About 150
Madison students go through the center to get Ritalin prescriptions,
he says, and probably an equal number obtain them through other doctors.

He estimates, based on interviews with students at the center and
conversations with colleagues from around the country, that more than
20 per cent of the Madison campus's students have misused Ritalin or a
similar drug on at least one occasion. The levels of abuse, he says,
have ranged from taking someone else's medication to stay alert while
studying, to mixing Ritalin with alcohol in order to "party longer."

The center has since become more selective in prescribing stimulants
such as Ritalin and Dexedrine. For example, health officials no longer
increase a student's dosages upon request; a doctor must sign off on
the change. And a student is allowed only one replacement prescription
for one that's been reported lost.

Some of the rules were in effect before, but were not strictly
enforced, Dr. Heiligenstein says. But toughening up the university's
policies, he acknowledges, isn't going to control prescriptions being
written and filled off the campus.

Though there's little hard data with which to gauge how big a problem
mixing drugs has become in high schools, a continuing drug study
indicates an increase among teenagers in the illicit use of
amphetamines -- psychotherapeutic stimulants that cannot legally be
bought or sold without a doctor's prescription.

According to the University of Michigan's 1999 "Monitoring the Future"
study, the use of amphetamines made a comeback in the 1990's, and
usage among 12th graders peaked in 1997, and has remained at the same
level for three years.

Mr. Clark, of Health and Addictions Research, says that in the past,
drug-users would choose a particular narcotic and remain loyal to it.
Now, he notes, they're using whatever substances they can get their
hands on.

"People tend to be less picky these days," he says, "and more willing
to try new combinations."