ONCE YOU POP (PILLS), YOU JUST CAN'T STOP

Local rehabilitation clinics, medical experts say they have seen a
rise in painkiller addiction among students.

Drug rehabilitation clinics near campus have reported seeing an
increase in the number of college students seeking treatment for
painkiller addiction, a trend that underscores a national increase in
painkiller addiction.

Shahan Suzmeyan, a credential counselor and marketing manager for CRC
Health Group, which operates the Jeff Grand Treatment Center for drug
use and addiction near campus, said an estimated 100 college students
have sought treatment at the clinic for painkiller addictions since
January. Though not all of those students were enrolled at USC,
Suzmeyan said there are typically about 10 USC students enrolled in
treatment programs at any given time.

Suzmeyan said students are increasingly able to fuel painkiller
addictions because it is becoming easier to buy drugs such as
OxyContin, Vicodin and Darvon on the Internet from
internationally-based pharmaceutical companies that are not as
stringently regulated as those within the U.S.

College students are particularly attracted to Internet pharmacies
because they can easily obtain prescription-strength pain medication
without a prescription, and at the same time they can escape the
stigmas normally attached to buying illegal drugs off the street.

"There's this proliferation of Internet-based pharmacies now - you
just get online, and with a couple of clicks you can get whatever
prescription medication you want delivered to your house without
going through a doctor. They will sell you whatever you want and
whatever you ask for," Suzmeyan said.

In addition, pain medication obtained traditionally from a doctor
lacks the stigma of illicit drugs, increasing the social acceptance
of painkiller abuse. Even the popular trends in drug abuse reflect
the social acceptance of painkillers, Suzmeyan said.

Suzmeyan said that fentanyl lollipops - which contain 10 milligrams
of the drug Fentanyl, a substance similar to highly-refined heroin in
its neurological effects - is a favorite among students who use painkillers.

The orange- and cherry-flavored lollipops, first designed for
children in chemotherapy treatment who were unable to take
painkillers, are now a fashionable drug of choice among students,
Suzmeyan said.

A Heroin-Like High

Painkillers produce neurological effects similar to heroin by
affecting how the brain regulates endorphin levels within the body,
giving users a heroin-like high caused by the two substances'
chemical similarities.

These opiate-related painkillers imitate or are derived from opiate
drugs, and students prefer them because they believe the painkillers
will achieve the same chemical satisfaction as a substance their
doctor would prescribe them, Suzmeyan said.

He said it is easier for students to accept a few Vicodin pills than
a shot of heroin because the two drugs have completely different
connotations regarding their use.

"People just pass them around like aspirins, basically, and there's
no stigma about it," Suzmeyan said.

But the drugs' similar neurological effects also contribute to the
same physical consequences of withdrawal and addiction, said Suzmeyan.

"Heroin is just the illegal street version of the same basic
chemical," Suzmeyan said. "People don't really make the connection
that the same basic chemical structure that gets you addicted [to
heroin] is present in pain medication, too."

It is these sort of experimental behaviors with painkillers that put
students at greater risk for addiction, Suzmeyan said. Students also
tend to amplify their risks of addiction and overdose by creating
lethal "drug cocktails" by combining painkillers with other
substances such as alcohol, experts say.

Can Campus Cause Cravings?

Students are more at risk for painkiller addiction because a college
environment is more conducive to experimenting with drugs and
alcohol, especially because students are leaving home and looking for
ways to deal with the new social and academic pressures that exist in college.

Matthew Palmer, a junior majoring in business administration, said he
understands why students might turn to painkillers in college, but
disagrees with painkiller abuse.

"People get involved in all different types of things, and people are
always experimenting with stuff, especially when they're stressed
out. I'm sure it's an issue," he said.

Although the treatment center has seen a rise in students with
painkiller addictions, some USC students said they doubt about
whether the addiction rise is significant on campus. They said
painkiller abuse is not a very visible problem - at least when
compared to other medications that students abuse.

"I've never seen it, but I know it happens," said Brandon Hale, a
senior majoring in biological sciences and business administration,
when asked about the recreational use of painkillers.

Hale said the practice of painkiller use is not commonplace, and he
said he has never seen anyone abuse painkillers. However, he said
he's heard about the recreational use of pain medication among students.

Rachel Woodhull, a senior majoring in sociology, said she didn't
think painkillers were as much of an issue as other substance abuses on campus.

"I think the bigger issue is people using Adderall and things to
study and to stay awake - I know so many people who do that," she
said. "I have friends who won't study without it."

Woodhull said that while students might pop Percocet tablets and
anti-depressants to relax, she's witnessed people more commonly abuse
medication used to treat attention-deficit/hyperactivity disorder.

Prescription Addictions

Suzmeyan said doctors, who are unaware of how their prescriptions are
used when they commit to proactive methods of pain management for
students, also fuel painkiller abuse.

Another source of painkiller abuse among students has been the buy,
sell and trade of prescribed painkillers acquired for medical reasons
through doctors.

Those students with a history of painkiller use related to injury or
illness said the medication can lead to physical or psychological
dependency, and they understand how the risks of painkiller addiction
increase with chronic or irresponsible use.

When asked if students finished taking all their prescribed pain
medication, the majority of students said they stopped the pills when
their pain stopped, and were left with excess amounts of pain
medication they didn't need to take.

Clara Suh, a sophomore majoring in policy, planning and development,
said she had taken painkillers and sleeping pills prescribed by a USC
physician after she had ACL reconstructive surgery to help cope with
the pain and discomfort after surgery.

"I have a really high pain threshold, so even the injury to begin
with was not very painful for me," she said. "I was really skeptical
of how much I would need the painkillers."

Suh said the medication made her drowsy, and she often drifted in and
out of consciousness.

"It was a very odd feeling because once the medicine kicked in, I was
really aware of the fact that I wasn't really in complete control of
myself," she said.

Palmer, who is on the USC track team, said he also had previous
experience with prescribed painkillers because of sports injuries. He
said that while he never experienced any adverse effects, he no
longer uses painkillers.

"After a while I guess I got more knowledgeable about painkillers, so
given the choice, I don't go for them now," Palmer said.

Dr. Ronald Alkana, a USC professor of molecular pharmacology and
toxicology, said opiate-related painkiller addiction is always a
risk, but the risk of painkiller addiction is much less for
prescribed painkillers used responsibly for pain.

"The abuse of these drugs has grown without a doubt," Alkana said,
but he believes that the treatment of pain usually justifies the use
of prescribed pain medications.

Pain management is a critical aspect of complete patient care, he said.

"Medically the concern should be relieving their pain," Alkana said,
but he noted that some health care providers worry about chronic
addiction and might hesitate to prescribe pain medication.

Healthful pain treatment really depends on just picking the right
pain medications for the condition and prescribing the right drug for
the person, Alkana said.

He said that it is important for health care providers to examine a
patient's history for addiction and determine the risk factor for
becoming dependent on these medications.Health care providers should
not prescribe heavy painkiller medications when the pain can be
handled by other means.

Alkana said that one of the largest concerns with the opiate-related
painkillers is the physical withdrawal when use stops.

When the body becomes accustom to chronically functioning with pain
medication, the body's chemical balance is severely disturbed when
the drug is removed, which can cause severe symptoms associated with
physical withdrawal, he said.

Suzmeyan said most students don't realize their addiction until they
feel the physical symptoms of withdrawal, which are like those
indicating heroin withdrawal: extreme physical pain.

Students seeking help in handling their addictions can access campus
counseling services or visit the CRC-operated Jeff Grand Treatment
Center on South Hill Street, within walking distance of campus.

Suzmeyan said problems with drugs, alcohol and addiction don't cure
themselves, and simply abstaining from painkillers does not resolve
the underlying issues of addiction.

"Addiction is kind of a lifelong thing," he said. "You're always
going to have that predisposition to be an addict."

These days, treatment and counseling are anyone's the best option for
recovery, said Suzmeyan.

"Nancy Reagan's 'just say no' approach apparently didn't work for
anybody," he said. "You know, I don't even think it worked for her."