WHAT DID SHE WANT WITH XANAX?

The arrest of Governor Jeb Bush's daughter on charges of prescription fraud
put a strange light on a familiar drug

Like most doctors, I've watched with concern the growing use of so- called
club drugs--psychotropic substances that catch on from time to time among
teenagers and young adults and become the rage at dance clubs and all-night
raves. I know about ecstasy, Rohypnol and ketamine. But I was taken by
surprise last week when Noelle Bush, daughter of Florida Governor Jeb Bush
(and the President's niece), was arrested in Tallahassee trying to buy
Xanax, having allegedly borrowed the name of a retired doctor and called in
a bogus prescription. Xanax, after all, is a widely prescribed antianxiety
medication--a cousin of Valium--and hardly fits the profile of a Gen X
party drug.

Xanax is usually used to relieve panic and anxiety, which may be why Noelle
wanted it. But though it ranks low on the scale of drugs most likely to be
abused (heroin is termed a Schedule I drug; Xanax is a Schedule IV), the
Drug Enforcement Administration has been keeping a close eye on it for
years. Like other benzodiazepines, it acts on the neurotransmitter
gamma-aminobutyric acid, decreasing brain activity and producing a drowsy
or calming effect. "It's like being drunk, without the toxicity of
alcohol," reports a helpful chat-room participant.

It's also quite addictive. "Xanax is extremely potent," says Dr. Steven
Juergens of Virginia Mason University, who was the first to write about
Xanax addiction, in 1988. "It acts quickly on the brain and has a short
half-life." Users of such drugs tend to come back for more and more. Xanax
is also used by partygoers as a "parachute" drug to bring them down from
the effects of stimulants such as ecstasy. It's this combination of drugs,
suggests Dr. Herbert Kleber, a professor of psychiatry at Columbia
University, that may account for the current interest in Xanax.

Benzodiazepine abuse is on the rise, according to the Health and Human
Service's Drug Abuse Warning Network. But so is prescription-drug abuse
generally. From 1990 to '98, National Institute on Drug Abuse statistics
show, the number of Americans who started misusing sedatives nearly
doubled, while abuse of pain relievers rose 180%.

We don't really know what Noelle Bush planned to do with those 40 Xanax
pills in the prescription or even whether she was getting them for herself.
Her parents issued a terse statement acknowledging that the family is
"deeply saddened" and reminding Americans that "substance abuse is an issue
confronting many families across our nation." Noelle's mother Columba
should know. As a board member of the Center on Addiction and Substance
Abuse at Columbia University, she has helped raise awareness about the
problem. Sadly, nothing she's done over the years has attracted nearly as
much attention as her daughter's arrest.

Dr. Gupta is a neurosurgeon and CNN medical correspondent

With Reporting by Jonathan D. Lynch