Will meds grip our kids?
By Zenaida Serrano
Advertiser Staff Writer
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She's 17 and about six months sober. A high school senior from Upcountry Maui, the teen lived off — and nearly died from — abusing prescription medications like Vicodin, Xanax and Percoset.
"I didn't know how to live my daily life without doing it," said the student, who asked that her name not be used.
Many teens and young adults, in Hawai'i and nationwide, are turning to prescription drugs to get high, to avoid anguish or upset, and even to attempt to gain advantage at their studies. It's an area of growing national concern — and rising local awareness.
On Thursday, a National Center on Addiction and Substance Abuse survey revealed that teens nationwide say it's easier to get prescription painkillers or other drugs than to buy beer.
And a recent study, by the Partnership for a Drug-Free America, showed nearly one in five teens across the country — 4.5 million — has abused prescription medicine to get high. The organization reported that today's teens are more likely to use prescription medications than illicit drugs such as ecstasy, cocaine or methamphetamines.
Anecdotal evidence shows local teens are increasingly knowledgeable about the intoxicating prospects of certain substances. The Maui senior was able to obtain and misuse prescription drugs for years; college students home for the summer trade rumors about friends who use ADHD drugs to help them study.
Local experts say there's no firm indication that prescription drug abuse is a rising trend in Hawai'i. Nevertheless, health advocates say they hope to seize the initiative before the problem grows, to address the issue and encourage parents to be proactive.
The state is also hoping to gather more data. The Department of Health, along with the University of Hawai'i John A. Burns School of Medicine, recently added "prescription drugs" as a new category in a student survey designed to assess the need for substance abuse treatment in different communities.
Efforts to inform parents and youth about this potential problem are also being made through public school peer education programs statewide, and organizations such as the Coalition for a Drug-Free Hawai'i and the Kalihi YMCA's Outreach Program.
"There are trends on the Mainland that we should be aware of," said Keith Yamamoto, chief of the health department's Alcohol and Drug Abuse Division. "That's something we have to track and make sure we keep on top of, if it becomes an issue here."
'ABSOLUTELY' A PROBLEM
Not to say that prescription drug abuse among Hawai'i teens isn't a problem at all.
It "absolutely" is, said Jeffrie Wagner, executive director with the Bobby Benson Center, the state's only residential treatment center for substance-abusing adolescents ages 13 to 17.
At the Bobby Benson Center, which each year serves 80 to 100 youths, about 80 percent of its teens have admitted recently abusing some sort of prescription drug, Wagner said.
"It's very easy access for the kids," Wagner said. "All you do is open up the parents', grandparents' or relatives' medicine cabinet ... and you can usually find something in one of them."
The Maui teen, who started heavily abusing prescription drugs — as well as alcohol and other street drugs — at about 14 years old, said she mainly got her prescription drugs from peers, who typically stole from relatives, or older friends, who got the meds from their own doctors.
"I basically (abused) anything I could get my hands on," she said.
And at Hina Mauka, the largest drug abuse treatment center in the Islands, prescription drug abuse has cropped up on the horizon. Of the 700 teens treated during the recent year, only about a "handful" abused prescription drugs, said chief executive Alan Johnson.
"We are seeing a few people who are having difficulties using some prescription drugs," Johnson said. "A couple years ago, we didn't really see that."
Commonly abused prescription drugs include stimulants, such as methylphenidate (Ritalin); opioids, such as oxycodone (OxyContin) and hydrocodone (Vicodin); and sedatives, such as benzodiazepine (Valium), said Dr. William Haning, director of the addiction medicine teaching service for the UH medical school's Department of Psychiatry.
Haning also noted an increasing prevalence of Hawai'i teens abusing a substance called dextromethorphan, found in over-the-counter cough medicines such as Robitussin.
"It's something parents won't necessarily expect, and it's probably worth alerting them to," said Haning, who is also co-director of the Pacific Addiction Research Center.
NOT 'HYSTERIC LEVELS'
It's unclear whether the number of Hawai'i teens abusing prescription drugs is rising, Wagner said.
"I'm not sure that it's an increase," he said. "It has just become more visible (via the media) because now everyone is concerned about it."
Local statistics also aren't available to substantiate whether prescription drug abuse has become an issue with youth here as it has with youth on the Mainland, Yamamoto said.
"I looked back at some of our past (treatment) services, in terms of what was identified as the primary substance abused among adolescents, and prescription drug abuse does not pop up," Yamamoto said.
In data collected in 2006 and 2007 by the Health Department's Alcohol and Drug Abuse Division, a majority of youths admitted into adolescent treatment programs identified marijuana as the primary substance abused (about 56 percent), followed by alcohol (about 36 percent).
"So if I have to say that the 'other' (category) would include, maybe, prescription drugs, that's only 6.1 percent," said Yamamoto, who emphasized he isn't seeing any kind of trend "at this time."
UH's Haning agreed: "The prevalence of opioid use — OxyContin, Vicodin, codeine, that kind of stuff — doesn't seem to be quite at the hysteric levels" as it is in parts of the Mainland, Haning said.
EFFORTS BEING MADE
Nonetheless, the health department and the UH medical school's Department of Psychiatry saw prescription drugs as enough of a potential trend among youth "that we wanted to identify it specifically" as a new category in a student survey, Yamamoto said. Information for the collaborative study was collected in 2007 and is being analyzed.
The Hawai'i Student Alcohol and Drug Use Survey, designed to assess the needs for substance abuse treatment in communities, was given to mainly public and some private school students in grades 6, 8, 10 and 12 statewide. The last study was done in 2003.
The issue is also being addressed during classroom presentations by many peer education programs in public schools statewide, as well as the Kalihi YMCA's Outreach Program. The Kalihi program offers prevention, intervention and treatment services to youth via outreach counselors, who also visit 14 high schools and 14 middle schools every day.
"In fact, prescription drug abuse has become so significant in the work we do, certainly more than it was five years ago," said Tony Pfaltzgraff, a senior vice president at the YMCA of Hono-lulu.
Within the past year, the Coalition for a Drug-Free Hawai'i also began including information about prescription drug abuse in its substance abuse presentations, which are given at schools and within communities statewide.
"I think parents and community members need to be aware that there are a whole array of substances that can be abused (by youths)," said Alan Shinn, executive director of the Coalition for a Drug-Free Hawai'i.
PARENTS: BE AWARE
Haning points out that prescription medications are extremely useful and beneficial when taken appropriately.
"The issue is not so much the intrinsic evil of the substance, it's how it's used," Haning said.
So the solution isn't to put a "hammer lock" on drugs, he said, but for parents to be aware of what's going on in their own homes and their teens' lives.
"If you are going to take responsibility for somebody under age 18, that implies a high level of supervision and engagement, and it means being willing to be disliked," Haning said. ... "It does involve (parents) being aware of what's going into the medication cabinet, being aware of their own behaviors, understanding that parental use of alcohol or of controlled substances — frequently, if not always — provides the basis for the kids' understanding of how to use those substances."
And as the summer blockbuster "Dark Knight" continues to set box-office records, the Partnership for a Drug-Free America encourages parents to use the standout Joker performance of actor Heath Ledger — who died earlier this year of a lethal combination of prescription medications — as an opportunity to start conversations with their teens about the very real risks of abusing and misusing prescription drugs.
The organization recommends parents be proactive and take a three-step approach to prevent teenage prescription drug abuse in their own homes. Parents can:
Meanwhile, the Maui teen, who has been clean for several months, credits her improvement to the constant guidance of one of her teachers and a psychiatrist, and her own personal battle to stay clean.
"For me, the high isn't worth the low," she said.
Now a peer education counselor at her school, she always reminds students she talks with that they're not alone if they need help.
"No matter how bad it gets, remember there are always people who care about you," she said. "There are always people who will help you and who will want to help you."
WHAT STEPS PARENTS CAN TAKE TO HELP PREVENT TEEN DRUG ABUSE
The White House Office of National Drug Control Policy's National Youth Anti-Drug Media Campaign offers parents these tips:
— Gannett News Service
HOW TO GET HELP
Among the local resources that can offer information and/or provide treatment for prescription drug abuse among adolescents:
For a listing of more treatment facilities in specific areas, go to the Substance Abuse & Mental Health Services Administration, U.S. Department of Health and Human Services, at www.samhsa.gov. In the right margin under "I Need Help With ... ," click on "A Substance Abuse Problem." Under "Find Treatment for Substance Abuse," click on "Substance Abuse Treatment Facility Locator."
"... prescription drug abuse has become so significant in the work we do, certainly more than it was five years ago."
Tony PfaltzgraffYMCA of Honolulu
Reach Zenaida Serrano at zserrano@honoluluadvertiser.com.