Depressant: Xanax
Nicknames: Z-bar, bricks, Benzos
Generic: alprazolam
Legitimate uses: Treats anxiety and sleeplessness; is an anticonvulsant
Kids take: Orally, or occasionally by crushing and snorting
Effects: Wooziness, floating feelings, mind-and-body numbness
Depressant: Valium
Nickname: blues
Generic: diazepam
Legitimate uses: Treats anxiety and sleeplessness; is an anticonvulsant
Kids take: Orally, or occasionally by crushing and snorting
Effects: Euphoria and sleepiness
Stimulants: Ritalin, Concerta
Nicknames: Rid, vitamin R, jif, R-ball, Ritty, Rits
Generic: methylphenidate
Legitimate use: Treats attention deficit hyperactivity disorder (ADHD) in children and adults
Kids take: Orally, or by crushing and snorting
Effects: Intense feeling of energy and increased concentration
Stimulant: Adderall
Nicknames: beans, black beauties, Christmas trees, double trouble
Generic: amphetamine and dextroamphetamine
Legitimate use: Treats ADHD
Kids take: Orally; crushing/snorting
Effects: Intense feeling of energy and increased concentration
Painkillers: Vicodin, Vicoprofen, Tussionex, Lortab, Norco
Nicknames: Vike, Watson-387, Tuss
Generic: hydrocodone
Legitimate use: Treats pain
Kids take: Orally; crushing/snorting
Effect: Intense euphoria
Painkillers: OxyContin, Percodan, Percocet
Nicknames: OC, cotton, Percs
Generic: oxycodone
Legitimate use: Treats pain
Kids take: Orally; crushing/snorting
Effect: Intense euphoria
Painkillers: Avinza, Kadian, MS Contin, MSIR, Oramorph SR, Rescudose, Roxanol
Nickname: Morph
Generic: morphine
Legitimate use: Treats pain
Kids take: Orally; crushing/snorting
Effects: Euphoria and hallucinations
Friday, November 21, 2008
Prescription Pills: The New Drug of Choice for Teens
By Annemarie Conte
Prescription pills are cheap, easy to explain, and even easier to score. But kids don't even realize how deadly their new drugs of choice can be.
It was just after dawn on one of those hot, sticky July days when the sun doesn't rise so much as slide up slowly like an egg poached by the humidity. Minutes earlier, a small platoon of police officers had eased their cruisers onto the side streets of Whippany, a prim New Jersey suburb. They drove past rows of vinyl-sided McMansions with fake-brick facades and matching Palladian windows, past Sports Authority basketball hoops and sleeping Audis and SUVs. Then, just like their cohorts from several other nearby towns, they parked and waited, the sweat trickling down under their Kevlar vests. More than 200 officers, each linked by radio to the task force headquarters, stopped at all-but-identical houses across three counties, pumped with the kind of adrenaline rush that comes from being part of a major takedown.
Less than an hour later, more than 50 kids and young adults with bed head, in T-shirts and flip-flops — many just roused by their shocked parents telling them that the police were at the door — stumbled into the central command unit to be processed. Among their number were recent graduates, star athletes, an actress in a school play, their wrists secured behind their backs with plastic handcuffs, just like they'd seen on Law & Order reruns.
At the center of it all was a baby-faced 18-year-old with gelled-back hair who was one class shy of graduation at Whippany Park High School. One of Evan Rokoszak's friends describes him as "sweet, goofy, and fun to be around." But for months leading up to that sweaty day in 2006, the police (later joined by the prosecutor's office in Operation Painkiller) had been investigating Rokoszak along with the students and recent grads involved in the drug ring he ran, which distributed and sold more than $50,000 of the prescription painkiller oxycodone each month — mostly to other students and alumni.
Almost daily, officers in Whippany had scanned the increasingly complex board at HQ that mapped out the key players in the business, praying that their own children's names wouldn't appear. Considering drug use was so rampant in the school that kids called it Whippany Perc (after the popular painkiller Percocet), how many students could remain untouched? "Everyone at school knew you could get pills from Evan if you were good friends with him," recalls a 2007 graduate who had attended school with the dealer for years. "Suddenly, everyone was good friends with him."
Statistically, too, the officers had reason to worry. Although high school drug use is down across the country, in the past 10 years the rate of prescription drug abuse among teens has risen steadily. Nearly one in five — 4.5 million — admits to abusing medications not prescribed to him or her, reported the 2005 Partnership Attitude Tracking Study conducted by the Partnership for a Drug-Free America.
In December 2007, at a sentencing related to the bust, New Jersey State Superior Court Presiding Criminal Judge Thomas V. Manahan in Morris County described the Whippany teens' activities as "a large-scale drug distribution syndicate," adding that the abuse of prescription drugs "is not so much a plague on our society as a cancer that continues to grow." Rokoszak's family spearheaded a letter-writing campaign to plead for leniency — because the teen, as they put it, "is remorseful and has turned his life around" — but the 30-odd letters were of no avail: In February 2008, Judge Manahan sentenced Rokoszak to seven years in state prison (he must serve a minimum of five). Hearing the decision, his mother broke down, sobbing, "Oh, my baby, my baby."
Schools throughout the country have problems just like Whippany Park's. The difference is that there the authorities took action. But law-enforcement officials elsewhere are catching on, too. Seven youths, two still in high school, were recently arrested in Merrimack, NH, on charges of distributing the prescription painkillers Vicodin and Klonopin, as well as marijuana, to other high school students. In May, 75 students at San Diego State University were arrested in a massive bust where police confiscated vast quantities of illegal and prescription drugs, weapons, and $60,000 in cash. Among the coeds picked up: a criminal-justice major and a homeland-security grad student. Perhaps most disturbing, in February, 14 students at Castle View High School and Castle Rock Middle School in Colorado — one of them a 13-year-old seventh grader — were caught using or distributing Vicodin and oxycodone, acts which would be felonies if adults committed them.
None of these arrests surprises the experts. Pharmaceutical abuse has become so commonplace that it has filtered down to younger kids: Prescription drugs are now the number one illicit drug among 12- to 13-year-olds, according to the 2006 National Survey on Drug Use and Health. And their own kid's arrest or even conviction is not the worst thing parents have to fear from this epidemic.
Pretty Pills, and Deadly
Adults think of prescription drugs purely as medicine, but kids have come up with ways to create effects similar to what they'd experience from street dope — from crushing pills to circumvent timed-release controls to doubling or tripling dosages or simply downing handfuls. What's more, if parents are in the dark regarding these drugs' potential for abuse, they're also often blind to how deadly they can be.
"As a mother, I was worried about cocaine, crystal meth, and drinking and driving — but I had no idea prescription drugs were an issue," says Francine Haight, an R.N. who lives near Laguna Beach, CA. In the winter of 2001, her son Ryan, an A student and star tennis player, was looking forward to starting college later that year. So she suspected nothing that February evening when he arrived home from his job in the plant nursery of a big-box store. He spent some time in their Jacuzzi, then went upstairs to bed. The next afternoon, when Ryan still hadn't gotten up, his mother went into his bedroom to check on him. He was dead, from an accidental overdose of Vicodin, Valium, and a trace of morphine. He'd been prescribed these drugs over the Internet by a doctor he'd never met; the prescriptions had been filled online by a pharmacist he'd never seen. "He didn't understand the dangers," Haight says. "He knew everyone had pills like these, so he figured they couldn't be dangerous. The doctor wouldn't prescribe them for you, and the pharmacist wouldn't give them to you, if they could kill you, right?"
Accidental-poisoning deaths among youths ages 15 to 24 increased 113 percent between 1999 and 2004, mostly due to prescription- and illegal-drug abuse, reports the Centers for Disease Control and Prevention. Upping overdose risks: Four out of 10 teens believe that prescription meds are much safer to use than illegal drugs — even when they are not prescribed by a doctor. What's more, nearly three out of 10 teens think these drugs are not addictive, according to the Partnership study. Kids trust prescription drugs because they're mass-produced, FDA-approved, familiar medicines. Even the nicknames teens give them — "jif," "Z-bar," "cotton" — suggest childhood treats and comfort food.
"I've heard many kids say, 'I'm not doing hard drugs. I wouldn't use heroin,'" says Troy Faddis, a licensed marriage and family therapist and the clinical director of the Aspen Achievement Academy, a wilderness recovery program in Loa, UT. "But opiates like OxyContin are the pharmaceutical equivalent of heroin."
"Your brain doesn't know if the high came from heroin or an opiate pill," agrees Roger Weiss, M.D., a professor of psychiatry at Harvard and the clinical director of the Alcohol and Drug Abuse Treatment Program at McLean Hospital in Belmont, MA. "Some teens who experiment with these drugs never use them again. Some try them and don't start using heroin but do get addicted to the prescription opiate. And some get physically dependent and progress to heroin. You don't know how you'll react." Like adults, kids can build up a tolerance to these drugs, and crave them in ever-greater quantities. And teens' common practice of mixing prescription pills together, or with alcohol, street drugs, or OTC products like cough syrup, increases the risk exponentially. "Combining creates a greater chance of accident or overdose," explains Dr. Weiss. "Kids are more likely to fall out of a window or to walk in front of a car because they're more intoxicated."
Easy Access
Teens often don't even have to leave home to get their first taste of prescription drug highs, points out Joshua Lyon, 33, author of the forthcoming book Pill Head, a chronicle of several teens' and young adults' struggle with prescription-painkiller addiction, as well as his own. "It's not like most parents are keeping unused marijuana or cocaine in the medicine cabinet," he says, but they often have old pills they don't keep track of. More than three in five teens say prescription pain relievers are easy to get from their parents' medicine chests; half say they're a snap to obtain through other people's prescriptions; and more than half say pain relievers are available everywhere, according to the Partnership study.
Case in point: Sara Swanson, who grew up in suburban St. Paul, MN, the daughter of two recovering alcoholics. "My parents always warned me about alcohol abuse," explains Swanson, "but my mom had back problems and never dreamed I'd take her muscle relaxants." Swanson moved on from her mother's pills to other drugs, trading cigarettes to her friends for their Adderall. "I loved the pills, and they were so easy to get," she says. "I'd look at the recommended dose and then double it."
Swanson, 18, has just graduated from Sobriety High School, a charter school in Edina, MN, attended by 60 students recovering from addiction through 12-step programs. But it took a failed suicide attempt — waking up to find friends asking her why she'd purposely tried to overdose — to make her realize she needed help.
In addition to "borrowing" from relatives and bartering with friends, hooked kids often get their fix by buying from dealers — both teens like Rokoszak and career criminals with a history of distribution. Those dealers, as well as more enterprising kids, may fill their supplies by using falsified prescriptions on- or off-line, by visiting multiple doctors and going to pharmacies with legal prescriptions, or by out-and-out theft from drugstores or homes.
Thanks to Francine Haight, however, Internet drug dealers should soon have a tougher time selling to kids. "For three years after Ryan died, I was in shock and could hardly function," she says. Despite her grief, she made the effort to speak out at colleges around the country and at a drug-awareness symposium for the DEA, and she founded the drug-awareness organization Ryan's Cause: Reaching Youths Abusing Narcotics (ryanscause.org). In April, the Senate passed the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which forbids U.S. online pharmacies to supply controlled substances to anyone without a valid prescription from a doctor he's met with at least once. "Unfortunately, Ryan's story is just one of many. We know of at least 18 people who have died due to overdoses from drugs purchased on the Internet through rogue pharmacies, and even more who have entered rehabilitation or suffered injuries due to these drugs," says Senator Dianne Feinstein, Democrat of California, a sponsor of the bill, which was working its way through the House of Representatives at press time.
Everyday Abuse
Easy availability, combined with kids' misperceptions of prescription drug safety, may explain why pill popping has become so accepted as part of the weed-and-alcohol culture of high school parties. "I don't think it's bad. There's no particular reason I didn't do [prescription drugs]," says one recent Whippany Park graduate who was friends with several of the arrested kids. "It's not any worse than drinking or smoking pot. Yes, it's illegal, but taking pills doesn't make you a bad person by any means." The Partnership study found nearly one-third of teens (7.3 million) agree that there's "nothing wrong" with using prescription drugs without a prescription once in a while.
The ways kids are taking the drugs now underscores this relaxed attitude. "We're finding that teens are no longer holding exclusive 'pharm parties,' where they'd get together and bring all the pills they could find, the way they did in years past," says the Aspen Achievement Academy's Faddis. Instead, they take them throughout the day, as a routine part of life. "School was really stressful, so kids would pop pills or snort Adderall during class to make it go faster," explains Anders Torgersen, 17, of Huntington Beach, CA. Torgersen asserts that when he was an athlete and top student at a strict private middle school, pressure to excel led him to start taking prescription drugs. "I loved Vicodin because it made me feel like God," he says. "If I punched a wall, I couldn't feel it. I had more power and confidence on the pills." He began dealing the meds in his freshman year of high school. He estimates that 70 percent of his schoolmates used drugs.
As Ryan Haight's and Torgersen's experiences suggest, any kid — even bright, motivated high achievers — can be lured by prescription drugs. But experts do see some common threads. "Many of our students have self-esteem issues. They start using the pills as a way of self-medicating for school or family problems and underlying depression and anxiety," says Faddis, who in 2007 performed a small but suggestive analysis of 37 kids in his program. He found that 34 of them had been evaluated to have parent-child relationship problems, such as serious breakdowns in communication and mutual respect. Other research indicates that using drugs can make kids feel more independent and grown-up. Teens who take alcohol or any kind of illegal drugs report feeling older than their real age, found a 2007 study from the University of Alberta in Edmonton. "One explanation: Kids are using drugs because they think of drug-taking as an adult behavior," says Kelly Arbeau, Ph.D., coauthor of the study. Torgersen, who just started his senior year this September at the Oakley School in Oakley, UT, an addiction-recovery high school, echoes Arbeau's analysis. "I was trying so hard to be independent. I thought I was mature," he says. "I wasn't."
Preventive Parenting
In September 2006, a few months after the Operation Painkiller bust and with a newfound awareness of their drug problem, the townspeople stationed police officers at Whippany Park and its sister school full-time to get to know the kids and keep an eye on their activities. A year later, the school district instituted a random-drug-screening policy, whereby kids are tested and, if the results are positive, parents are notified. The policy has been controversial among parents concerned for their kids' privacy, but anecdotal evidence suggests a reduction in abuse. "These measures have been a deterrent," says Sibila Dubac, guidance coordinator and substance-awareness coordinator for Whippany Park High School. "They've increased awareness and decreased incidents." She adds that kids are afraid of getting caught, and don't want to lose on-campus parking or extracurricular privileges.
Regardless of what measures schools take, however, primary responsibility for keeping kids drug-free remains with parents — and there are steps you can take to reduce your child's risks. "Parents need to talk about drugs with their kids, not just to them," says Haight. "You learn so much when you let them talk, and once they know you're receptive, they're not afraid to come to you." As for when and how to approach the topic, "there's no easy answer that will apply to all families," says Faddis. You know your child and what she responds to best. "But your attitude is important," he adds. "If you seem to be disciplining, rather than nurturing, she may just get defensive." You want your child to be safe — that's what you need to communicate to her. He recommends starting with something like, "I'm worried, because drugs are a big problem and anyone can be sucked in, especially if they have bad information. I don't want you to get hurt." Be brief (experts say that the effectiveness of the discussion falls off after the first few minutes); have this conversation more than once; and be honest — it's your conviction, as much as the facts, that will carry weight with your child. If you want a supplement to fill her in on the details, the DEA has an educational Website for teens on the topic of drug abuse: justthinktwice.com. In accessible language, the site covers all kinds of drugs, including controlled-substance prescription meds, and offers advice from peers, as well as links to where kids can find help.
Another critical step, says Pill Head author Lyon, is to remove temptation from your house. Though it may sound obvious, few parents take the precaution of locking up their prescriptions, noting on the bottles how many pills should be left in each — and checking them every two weeks. "If you buy a gun, you don't just keep it lying around," he points out. "You lock it up in a safety box." If your child takes a daily prescription, like Ritalin, keep the bottle yourself and give him only a day's worth of pills at a time. The Partnership for a Drug-Free America's Not in My House campaign suggests further that you dispose of any leftover pills by mixing them with kitty litter or coffee grounds to make them unpalatable, putting the mixture into an empty can or bag, and throwing it in the trash. (Flushing pills down the toilet can cause them to leach into the water supply.)
Finally, parents should watch for behavior change. "Signs could be alterations in your son's or daughter's sleep/wake cycle or mood patterns — or you might observe a new level of secretiveness and sneaking around," says Dr. Weiss. The specific indications can be as seemingly minor as your child copying song lyrics about drugs in her notebooks. "Granted, all of these things can occur normally during adolescence, and every kid is different," Dr. Weiss adds, "but parents tend to know their kids well — and when they are really changing."
Like Torgersen, whose grades barely dipped, many kids become functioning addicts, and even observant parents may miss or misinterpret what symptoms there are. When Francine Haight looks back on the last months of Ryan's life, she realizes that there were small clues: He was more quiet than usual, slept more, and started hanging out with friends she didn't like. At the time she rationalized that he was reacting to her divorce from his father, the death of their dog, school pressures, or his sister's leaving for college — anything but drugs. "I just didn't pick up on the signs," she says.
If you do suspect a problem, it's essential to address it with your child, say experts. Admittedly, this is easiest to do when you already have a strong, communicative relationship; if you don't, Faddis counsels bringing in outside help, like a therapist, right away. While parents may feel conflicted and worry about antagonizing their child with accusations, Sara Swanson's mother, Michelle Swanson, can testify that discovering the truth and following through should take precedence. "I was scared to death that Sara would hate me for confronting her and accusing her of using drugs," she says, "but I was more afraid of finding out one day that she was dead. I wanted to be my daughter's best friend, but at that critical time in her life, I had to be the parent."
"They were willing to listen to what I had to say and decide on the right consequence," remembers Sara, who says she benefited much more from the counseling and treatment her parents got her than she might have from stern lectures and grounding: "If they had shut me in my room, I'd have been so much more depressed than I was."
Several months into Evan Rokoszak's jail sentence, his Facebook page, strewn with postings, was a virtual memorial to him and his former life. "[Everything] is so different without you, we all miss you so much," reads one post. And, apparently without irony, "What doesn't kill you, will only make you stronger."
Drugs didn't kill Sara Swanson — but she has a different take on what's helped her grow stronger. "When my parents intervened, I hated them for ruining my fun, but I respect them 20 times more now that I can think clearly," she says. "They were there for me when I needed them. If they hadn't figured out what was going on with me and spoken up, or if they just turned their heads, I would probably be dead right now."
Prescription pills are cheap, easy to explain, and even easier to score. But kids don't even realize how deadly their new drugs of choice can be.
It was just after dawn on one of those hot, sticky July days when the sun doesn't rise so much as slide up slowly like an egg poached by the humidity. Minutes earlier, a small platoon of police officers had eased their cruisers onto the side streets of Whippany, a prim New Jersey suburb. They drove past rows of vinyl-sided McMansions with fake-brick facades and matching Palladian windows, past Sports Authority basketball hoops and sleeping Audis and SUVs. Then, just like their cohorts from several other nearby towns, they parked and waited, the sweat trickling down under their Kevlar vests. More than 200 officers, each linked by radio to the task force headquarters, stopped at all-but-identical houses across three counties, pumped with the kind of adrenaline rush that comes from being part of a major takedown.
Less than an hour later, more than 50 kids and young adults with bed head, in T-shirts and flip-flops — many just roused by their shocked parents telling them that the police were at the door — stumbled into the central command unit to be processed. Among their number were recent graduates, star athletes, an actress in a school play, their wrists secured behind their backs with plastic handcuffs, just like they'd seen on Law & Order reruns.
At the center of it all was a baby-faced 18-year-old with gelled-back hair who was one class shy of graduation at Whippany Park High School. One of Evan Rokoszak's friends describes him as "sweet, goofy, and fun to be around." But for months leading up to that sweaty day in 2006, the police (later joined by the prosecutor's office in Operation Painkiller) had been investigating Rokoszak along with the students and recent grads involved in the drug ring he ran, which distributed and sold more than $50,000 of the prescription painkiller oxycodone each month — mostly to other students and alumni.
Almost daily, officers in Whippany had scanned the increasingly complex board at HQ that mapped out the key players in the business, praying that their own children's names wouldn't appear. Considering drug use was so rampant in the school that kids called it Whippany Perc (after the popular painkiller Percocet), how many students could remain untouched? "Everyone at school knew you could get pills from Evan if you were good friends with him," recalls a 2007 graduate who had attended school with the dealer for years. "Suddenly, everyone was good friends with him."
Statistically, too, the officers had reason to worry. Although high school drug use is down across the country, in the past 10 years the rate of prescription drug abuse among teens has risen steadily. Nearly one in five — 4.5 million — admits to abusing medications not prescribed to him or her, reported the 2005 Partnership Attitude Tracking Study conducted by the Partnership for a Drug-Free America.
In December 2007, at a sentencing related to the bust, New Jersey State Superior Court Presiding Criminal Judge Thomas V. Manahan in Morris County described the Whippany teens' activities as "a large-scale drug distribution syndicate," adding that the abuse of prescription drugs "is not so much a plague on our society as a cancer that continues to grow." Rokoszak's family spearheaded a letter-writing campaign to plead for leniency — because the teen, as they put it, "is remorseful and has turned his life around" — but the 30-odd letters were of no avail: In February 2008, Judge Manahan sentenced Rokoszak to seven years in state prison (he must serve a minimum of five). Hearing the decision, his mother broke down, sobbing, "Oh, my baby, my baby."
Schools throughout the country have problems just like Whippany Park's. The difference is that there the authorities took action. But law-enforcement officials elsewhere are catching on, too. Seven youths, two still in high school, were recently arrested in Merrimack, NH, on charges of distributing the prescription painkillers Vicodin and Klonopin, as well as marijuana, to other high school students. In May, 75 students at San Diego State University were arrested in a massive bust where police confiscated vast quantities of illegal and prescription drugs, weapons, and $60,000 in cash. Among the coeds picked up: a criminal-justice major and a homeland-security grad student. Perhaps most disturbing, in February, 14 students at Castle View High School and Castle Rock Middle School in Colorado — one of them a 13-year-old seventh grader — were caught using or distributing Vicodin and oxycodone, acts which would be felonies if adults committed them.
None of these arrests surprises the experts. Pharmaceutical abuse has become so commonplace that it has filtered down to younger kids: Prescription drugs are now the number one illicit drug among 12- to 13-year-olds, according to the 2006 National Survey on Drug Use and Health. And their own kid's arrest or even conviction is not the worst thing parents have to fear from this epidemic.
Pretty Pills, and Deadly
Adults think of prescription drugs purely as medicine, but kids have come up with ways to create effects similar to what they'd experience from street dope — from crushing pills to circumvent timed-release controls to doubling or tripling dosages or simply downing handfuls. What's more, if parents are in the dark regarding these drugs' potential for abuse, they're also often blind to how deadly they can be.
"As a mother, I was worried about cocaine, crystal meth, and drinking and driving — but I had no idea prescription drugs were an issue," says Francine Haight, an R.N. who lives near Laguna Beach, CA. In the winter of 2001, her son Ryan, an A student and star tennis player, was looking forward to starting college later that year. So she suspected nothing that February evening when he arrived home from his job in the plant nursery of a big-box store. He spent some time in their Jacuzzi, then went upstairs to bed. The next afternoon, when Ryan still hadn't gotten up, his mother went into his bedroom to check on him. He was dead, from an accidental overdose of Vicodin, Valium, and a trace of morphine. He'd been prescribed these drugs over the Internet by a doctor he'd never met; the prescriptions had been filled online by a pharmacist he'd never seen. "He didn't understand the dangers," Haight says. "He knew everyone had pills like these, so he figured they couldn't be dangerous. The doctor wouldn't prescribe them for you, and the pharmacist wouldn't give them to you, if they could kill you, right?"
Accidental-poisoning deaths among youths ages 15 to 24 increased 113 percent between 1999 and 2004, mostly due to prescription- and illegal-drug abuse, reports the Centers for Disease Control and Prevention. Upping overdose risks: Four out of 10 teens believe that prescription meds are much safer to use than illegal drugs — even when they are not prescribed by a doctor. What's more, nearly three out of 10 teens think these drugs are not addictive, according to the Partnership study. Kids trust prescription drugs because they're mass-produced, FDA-approved, familiar medicines. Even the nicknames teens give them — "jif," "Z-bar," "cotton" — suggest childhood treats and comfort food.
"I've heard many kids say, 'I'm not doing hard drugs. I wouldn't use heroin,'" says Troy Faddis, a licensed marriage and family therapist and the clinical director of the Aspen Achievement Academy, a wilderness recovery program in Loa, UT. "But opiates like OxyContin are the pharmaceutical equivalent of heroin."
"Your brain doesn't know if the high came from heroin or an opiate pill," agrees Roger Weiss, M.D., a professor of psychiatry at Harvard and the clinical director of the Alcohol and Drug Abuse Treatment Program at McLean Hospital in Belmont, MA. "Some teens who experiment with these drugs never use them again. Some try them and don't start using heroin but do get addicted to the prescription opiate. And some get physically dependent and progress to heroin. You don't know how you'll react." Like adults, kids can build up a tolerance to these drugs, and crave them in ever-greater quantities. And teens' common practice of mixing prescription pills together, or with alcohol, street drugs, or OTC products like cough syrup, increases the risk exponentially. "Combining creates a greater chance of accident or overdose," explains Dr. Weiss. "Kids are more likely to fall out of a window or to walk in front of a car because they're more intoxicated."
Easy Access
Teens often don't even have to leave home to get their first taste of prescription drug highs, points out Joshua Lyon, 33, author of the forthcoming book Pill Head, a chronicle of several teens' and young adults' struggle with prescription-painkiller addiction, as well as his own. "It's not like most parents are keeping unused marijuana or cocaine in the medicine cabinet," he says, but they often have old pills they don't keep track of. More than three in five teens say prescription pain relievers are easy to get from their parents' medicine chests; half say they're a snap to obtain through other people's prescriptions; and more than half say pain relievers are available everywhere, according to the Partnership study.
Case in point: Sara Swanson, who grew up in suburban St. Paul, MN, the daughter of two recovering alcoholics. "My parents always warned me about alcohol abuse," explains Swanson, "but my mom had back problems and never dreamed I'd take her muscle relaxants." Swanson moved on from her mother's pills to other drugs, trading cigarettes to her friends for their Adderall. "I loved the pills, and they were so easy to get," she says. "I'd look at the recommended dose and then double it."
Swanson, 18, has just graduated from Sobriety High School, a charter school in Edina, MN, attended by 60 students recovering from addiction through 12-step programs. But it took a failed suicide attempt — waking up to find friends asking her why she'd purposely tried to overdose — to make her realize she needed help.
In addition to "borrowing" from relatives and bartering with friends, hooked kids often get their fix by buying from dealers — both teens like Rokoszak and career criminals with a history of distribution. Those dealers, as well as more enterprising kids, may fill their supplies by using falsified prescriptions on- or off-line, by visiting multiple doctors and going to pharmacies with legal prescriptions, or by out-and-out theft from drugstores or homes.
Thanks to Francine Haight, however, Internet drug dealers should soon have a tougher time selling to kids. "For three years after Ryan died, I was in shock and could hardly function," she says. Despite her grief, she made the effort to speak out at colleges around the country and at a drug-awareness symposium for the DEA, and she founded the drug-awareness organization Ryan's Cause: Reaching Youths Abusing Narcotics (ryanscause.org). In April, the Senate passed the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, which forbids U.S. online pharmacies to supply controlled substances to anyone without a valid prescription from a doctor he's met with at least once. "Unfortunately, Ryan's story is just one of many. We know of at least 18 people who have died due to overdoses from drugs purchased on the Internet through rogue pharmacies, and even more who have entered rehabilitation or suffered injuries due to these drugs," says Senator Dianne Feinstein, Democrat of California, a sponsor of the bill, which was working its way through the House of Representatives at press time.
Everyday Abuse
Easy availability, combined with kids' misperceptions of prescription drug safety, may explain why pill popping has become so accepted as part of the weed-and-alcohol culture of high school parties. "I don't think it's bad. There's no particular reason I didn't do [prescription drugs]," says one recent Whippany Park graduate who was friends with several of the arrested kids. "It's not any worse than drinking or smoking pot. Yes, it's illegal, but taking pills doesn't make you a bad person by any means." The Partnership study found nearly one-third of teens (7.3 million) agree that there's "nothing wrong" with using prescription drugs without a prescription once in a while.
The ways kids are taking the drugs now underscores this relaxed attitude. "We're finding that teens are no longer holding exclusive 'pharm parties,' where they'd get together and bring all the pills they could find, the way they did in years past," says the Aspen Achievement Academy's Faddis. Instead, they take them throughout the day, as a routine part of life. "School was really stressful, so kids would pop pills or snort Adderall during class to make it go faster," explains Anders Torgersen, 17, of Huntington Beach, CA. Torgersen asserts that when he was an athlete and top student at a strict private middle school, pressure to excel led him to start taking prescription drugs. "I loved Vicodin because it made me feel like God," he says. "If I punched a wall, I couldn't feel it. I had more power and confidence on the pills." He began dealing the meds in his freshman year of high school. He estimates that 70 percent of his schoolmates used drugs.
As Ryan Haight's and Torgersen's experiences suggest, any kid — even bright, motivated high achievers — can be lured by prescription drugs. But experts do see some common threads. "Many of our students have self-esteem issues. They start using the pills as a way of self-medicating for school or family problems and underlying depression and anxiety," says Faddis, who in 2007 performed a small but suggestive analysis of 37 kids in his program. He found that 34 of them had been evaluated to have parent-child relationship problems, such as serious breakdowns in communication and mutual respect. Other research indicates that using drugs can make kids feel more independent and grown-up. Teens who take alcohol or any kind of illegal drugs report feeling older than their real age, found a 2007 study from the University of Alberta in Edmonton. "One explanation: Kids are using drugs because they think of drug-taking as an adult behavior," says Kelly Arbeau, Ph.D., coauthor of the study. Torgersen, who just started his senior year this September at the Oakley School in Oakley, UT, an addiction-recovery high school, echoes Arbeau's analysis. "I was trying so hard to be independent. I thought I was mature," he says. "I wasn't."
Preventive Parenting
In September 2006, a few months after the Operation Painkiller bust and with a newfound awareness of their drug problem, the townspeople stationed police officers at Whippany Park and its sister school full-time to get to know the kids and keep an eye on their activities. A year later, the school district instituted a random-drug-screening policy, whereby kids are tested and, if the results are positive, parents are notified. The policy has been controversial among parents concerned for their kids' privacy, but anecdotal evidence suggests a reduction in abuse. "These measures have been a deterrent," says Sibila Dubac, guidance coordinator and substance-awareness coordinator for Whippany Park High School. "They've increased awareness and decreased incidents." She adds that kids are afraid of getting caught, and don't want to lose on-campus parking or extracurricular privileges.
Regardless of what measures schools take, however, primary responsibility for keeping kids drug-free remains with parents — and there are steps you can take to reduce your child's risks. "Parents need to talk about drugs with their kids, not just to them," says Haight. "You learn so much when you let them talk, and once they know you're receptive, they're not afraid to come to you." As for when and how to approach the topic, "there's no easy answer that will apply to all families," says Faddis. You know your child and what she responds to best. "But your attitude is important," he adds. "If you seem to be disciplining, rather than nurturing, she may just get defensive." You want your child to be safe — that's what you need to communicate to her. He recommends starting with something like, "I'm worried, because drugs are a big problem and anyone can be sucked in, especially if they have bad information. I don't want you to get hurt." Be brief (experts say that the effectiveness of the discussion falls off after the first few minutes); have this conversation more than once; and be honest — it's your conviction, as much as the facts, that will carry weight with your child. If you want a supplement to fill her in on the details, the DEA has an educational Website for teens on the topic of drug abuse: justthinktwice.com. In accessible language, the site covers all kinds of drugs, including controlled-substance prescription meds, and offers advice from peers, as well as links to where kids can find help.
Another critical step, says Pill Head author Lyon, is to remove temptation from your house. Though it may sound obvious, few parents take the precaution of locking up their prescriptions, noting on the bottles how many pills should be left in each — and checking them every two weeks. "If you buy a gun, you don't just keep it lying around," he points out. "You lock it up in a safety box." If your child takes a daily prescription, like Ritalin, keep the bottle yourself and give him only a day's worth of pills at a time. The Partnership for a Drug-Free America's Not in My House campaign suggests further that you dispose of any leftover pills by mixing them with kitty litter or coffee grounds to make them unpalatable, putting the mixture into an empty can or bag, and throwing it in the trash. (Flushing pills down the toilet can cause them to leach into the water supply.)
Finally, parents should watch for behavior change. "Signs could be alterations in your son's or daughter's sleep/wake cycle or mood patterns — or you might observe a new level of secretiveness and sneaking around," says Dr. Weiss. The specific indications can be as seemingly minor as your child copying song lyrics about drugs in her notebooks. "Granted, all of these things can occur normally during adolescence, and every kid is different," Dr. Weiss adds, "but parents tend to know their kids well — and when they are really changing."
Like Torgersen, whose grades barely dipped, many kids become functioning addicts, and even observant parents may miss or misinterpret what symptoms there are. When Francine Haight looks back on the last months of Ryan's life, she realizes that there were small clues: He was more quiet than usual, slept more, and started hanging out with friends she didn't like. At the time she rationalized that he was reacting to her divorce from his father, the death of their dog, school pressures, or his sister's leaving for college — anything but drugs. "I just didn't pick up on the signs," she says.
If you do suspect a problem, it's essential to address it with your child, say experts. Admittedly, this is easiest to do when you already have a strong, communicative relationship; if you don't, Faddis counsels bringing in outside help, like a therapist, right away. While parents may feel conflicted and worry about antagonizing their child with accusations, Sara Swanson's mother, Michelle Swanson, can testify that discovering the truth and following through should take precedence. "I was scared to death that Sara would hate me for confronting her and accusing her of using drugs," she says, "but I was more afraid of finding out one day that she was dead. I wanted to be my daughter's best friend, but at that critical time in her life, I had to be the parent."
"They were willing to listen to what I had to say and decide on the right consequence," remembers Sara, who says she benefited much more from the counseling and treatment her parents got her than she might have from stern lectures and grounding: "If they had shut me in my room, I'd have been so much more depressed than I was."
Several months into Evan Rokoszak's jail sentence, his Facebook page, strewn with postings, was a virtual memorial to him and his former life. "[Everything] is so different without you, we all miss you so much," reads one post. And, apparently without irony, "What doesn't kill you, will only make you stronger."
Drugs didn't kill Sara Swanson — but she has a different take on what's helped her grow stronger. "When my parents intervened, I hated them for ruining my fun, but I respect them 20 times more now that I can think clearly," she says. "They were there for me when I needed them. If they hadn't figured out what was going on with me and spoken up, or if they just turned their heads, I would probably be dead right now."
Teaching Your Child About Democracy
Future Voter
Before Election Day:
Tune in together. Analyze campaign ads on YouTube. Kids are skilled TV watchers. Ask them to identify an ad's message and decide whether or not it's fair.
Get out on the trail. If candidates speak nearby, take your kid. Or put up signs together in your neighborhood to show her how people can support a candidate.
Lead dinner discussions. Start with kid-friendly questions like "At what age should people be able to vote?" Also share your own stories of memorable elections during your lifetime.
On Election Day:
Take her to vote. Let her watch democracy in action. Seeing the booth will make it less intimidating when she first votes.
Explain why it works. Post-poll is a good time to discuss how elections make a nation strong. Point out that voting gives all citizens a chance to contribute.
Celebrate! Watch the returns or throw a party. The key is to inspire your voter-to-be.
First-Time Voter
Before Election Day:
Make sure she's registered. Deadlines vary, but in most states, she must sign up 30 days in advance. Find state-by-state guidelines and registration forms at declareyourself.com.
Help her decide where to vote. If she's away at college, she can cast an absentee ballot or register and vote there. That way, she will have a say in the government where she's living.
Respect her opinion. Discuss the issues, but let her decide. Don't expect her to be in lockstep with your politics.
On Election Day:
Remind her. Call, e-mail, or text her. It's not nagging; it's showing you care about her and you want to be sure her voice is heard.
Suggest going with a group. Voting as a family or with peers makes it a fun outing — and more likely she'll go.
Celebrate! Voting is a milestone, so have breakfast out afterward, or send a congratulatory card or e-mail.
Before Election Day:
Tune in together. Analyze campaign ads on YouTube. Kids are skilled TV watchers. Ask them to identify an ad's message and decide whether or not it's fair.
Get out on the trail. If candidates speak nearby, take your kid. Or put up signs together in your neighborhood to show her how people can support a candidate.
Lead dinner discussions. Start with kid-friendly questions like "At what age should people be able to vote?" Also share your own stories of memorable elections during your lifetime.
On Election Day:
Take her to vote. Let her watch democracy in action. Seeing the booth will make it less intimidating when she first votes.
Explain why it works. Post-poll is a good time to discuss how elections make a nation strong. Point out that voting gives all citizens a chance to contribute.
Celebrate! Watch the returns or throw a party. The key is to inspire your voter-to-be.
First-Time Voter
Before Election Day:
Make sure she's registered. Deadlines vary, but in most states, she must sign up 30 days in advance. Find state-by-state guidelines and registration forms at declareyourself.com.
Help her decide where to vote. If she's away at college, she can cast an absentee ballot or register and vote there. That way, she will have a say in the government where she's living.
Respect her opinion. Discuss the issues, but let her decide. Don't expect her to be in lockstep with your politics.
On Election Day:
Remind her. Call, e-mail, or text her. It's not nagging; it's showing you care about her and you want to be sure her voice is heard.
Suggest going with a group. Voting as a family or with peers makes it a fun outing — and more likely she'll go.
Celebrate! Voting is a milestone, so have breakfast out afterward, or send a congratulatory card or e-mail.
Tuesday, November 4, 2008
Getting the Message Across
While there's no one-size-fits-all approach, there are ways to get your kids' attention and cooperation -- no matter how much he may grumble.
Play the independence card. Nobody loves being told what to do -- especially teens. Knowing they can handle themselves without someone directing them is very motivating." When you suggest a lesson, say to your teen or tween, "I'd like to show you how to cook a few dishes [or other life skill], so you can take care of yourself when you're on your own."
Talk about safety. Every once in a while things go wrong; it makes sense to address life's realities. Say: "Stuff happens. To be safe, you need to know what to do in case of a power outage [flat tire, etc.]."
Be matter-of-fact. When teaching even the simplest skill, make sure your tone isn't condescending. Also try to explain the benefits of doing something a certain way. Try, "Separate the dark clothes from the light before washing or you'll end up with gray underwear."
Get specific. Break the job into small steps and work with your teen for a few lessons until he knows what he's doing. Be very explicit about what you expect: "The lawn mower gas can has to be recapped and put back in the garage, not left on the lawn." Compliment all efforts.
Look for an opening. When your kids complain "Chicken again?" have them plan a meal, including putting the ingredients on the shopping list, and prepare it with your help. Assign each kid a day of the week to fix dinner. Or at bill-paying time, have them write the checks for you to sign, as practice for when they have their own account.
Ask what they'd like to learn. You'll get nowhere trying to force-feed your ideas to an uninterested child. Instead, start with something he wants to master, then build from there. For example, say, "Now that you've conquered your favorite pasta dish, how about meatballs or turkey burgers?"
Appeal to the ego. Have your son teach you something, like how to download material to your new iPod. In the glow of his success, he may be more open to listening when you bring up money management.
Time the lessons. If he's a morning grouch, don't suggest a new skill at the breakfast table. Don't try to recruit her as your sous-chef while she's watching her favorite TV show. Likewise, the teen who has daily swim team practices may be more receptive on the weekend than during the week.
Know when to back off. Nobody likes to be micromanaged. Similarly, don't impose arbitrary standards. Your vision of clean, sorted, and folded laundry may not match his. When kids view things as a parent's personal taste, they feel less obliged to comply. As long as he's made a reasonable attempt, let it go. If he doesn't care whether his socks are paired, so be it.
Highlight what's in it for her. Point out that if she makes her lunch, she gets to choose what she eats. Or if she learns to make lasagna, you'll reward her by helping pay for a dinner party for her friends.
Play the independence card. Nobody loves being told what to do -- especially teens. Knowing they can handle themselves without someone directing them is very motivating." When you suggest a lesson, say to your teen or tween, "I'd like to show you how to cook a few dishes [or other life skill], so you can take care of yourself when you're on your own."
Talk about safety. Every once in a while things go wrong; it makes sense to address life's realities. Say: "Stuff happens. To be safe, you need to know what to do in case of a power outage [flat tire, etc.]."
Be matter-of-fact. When teaching even the simplest skill, make sure your tone isn't condescending. Also try to explain the benefits of doing something a certain way. Try, "Separate the dark clothes from the light before washing or you'll end up with gray underwear."
Get specific. Break the job into small steps and work with your teen for a few lessons until he knows what he's doing. Be very explicit about what you expect: "The lawn mower gas can has to be recapped and put back in the garage, not left on the lawn." Compliment all efforts.
Look for an opening. When your kids complain "Chicken again?" have them plan a meal, including putting the ingredients on the shopping list, and prepare it with your help. Assign each kid a day of the week to fix dinner. Or at bill-paying time, have them write the checks for you to sign, as practice for when they have their own account.
Ask what they'd like to learn. You'll get nowhere trying to force-feed your ideas to an uninterested child. Instead, start with something he wants to master, then build from there. For example, say, "Now that you've conquered your favorite pasta dish, how about meatballs or turkey burgers?"
Appeal to the ego. Have your son teach you something, like how to download material to your new iPod. In the glow of his success, he may be more open to listening when you bring up money management.
Time the lessons. If he's a morning grouch, don't suggest a new skill at the breakfast table. Don't try to recruit her as your sous-chef while she's watching her favorite TV show. Likewise, the teen who has daily swim team practices may be more receptive on the weekend than during the week.
Know when to back off. Nobody likes to be micromanaged. Similarly, don't impose arbitrary standards. Your vision of clean, sorted, and folded laundry may not match his. When kids view things as a parent's personal taste, they feel less obliged to comply. As long as he's made a reasonable attempt, let it go. If he doesn't care whether his socks are paired, so be it.
Highlight what's in it for her. Point out that if she makes her lunch, she gets to choose what she eats. Or if she learns to make lasagna, you'll reward her by helping pay for a dinner party for her friends.
Basic Training: Teaching Kids Responsibility
Kids who can handle everyday tasks are happier and more confident. It's never too late to start teaching them what they should know.
What Kids Need to Know
Print this list and keep it where you can refer to it often. When your tween or teen learns a new skill, give yourself a pat on the back, too (for your good parenting and because you'll have fewer things on your to-do list). As your child learns, you get the satisfaction of watching her mature into the competent person you always hoped she'd be.
Food
Use microwave
Plan and shop for a healthy diet
Read nutrition labels and know what's good and what's not
Prepare, serve, and store food to avoid spoilage
Cook a well-balanced meal
Know which kitchen tools and equipment to use for which tasks
Money
Make a weekly or monthly budget and stick to it
Use an ATM
Open, use, and balance a checking account
Apply for a credit card and use it responsibly
Save up to buy a desired item
Set aside money for charity
Keep track of important papers
Clothes
Sew on a button
Mend a seam
Store garments properly
Follow fabric-care labels
Do laundry, including treating simple stains
Wash and dry items by hand
Fold clothes
Pack a suitcase
Sort and properly put away unneeded seasonal items
House
Know where the circuit breaker is and how to use it
Locate and use water and furnace shutoffs
What to do in case of kitchen fire
Use a fire extinguisher
Perform basic first aid
Fix a running toilet
Hang a picture
Use all household appliances
Car
Pump gas
Check oil level and add oil if needed
Check washer fluid and add more if necessary
Arrange routine maintenance
Jump-start car
Change tire
Check and add air to tires
Produce documents if stopped by police
What Kids Need to Know
Print this list and keep it where you can refer to it often. When your tween or teen learns a new skill, give yourself a pat on the back, too (for your good parenting and because you'll have fewer things on your to-do list). As your child learns, you get the satisfaction of watching her mature into the competent person you always hoped she'd be.
Food
Use microwave
Plan and shop for a healthy diet
Read nutrition labels and know what's good and what's not
Prepare, serve, and store food to avoid spoilage
Cook a well-balanced meal
Know which kitchen tools and equipment to use for which tasks
Money
Make a weekly or monthly budget and stick to it
Use an ATM
Open, use, and balance a checking account
Apply for a credit card and use it responsibly
Save up to buy a desired item
Set aside money for charity
Keep track of important papers
Clothes
Sew on a button
Mend a seam
Store garments properly
Follow fabric-care labels
Do laundry, including treating simple stains
Wash and dry items by hand
Fold clothes
Pack a suitcase
Sort and properly put away unneeded seasonal items
House
Know where the circuit breaker is and how to use it
Locate and use water and furnace shutoffs
What to do in case of kitchen fire
Use a fire extinguisher
Perform basic first aid
Fix a running toilet
Hang a picture
Use all household appliances
Car
Pump gas
Check oil level and add oil if needed
Check washer fluid and add more if necessary
Arrange routine maintenance
Jump-start car
Change tire
Check and add air to tires
Produce documents if stopped by police
My son likes to share his problems, but then gets annoyed with my advice and rejects it. Can I be helpful without upsetting him?
When kids tell you things and then don't want your input, it's confusing and frustrating. But sometimes they just want to vent. The next time he unloads, say, "I'd like to help, but are you telling me this because you want me to just listen or do you want advice too? Either way is fine, but just let me know." Then sit back and let him tell you what he needs.
I saw explicit lyrics my 17-year-old and his friends wrote for their garage band. How can I get him to write about other things?
You can't force your son to change what he writes. What's more important is what you mean by explicit. If your son, for example, is describing his frustrations about school, politics, or other issues with graphic images and bad words, it's probably a healthy outlet for him (though you still want to know why those issues are bothering him). But if he's singing about sexually degrading themes or violence, you need to talk to him. In addition, ask an adult male he respects to explain that a true man doesn't express himself by demeaning anyone else.
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