Officials see shift in teen drug use toward ‘pharming’

Colin Mathews, the 15-year-old who died after taking an unconfirmed amount of OxyContin on March 28, was not the only one in his circle of friends misusing prescription medications.

From ‘friend’ entries on his MySpace page, it appears the pain killer morphine; attention deficit pills Adderall, Focalin and Dexedrine; and cough suppressant dextromethorphan, which can induce hallucinations in high doses, were all used recreationally among his peers.

Add to that list alcohol, marijuana, hallucinogenic mushrooms and accounts of being in “outerspace” and passed out “in a puddle of vomit,” and it’s clear that these teens were no strangers to experimentation.

Canary in the

coal mine?

While the death of a teen is nothing short of tragic, do the circumstances surrounding it hint at a larger problem islandwide?

By all accounts from Kaua‘i officials, prescription drugs fall far behind alcohol and marijuana among the top choices for teens. Nevertheless, “pharming,” or misusing pharmaceuticals to get high, is on the rise.

“The good news is we have a lot of children who do not experiment,” said county Anti-Drug Coordinator Theresa Koki. “The bad news, however, is that other teens show no fear when it comes to trying drugs.”

Koki said she’s heard of teens taking whatever is in the medicine cabinet — from pain pills to hormone therapy for menopause to antibiotics to Viagra. There’s even a trend of bringing a variety of medication to a party, laying it out on a table and choosing randomly, she said.

Some teens go one step further: crushing and mixing a variety of pills, then snorting the result, called “fairy dust.”

The National Institute on Drug Abuse has identified three classes of commonly abused prescription drugs: opioids, central nervous system depressants and stimulants.

Opioids such as OxyContin, Percocet, Vicodin and morphine are used to treat pain and are derived from the same source as heroin. Central nervous system depressants such as Valium and Xanax, treat anxiety and sleep disorders. And stimulants such as Dexedrine and Ritalin treat the sleep disorder narcolepsy and attention-deficit hyperactivity disorder.

Taken in high doses, stimulants can lead to compulsive use, paranoia, dangerously high body temperatures and irregular heartbeat.

Long-term use of opioids or central nervous system depressants can lead to physical dependence and addiction, as well as tolerance, according to the institute.

Dr. Gerald McKenna, founder and director of Kaua‘i outpatient treatment program Ke Ala Pono, says the shift in drug patterns toward painkillers carries a higher overdose-death risk than stimulants such as crystal meth or cocaine.

“You don’t overdose and die (with stimulants) the way you do with opiates,” he said. “There’s a disconnect generally with teens thinking drugs aren’t dangerous. They’re more careless about experimenting.”

Some of the latest drug trends go beyond pharmaceuticals to household products and over-the-counter medicines. “Dusting” involves sniffing gas from aerosol cans such as computer keyboard cleaner, whip cream or Axe body spray; “robing,” yet another fad, combines Robitussin cough medicine with Vicodin.

And both are happening on Kaua‘i, according to officials.

“We have a drug problem, that’s undeniable,” Assistant Police Chief Roy Asher said.

However, the Kaua‘i Police Department says pharming has not yet become a big enough issue to track.

Most of the department’s interface with drug use is linked to crimes such as burglary, assault and theft.

These continue to be primarily perpetrated by adults and in general are associated with alcohol, marijuana and meth — not prescription meds.

Vice Unit Lt. Eric Shibuya said he’s heard about OxyContin and ecstasy use among teens but hasn’t been able to verify it.

“All it takes is one incident to blow up the whole picture,” Shibuya said. “There may be 1 percent visible, but you find a lot more below the surface.”

Drug use persists, but alcohol is No. 1 choice

The most recent Kaua‘i-specific study on teen substance use, conducted by the Department of Health in 2003, found that 32, 36 and 47 percent of 10th-, 11th- and 12th-graders, respectively, had tried drugs in their lifetime.

Those figures dropped considerably when asked about recent usage: 12, 16 and 27 percent of 10th-, 11th- and 12th-graders reported using drugs in the past 30 days.

The statistics for specific drugs, including prescription sedatives or tranquilizers, was markedly lower. Some 3 percent of 10th-graders and roughly 4 percent of 11th- and 12th-grade students reported use in their lifetime; those numbers dropped to 1 percent for 10th- and 12th-graders and 2 percent for 11th-graders for use in the past 30 days.

Overwhelmingly, Kaua‘i officials agreed that alcohol and marijuana are still the “mainstays.”

According to the Hawai‘i Department of Health, 62 percent of Kaua‘i 10th-graders and 70 percent of 11th- and 12th-graders have used alcohol in their lifetime. Between 25 and 26 percent of 10th-, 11th- and 12th-graders had used alcohol during the previous month.

The study also revealed that almost 22 percent of Kaua‘i seniors had been drunk or high at school in the past year.

Three incidents involving alcohol at school functions last month suggests that use has not dramatically declined.

On April 26, Kapa‘a High School’s prom at the Princeville Hotel was cut short due to drunken behavior by a few students.

The weekend prior, a student was taken to the hospital for alcohol poisoning from St. Theresa’s School Carnival.

The weekend before that, a teen was taken to the hospital from Island School’s prom for what appeared to be “too much alcohol.” The teen, who is not an Island School student, was attending the event as a guest, according to the school.

National statistics affirm that Kaua‘i teen preferences — alcohol and marijuana being most popular, with a rise in prescription drugs — fall in line with the rest of the country.

Nationwide, prescription drug abuse among teens has remained steady, according to the 2007 “Monitoring the Future” survey conducted by the University of Michigan and sponsored by The National Institute on Drug Abuse.

The survey — which annually samples the behaviors, attitudes and values of approximately 50,000 eighth- through 12th-graders — showed that sedatives, tranquilizers and narcotics other than heroin such as OxyContin and Vicodin have increased in use outside of their legitimate medical intent.

“While most of the illicit drugs have shown considerable declines in use over the past decade or so, most prescription psychotherapeutic drugs did not,” the report states. “As a result, they have become a relatively more important part of the nation’s drug abuse problem.”

OxyContin abuse, for example, was slightly higher in 2007 than when it was first measured in 2002. At least one in every 20 high school seniors, or 5.3 percent, said they had tried the narcotic in the past year.

Over-the-counter cough and cold medication abuse also held steady in 2007 at 4, 5 and 6 percent in grades 8, 10, and 12, respectively.

“This problem of youth misuse of these over-the-counter medications does not seem to be getting worse, but there is little evidence yet of much improvement,” Lloyd Johnston, principal investigator of the study, said.

But for McKenna, who has devoted more than 20 years to addiction medicine, the newest fads and trends, though important, are just symptoms of the real issue behind teen drug use.

“The drugs keep changing, but the problem doesn’t change,” McKenna said. “The whole idea that we are an addictive society is the problem.”

• Blake Jones, business writer/assistant editor, can be reached at 245-3681 (ext. 251) or bjones@kauaipubco.com

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