Growing concern over abuse of perscription narcotics by youth

M. McKinnon
Atikokan Progress

Concern is increasing about young people here using prescription medicines as recreational drugs.
The evidence is both statistical and anecdotal, and suggests that abuse of powerful prescription medications here by young people is higher than in other parts of the province.
“I am afraid we are going to lose a kid,” said public health nurse Eva Shields. “We need to make sure that people understand it’s not the same at all [as when we were younger]. This stuff is so different, so much more dangerous, than what we were exposed to... This isn’t about rolling a joint.”
Hugh Dennis, of the Substance Abuse Prevention Team, said an informal survey he conducted in grade 10 classes during safety (as opposed to ‘just say no’) presentations suggested 40% of them had seen a friend use Oxycontin (a brand name for the drug oxycodone, a powerful opiate-based pain reliever).
That’s not to suggest anything like 40% are using these drugs - in a small community a few users can be friends to many - but it does indicate prescription drug abuse is happening here. And it is consistent with the findings of the most recent Ontario Student Drug Use Survey (2005). It’s an anonymous survey, and the most reliable estimate of drug use among teens. It put Oxycontin use among teens at 1% province-wide - but 4.5% in Northwestern Ontario. In 2005.
Dennis was also part of a series of presentations in Dryden, by the Mayor’s Committee on Drug Abuse, to students from grades 7 through 12. He, along with a narcotics officer and the head of the needle exchange program for the Northwest, a recovering addict, covered the full gamut of abused drugs (both the ‘street’ variety, and illegally obtained prescription drugs).
“There wasn’t one thing we talked about that the kids weren’t aware of,” he said. He wants parents to understand that “the age when kids start to experiment is down to grade five and six now, and that there are already regular users in grades seven and eight.”
OPP Insp. John Kendrick, expressed similar concerns in a presentation to Council on July 20 (although he also noted “alcohol remains the number one drug being abused.”)
“Basically, these drugs are coming from our medicine cabinets,” he said. “A single, high dose pill can sell on the street for $80.”
We also spoke with a recovering addict - now in the methadone program here - who told us his addiction started with a prescription for Oxycontin. He was also, for a time, part of the drug scene here, and told us prescription drugs were readily available in Atikokan. And, he added, he had been offered cash for his methadone, by youngsters (ages 13 or 14) he didn’t even know.
The problem has prompted a number of agencies to band together to form an opiate task force to tackle the problem from three perspectives - education and prevention, enforcement and treatment.
Oxy
Oxycodone - the active ingredient in Oxycontin, Percocet, Percodan, and some other prescription pain relief medications - is an opioid analgesic medication synthesized from opium-derived thebaine.
When taken normally, Oxycontin is a time-release drug that gradually releases oxycodone over about 12 hours. But abusers will crush it or chew it, and thereby destroy its time-release properties, to get the full effect of all the oxycodone at once (the high, or rush).
Oxycontin is commonly prescribed in doses ranging from 10 milligrams per pill to 80 mg per pill. On the street, pills generally sell for about a dollar a milligram.
Percocet, Percodan and other prescription forms of oxycodone contain smaller doses of oxycodone, combined with other drugs (such as acetaminophen in Percocet) that will make the user sick if the pill is taken in high doses.
Oxycodone has the addictive properties of all opioids, and prescription users usually have to be weaned off the drug. Taking it regularly to get high can quickly lead to addiction. As the brain adjusts to the drug, larger doses are required to get high, and soon even large doses provide less and less pleasure. At some point - it varies from person to person - withdrawal will set in without the drug.
“People just don’t realize how fast you can get addicted. I started with a prescription, and went into withdrawal [when it ran out],” said the recovering addict.
“What I see going on now scares me…. 14 and 15 year olds taking whatever, snorting a mix of medications - heart medications, muscle relaxants. It’s the same when you buy it, though. You never really know what you are getting.”
In high doses, overdoses, or in patients not tolerant to opiates, oxycodone can cause shallow breathing, bradycardia (lowered heart rate), cold, clammy skin, apnea (breathing failure), hypotension (abnormally low blood pressure), pupil constriction, circulatory collapse, respiratory arrest, and death.
The risk of overdosing increases if Oxycontin is taken with other drugs, including alcohol.
One of the key elements of the Substance Abuse Prevention Team’s safety presentations is to convince youth not to wait if someone has an adverse reaction after taking a drug. Passing out is an adverse reaction and is cause for calling 9-1-1 for emergency medical treatment.
“Kids will be afraid to call for help,” said Shields. “That’s the problem for teens - they are afraid to be the one to blow the whistle.”
But in the case of an opioid overdose - or even severe alcohol poisoning - getting help can be the difference between life and death.
Getting help
If you are concerned about your use of opioids or other drugs, talk to your doctor or to a nurse at the Northwestern Health Unit (597-6871). Your visit will be completely confidential. They will treat your use as a health issue, and will not report you to the police or parents. And they can provide real help.
The recovering addict we spoke with took a friend when he went to see the doctor three years ago. “I was so scared; I didn’t know how the doctor would react,” he said. “And he was great. I was surprised, even shocked, at how open to helping he was.”
Harming who?
One of the overriding myths users buy into is that their use of drugs hurts no one but themselves.
What that doesn’t take into consideration is: Where did the drugs come from?
In the case of prescription meds, they were most likely stolen. Insp. Kendrick said investigation into dealers generally leads to organized crimes. Dennis said another source was addicts who steal to fund their own habits - either to get the drugs directly, or to get other drugs, goods or cash they can sell to satisfy their need.
“In one case in the region, we had 76 break-ins in one area in two years. The drug users had targeted seniors, going for drugs and cash,” he said.

Methadone
Methadone acts on the same pleasure centres of the brain as opiates, without producing the high associated with opiates. It has become an effective treatment for opiate addicts, because it prevents withdrawal symptoms, and otherwise allows addicts to live a normal life.
In most people it is long-lasting - the body takes a longer to metabolize it than other opioids. This makes setting the proper dosage for a recovering addict difficult, and makes the drug especially dangerous on the street.
“The only reason to take it is to blunt the effects of withdrawal,” said pharmacist Earle Arnold. “It’s just not a useful drug, like the other narcotics, because there is no high.”
Methadone is extremely dangerous for someone searching for a high. That’s because they won’t get that high, and will take more. Or they will try other drugs in search of the high after taking the methadoen. But the methadone in their system will dull the effect of the other opiates, leading them to take more. Overdoses are the result, often lethal overdoses.
“It is just so dangerous as a street drug. When it’s out there on the street, people die. Period.” said Arnold.
“There are a lot of rules around [prescribed] methadone use, and everyone in the chain takes them all very seriously,” he continued. Prescription users are tested regularly for their use of other drugs, have to take their dose in the presence of others for quite a while when they start treatment, and are generally closely monitored for addictive behaviour and methadone side effects.
The treatment is far from easy - particularly in the early stages, as the correct dosage is being determined - and patients who succeed in kicking a drug habit with methadone have to be highly motivated. But it does work.
“People on methadone are completely changed,” said Arnold. “Once they are stabilized, you start to realize that [the person taking opiates] wasn’t them. Their need for the drug dominated their life - their whole life was about searching for and taking their drug. They didn’t have time or need for anything else.”
It’s ironic, and sad, to see a drug that has helped so many escape the destructive cycle of addiction has found its way onto the street, to foster more addiction.
“Methadone saved my life, got me back with my kids…. I’ve been clean for years,” the recovering addict told us. “This [seeing methadone being used as a street drug] is the worst part for me. It helped me, and now it’s become a negative.”
“People think methadone is like doing Percocets - snort it and get instant energy. But methadone isn’t like that - it doesn’t get you high, at all.”