Prescription drug abuse more than kids getting high: group

BOSTON (Reuters) - As state, federal and local authorities across the United States struggle to contain a rising tide of prescription-drug abuse, Reuters Boston Bureau Chief Jason Szep spoke with Stephen Pasierb, president and chief executive of the Partnership for a Drug-Free America, a non-profit advocacy group.

What follows are excerpts from the interview.

REUTERS: What prescription drugs are abused the most and how would you characterize the scale of the problem?

PASIERB: On the prescription side, there's a number of abused products or misused products, from the Attention Deficit things like Ritalin and Adderall on and on and on. But probably the most pernicious and most dangerous of all those are the prescription pain relievers. These are led by OxyContin and then the Percodan, Percocet and then followed up by Vicodin and all the hydrocodone generics.

A lot is said in this field about how this is a behavior simply of kids going out to get high. And we've always advanced the thesis that it's not that simple. And in fact we just completed some research about a month and a half ago which we did some Capital Hill briefings on, which really goes into this mindset that teenagers in particular have, where it's a much more purposeful behavior. They're quite sophisticated in their understanding of what these different drugs are. And while there is indeed a segment who simply use these as a new way to go out and get wrecked, there's an equal segment who are using them exactly for their intended purposes, but outside of a doctor's recommendation or prescription.

So, if you will, that college student who will tell you I am not a drug abuser, I am not a bad person. But if I can get Ritalin and Adderall to help me study, I'm going to do it. Because I have used it, and I get better grades on it'. So, to him or her, their experience is both very tactical and positive. So in the idea of trying to go tell them Well, that's bad', the results that this child has seen are exactly right and exactly in line so that they only see benefit.

And then you've got this other segment who are truly self medicating. They're either in pain, or they're depressed, or there's something going on in their life. And their misuse/abuse of prescription drugs has helped them manage their lives better. So, what is frequently thrown out there, particularly on the government side as prescription drug abuse, the new threat, is much more finesse than simply saying that. And we kind of layer on top of that, some additional attitudinal research we've done where if you look at both teenagers and young adults, and their parents, what you find is this kind of veil of safety and appropriateness around all of these products. You see the teenager saying it's a new and much safer way to get high, saying I wouldn't do illegal street drugs. You have no idea where those come from. But, heck, these are made in a sterile lab and they're FDA approved'. They see less risk in it.

We've also seen a scary number of websites where teenagers are saying that prescription pain relievers were not addictive. They're not like heroin'. Well, OxyContin is pharmaceutical heroin, there's really no difference between the two.

And so what you have for really the first time on the drug landscape in America is a kind of this shift from the host of agricultural products, what we call farming with a "f", marijuana, poppies, cocoa, to pharming with a "ph", this host of pharmaceutical products, from a wide range, which consumers are abusing and really see no downside, no stigma, I'm not a bad person, I'm not taking my health at risk'. None of the normal triggers that would play around substance abuse

REUTERS: How do you quantify the growth in this area?

PASIERB: Well what we know from the studies we've done, which kind of mirror some of the government ones, is we've got about 20 percent of teenagers who've admitted to abusing a prescription drug. And about 10 percent who have admitted to abusing over-the-counter cough medicine with the intent to get high. So you've got about a one in five, or one in ten level on each of those.

What we we're seeing in some of the studies was not a kind of entry-level behavior or a replacement behavior as in My drug abuse behavior started with prescription drugs, or I stopped smoking marijuana so I could do prescription drugs'. But these becoming a new tier in the ladder, if you will. Kids were always drawing a line between getting drunk and smoking marijuana, and then harder drugs. And that gap between those two was very wide. I would smoke marijuana, I wouldn't touch cocaine'. Prescription drugs have filled that gap. So, they've become a bridge.The government has done some studies that show that new initiates of prescription drug abuse are now outstripping new initiates of marijuana use. And so they assume gateway. But when you do the research, the deeper research among teenagers, what you find is they're already drug-experienced, particularly from a drinking, marijuana standpoint. And now this is helped them go a step further. And what we see is the kids who have abused prescription drugs saying now I would be willing to try cocaine because I like that stimulant affect'.

So that is in our mind becoming the new understanding of this issue, which is yet to be widely disseminated. There's the purposeful use, get high, get the intended effects for very tactical purposes, or self-medicate to manage my life'. And then this idea that this behavior lies in the middle of the substance abuse continuum, not at the front end.

REUTERS: What role does the pharmaceutical industry play in this? We've seen that Purdue Pharma LP, which makes the potent painkilling drug OxyContin, was sued in the past and settled last year over improper marketing of the drug. Do you think drug companies have learned a lesson on marketing?

PASIERB: I think they are learning it. There's a new controlled version of Vicodin coming out And the effort that Abbott Pharmaceuticals is putting in to making sure that everyone is trained, and they don't do it the wrong way, to me, has to be born out of all the mistakes that Perdue Pharma made. So you got that compare and contrast. But when you talk about the pharmaceutical industry, the pharmaceutical industry needs to be doing more in terms of the public. They need to be training their sales forces better. They need to be educating doctors differently. Most physicians, as great a physician as you are, in all of your medical schooling, you get somewhere around four hours on addiction. But yet you can go out and prescribe some of these really, really amazing drugs.

REUTERS: What's the best way for law enforcement to approach prescription drug abuse?

PASIERB: Pharmaceutical theft was an issue. But most kids are stealing it at home. OxyContin, when it was hot, when you looked at the Appalachian states, states like Maine, the law enforcement issue was a huge and there were a number of pharmacy robberies, and things like that. That's kind of crested. The larger problem is the kids stealing five of them from Grandma's house.