Abuse of prescription drugs skyrockets in U.S.

Pharmaceuticals available readily over the Internet

October 26, 2003|By Judith Graham and Michael Higgins | Judith Graham and Michael Higgins,CHICAGO TRIBUNE

CHICAGO - At colleges across the country, students are taking pills they've sneaked from home, tossing them into bowls and swallowing handfuls with a chug of beer or a sip of a margarita.

It's called "pharming," for the pharmaceuticals ingested.

In office towers, workers sitting at computers are barraged by spam e-mails offering prescription drugs at low prices, no prescription required.

"No physical exam," promises one widely circulated message for painkillers, stimulants, tranquilizers and anti-depressants.

The face of drug addiction is changing in America, from cocaine or heroin addicts snorting or shooting up to teen-agers and grandmothers popping pills purchased at the local pharmacy or delivered through the mail in plain packages.

Radio personality Rush Limbaugh turned a spotlight on the epidemic this month when he admitted being hooked on prescription painkillers and told his audience he planned to get help.

Prescription drug abuse is the fastest-growing type of substance abuse in the United States, a phenomenon fed by aggressive drug marketing, Americans' habit of taking pills for any ailment, physicians' tendency to over-prescribe, and the Internet, which is expanding the availability of drugs exponentially.

About 6.2 million Americans, including disproportionately high numbers of the young and the aged, abuse prescription drugs, according to government data released last month.

In 2001, 2.4 million people started abusing pain relievers - the drugs Limbaugh has been accused of asking his housekeeper to buy for him - almost four times as many as the 628,000 reported as abusers in 1990, according to the U.S. Substance Abuse and Mental Health Services Administration.

The problem of prescription-drug misuse is so acute that parents might need to start locking their medicine cabinets, just as liquor cabinets were locked decades ago to keep out children, said Joseph Califano, president of the National Center on Addiction and Substance Abuse at Columbia University.

For many people, popping pills might appear to be a more sanitized, less stigmatized way to get relief from stress. Instead of dealers on mean streets, frequent sources are doctors duped by patients or pharmacies responding to call-ins for fake prescription refills.

Califano, a former U.S. Cabinet secretary, quoted figures from last year for legal prescriptions in the United States: 153 million for narcotics, such as Vicodin, Percocet or OxyContin; 53 million for tranquilizers such as Xanax or Valium; 23.5 million for stimulants such as Adderal or Ritalin; and 5 million for sedatives such as Soma.

On top of that is an unknown quantity of counterfeit prescription drugs streaming into the country through the Internet and other sources, often of unknown quality and diverted to the underground market.

At least 2,000 Web sites now sell prescription drugs, the Food and Drug Administration estimates.

Traditionally, investigators have looked for geographic "clusters" of drug-related problems - such as admissions to emergency rooms or to jails - to identify physicians who might be over-prescribing, buyers who might be doctor-shopping and other drug schemes. With the Internet, though, clusters aren't readily detectable.

Last week the FDA and the Drug Enforcement Administration formed a task force that will aggressively pursue outfits that market prescription drugs illegally over the Internet. Doctors who prescribe drugs over the Internet based only on customers' answers to e-mail questionnaires also might be targeted.

While some Web-based outfits are legitimate - filling prescriptions written by patients' doctors online for a reduced price - many are rogue pharmacies, offering to be both doctor and drug salesman to anyone with a credit card. They're typically secretive, rarely listing their full corporate names, business addresses or the names of doctors and pharmacists they employ.

Many are based in foreign countries. Most require only that the shopper fill out a short online questionnaire and provide no oversight of often dangerously addictive drugs.

"Basically, you can get as much as you want of anything if you know how to do it," said Dr. Daniel Angres, director of Rush Behavioral Health, a treatment program with several sites in the Chicago area. "None of us wants to think about it in terms of where it might go."

The Chicago Tribune is a Tribune Publishing newspaper.

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