The Killers in Your Medicine Cabinet

The Pills They Take
In 2009, high school seniors admitted to abusing these five commonly prescribed drugs.
Vicodin, 9.7%
OxyContin, 4.9%
Xanax, 3.6%
Valium, 1.9%
Klonopin, 1.5%

Lots and lots of kids. Nearly one in five teens has used prescription drugs to get high; one in ten high school seniors reports having abused a prescription drug in the past year. And that’s just what teens are willing to admit. They say they like the woozy, light-headed feeling that drugs like Vicodin, used in excess, can induce. “It takes everything away,” says Jack,* 17, from rural Maine.

“You don’t feel hurt; you don’t feel stress. Nothing bothers you.”

Accidental fatal drug overdoses have soared by 500 percent since 1990, and federal officials say prescription medications—primarily painkillers such as OxyContin, Vicodin, and methadone, all synthetic versions of opium—are largely to blame. According to the U.S. Centers for Disease Control and Prevention (CDC), opioid painkillers now cause more lethal overdoses than heroin and cocaine put together. Most alarming: The rate of fatal overdose among 15- to 24-year-olds has spiked 300 percent in recent years. Young people simply don’t understand that even legal prescription drugs have a “wild-card factor,” says Thomas Andrew, MD, New Hampshire’s chief medical examiner. Methadone, the biggest prescription drug killer in New Hampshire, kicks in slowly, then lingers at full strength. That long “half-life” is dangerous for anyone not used to the drug, Dr. Andrew says. “They’ll take 40 milligrams, which is a big dose, and a little while later, they’ll say, ‘I’m really disappointed. I thought I’d get a buzz on from this. I’m just going to take another 40.’

“But by the time the full 80 milligrams kicks in, it’s not going to make them feel the way they want to feel,” Dr. Andrew says. “It’s going to stop their respiration.”

Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA), is most worried by the growing trend among teens of sampling a variety of prescription drugs and then drinking alcohol. “Kids are not pharmacologists,” she says. “They may say, ‘Fentanyl, OxyContin—what’s the difference?’ So they take a bunch of things and may combine them with alcohol.”

That’s a deadly miscalculation, Dr. Volkow says. The amount of opioid painkiller needed to induce euphoria is already frighteningly close to the amount that can kill you. That margin virtually disappears if you add alcohol or tranquilizers like Klonopin, Valium, and Xanax, which also depress the brain’s respiratory center. One 40 mg methadone pill, washed down with two gin and tonics, can be fatal. Says Dr. Volkow, “You are playing a game of Russian roulette you do not understand.”

“People think of drugs as coming into the United States from another country,” says David Pavlik, a senior intelligence analyst at the Justice Department’s National Drug Intelligence Center. “But increasingly, these drugs are coming from inside our own medicine cabinets.”

Americans used to grab an aspirin for a sore back or a toothache. Now we’re much more likely to select from an array of leftover prescription painkillers on our bathroom shelves, says Dr. Volkow. Doctors write 180 million prescriptions for opioids every year, a fourfold increase in the past 20 years, she says. (The CDC, using a different calculation, cites a tenfold spike since 1995.)

Why so many opioid prescriptions? Experts say that after years of undermedicating pain, even for cancer patients, doctors now understand that pain thwarts the healing process. “Now people don’t fear cancer as much as they used to, because of opioids,” explains Seddon Savage, MD, a New Hampshire anesthesiologist and an addiction expert, who is president of the American Pain Society.

But the pendulum may have swung too far. Many opioid prescriptions are written to ward off discomfort from minor medical procedures, Dr. Volkow says. Half of those pills don’t get used.

Even children barely into adolescence are routinely prescribed powerful painkillers. Dr. Volkow was astonished when she took the helm at NIDA seven years ago and saw the statistics: Painkillers like OxyContin, Percocet, and Vicodin are now the most commonly abused pills among 12- to 13-year-olds.

“It just blew my mind,” she says. “Adolescents are being prescribed opioids by dentists and oral surgeons. They’re sent home after molar extraction with many more pills than they need.” In fact, a recent NIDA study found that 30 percent of teen prescription drug abusers have a doctor’s prescription for their medication.

Of course, teens get hurt just like adults do, and opioids relieve their pain. But doctors sometimes prescribe pills for too long or lose track of how many their young patients are taking. Greg,* 18, a high school athlete in rural Maine, got a prescription for Vicodin after he tore a rotator cuff in his sophomore year. He started by taking one pill a day, but at a party, he heard that Vicodin was an easy high. Soon he was taking four or five pills a day. Greg’s doctor, unaware that he had gotten hooked, renewed the prescription for two years.

Greg ultimately stopped taking Vicodin cold turkey and suffered through a harrowing week of withdrawal. Now he has strong advice for parents. “If your son or daughter is prescribed Vicodin, you should be watching the pills,” he says. “You should count them. Because some kids will take five or six in an hour.”

Even if you don’t have a prescription, pills aren’t hard to find. More than three out of five teens say that prescription pain relievers are easy to pilfer from the family bathroom, according to a recent survey by the Partnership for a Drug-Free America.

“Kids will text their friends,” says Jeff Upton, a police officer stationed in South Berwick’s Marshwood High School. “‘I’m at my grandma’s house. I can snag a few Oxys from her hip surgery.’ ‘My buddy’s brother has a prescription for Ritalin.’”

Medicine cabinet empty? Not a problem. “It’s way easier to buy pills than beer,” says Jack, the 17-year-old from rural Maine. “Beer, you have to buy from somebody who’s 21, and the store has to be open.” At school, pills can be exchanged for money in a handshake or by swapping jackets. You don’t need a pipe, rolling papers, or even a match. “It’s just one small white pill,” Greg says. “A lot of kids do it for the convenience.”

Another advantage: An opioid high isn’t immediately detectable. “If a kid has just smoked marijuana, I can smell it,” Upton says. “If he drank alcohol, I can smell it. If he takes some prescription drugs—I won’t know it.”

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