Prescription drugs: They're legal but still lethal

Editor's note: This story originally ran on April 8, 2002 as part of the Daily Herald's "Hidden Scourge: Heroin in the Suburbs" series.

Sequestered in her bedroom with her best friend, teenager Melissa Schieler sobbed uncontrollably.

Earlier that day, her mother refused to drive them to the mall. Schieler was furious.

She was so distraught over her mother's decision, she took eight times the dose of her prescription anti-depressant, thinking the resulting high would make her feel better.

In the middle of her tirade, which took place nearly two years ago, the Streamwood High School student stopped mid-sentence, staring into her friend's eyes, unable to speak.

Schieler can't recall the next few hours of her life as her body fought against the onslaught of medication she had dumped into her system. Family members told her she was convulsing as they rushed her to the hospital in what would be her first prescription drug overdose.

"When I was in a bad mood, I thought taking more would make me feel happier," said the now-19-year-old Schieler. "It was so stupid."

Schieler's experience is just another entry into the prescription drug abuse story that appears to be turning into a longer, darker and deadlier tale. Prescription drug abuse is on the rise, experts say, and people from all walks of life are doing the abusing, according to the National Institute on Drug Abuse, an arm of the National Institutes of Health in Bethesda, Md.

Later this month, Alex Grippo, a 20-year-old former Maine South High School football player, will be in court facing seven felony drug charges after police say they found "large quantities" of illegally obtained prescription medication at his Park Ridge home on Feb. 9. Police were called to the Grippo home that day after a 911 call alerted them to a Hanover Park resident Matthew Paull, 20, who fell asleep on a couch and died.

On the rise

NIDA's Community Epidemiology Work Group classifies prescription drugs as "emerging drugs" because of the increasing prevalence of abuse.

Based on the 1999 National Household Survey on Drug Abuse, about 9 million people age 12 and older used prescription drugs for non-medical reasons, with about 1.6 million of those abusing for the first time. The findings show a major increase from 1980s data, when there were fewer than 500,000 first-time users per year, according to the survey.

Incidences in emergency room visits because of overdose of the prescription pain reliever hydrocodone - considered the most widely abused prescription drug - increased from more than 6,000 in 1993 to more than 14,000 in 1999, according to NIDA.

Easier access, peer pressure and current drug trends are contributing to the rise of prescription drug abuse among teens and young adults, said Jack Stein, NIDA deputy director of the office of science policy and communications.

"It is not a new problem, but it is a growing problem that needs renewed interest," Stein said.

Drug enforcement agents are also seeing an increase in the number of prescription drug cases, according to an official at the U.S. Drug Enforcement Administration in Washington whose name could not be used for this article, as U.S. DEA policy dictates.

The supply comes from unscrupulous doctors and pharmacists, professional prescription drug thieves who break into labs, "doctor shoppers" who feign sicknesses and legitimately ill people who go to a number of doctors in an attempt to sell their extra supply.

Also, there are people working in prescription drug rings who "bust prescriptions" - obtain drugs through faked prescriptions to sell on the illicit drug market. In some cases, one pill can cost $80, rivaling other drugs such as heroin and cocaine in expense, the agent said.

Many people who abuse the drugs feel more comfortable abusing prescription drugs because of the exact dosage, purity and the fact that there is less stigma attached to them than other drugs like heroin or cocaine, he said.

Some fool themselves into believing these drugs are safer because they have been approved by the Food and Drug Administration, but they are just as deadly, he said.

"Lately, more young people are dying," the agent said. "And it ain't glamorous to die."

Park Ridge police don't know for sure that prescription drugs caused Paull's death, because toxicology reports are still pending. What they do know is that Paull and Grippo, who barely knew each other, started out the night before at the same party in another nearby suburb. Paull was one of a group of partygoers who ended up at about 2 a.m. at the home where Grippo lives with his parents, who were not home that night, police said. According to witnesses, Paull fell asleep on a couch shortly after he arrived at Grippo's home, police said.

At about 9 a.m. the next morning, a friend tried to wake Paull, but he was cold and unresponsive. The friend called 911. By the time paramedics arrived, Paull was unconscious and not breathing, police said. At 9:24 a.m., Paull was pronounced dead at Resurrection Hospital in Chicago. Paull was buried Feb. 15 in a Palatine cemetery.

Grippo is currently in an undisclosed drug rehabilitation center, awaiting his April 24 court date for seven counts of possession of a controlled substance, said his attorney, Jennifer Edlund. Grippo was not available to talk about what happened the night Paull died.

"Alex is in a program, and he is not supposed to be distracted," Edlund said.

In a visual screening, Park Ridge police found seven prescription drugs "in large amounts" in plain view in the home, reports indicated. Grippo did not have a prescription for any of them, so he faces the felony charges, said Park Ridge Police Chief Jeff Caudill.

Known to medical professionals as codeine, zolpidam, diazepam, lorazepam, alprazolam, clonazepam and temazapam, many of the drugs found in the Grippo home have well-known brand names: Valium, Xanax, Ativan and Klonopin.

Many of these prescription drugs are in the same chemical class called benzodiazepines - central nervous system depressants that are some of the most frequently abused prescription drugs because of their mind-altering abilities.

According to the U.S. Department of Justice, benzodiazepines are frequently associated with teens and young adults who are looking to obtain a high. It results in reduced inhibition and impaired judgement. Also, the use of alcohol or other depressants with benzodiazepines can be deadly.

"What happens is they take multiple things in different combinations - dangerous combinations," said Jason Leonard, psychologist at DePaul University and an expert on drug abuse.

Benzodiazepines are highly addictive depressants. Doctors prescribe them to patients for sedation, sleep induction, anxiety relief, muscle spasm reduction and seizure prevention.

In high doses, they act as hypnotics. If abused, benzodiazepines cause brain seizure ultimately resulting in death, Stein said.

"It creates major havoc on body systems, there is no doubt about that," Stein said. "Most kids don't think that far in advance that this could possibly happen to them."

Hitting bottom

Schieler's path down the road of drug abuse began after a doctor in August 2000 prescribed her Wellbutrin for depression.

Under a doctor's care for mood swings and uncontrollable outbursts of anger since she was 12, Schieler found being a teen at Streamwood High School difficult and considered dropping out, she said.

Wellbutrin, generally prescribed for depression, was supposed to alleviate her teenage anxieties. And for a while it did, making Schieler feel happy and upbeat.

Schieler figured taking a bigger dose would make her feel even more jubilant, giving her a "high."

"It made me feel happy and smiley," Schieler said. "I got addicted to the feeling."

She began hoarding her pills. Schieler was supposed to be taking one a day, but instead she'd hide them for a later time when she could take many times her regular dose, sometimes eight pills at once. "It was like being on a lot of coffee," Schieler said. "It was that giddy happiness when you're around your friends."

It was only after she had a second drug overdose in April 2001, her family again rushing to the hospital in an effort to save her life, did Schieler decide to stop.

"I saw what it did to my family and, that was a big thing for me." Schieler said. "I decided I didn't want to abuse prescription drugs anymore."

Profile of abuse

About the same time, NIDA researchers, so concerned about the increase in prescription drugs abuse, held a scientific forum in Washington, D.C., to launch an initiative to stem the abuse.

Research showed that the number of people who now abuse prescription drugs each year roughly equals the number who abuse cocaine - about 2 to 4 percent of the population, according to Howard Chilcoat of the Johns Hopkins University School of Public Health and Hygiene in Baltimore, who presented his finding at the drug forum. Whites are more likely than other racial or ethnic groups to abuse prescription drugs. Many people who abuse these drugs also have psychiatric disorders. Persons age 18 to 25 are more likely than persons in other age groups to begin abusing prescriptiondrugs. Also, girls ages 12 to 17 are more likely than boys to begin prescription drug abuse, according to Chilcoat's findings.

Abuse of benzodiazepines is particularly high among heroin and cocaine abusers. About 50 percent of people entering treatment for narcotic or cocaine addiction also report abusing benzodiazepines, according to U.S. Department of Justice statistics. Benzodiazepine withdrawal symptoms mirror those of alcohol, said Frank Gotthard, drug counselor at Renz Addiction Counseling Center in Elgin.

Most of the patients at the center for prescription drugs are people in their 30s who have overused drugs like Xanax and Valium. They start out legally obtaining the drug from a doctor, and they begin abusing it, not realizing how addictive these drugs are until it's too late, he said.

"They are not aware they are getting addicted," Gotthard said. "Then they start going to more than one doctor and pharmacist. There is no record they are getting too much."

While researchers are seeing more prescription drug abuse, no one knows exactly why it appears to be growing, Stein said.

Looking at drug trends over the past few decades, there aren't clear indicators why one drug is more popular at a particular time, Stein said.

Some drugs suddenly come "in vogue," and it is up to researchers and drug enforcers to be ahead of the curve, he said. Since prescription drugs are dispensed legally, abuse can be harder to prevent and spot than illicit drugs, Stein said. Also, medical professionals might not be properly trained to spot abusers, according to NIDA findings. According to a recent national survey of primary care physicians and patients regarding substance abuse, more than 46 percent of physicians reported that it was difficult to discuss prescription drug abuse with their patients, according to NIDAinformation.

Preventing abuse by teens involves many levels of responsibilities from doctors, pharmacists and parents, Stein said. "It has to be a big part of physician training," Stein said. "Parents have to take responsibility to track their pills, for they may be clandestinely absconded."

As for Schieler, she is no longer in charge of her pills. After her second overdose, she quit on her own, deciding she didn't want to go into a drug treatment program since she wasn't physically addicted to her pills. As a result, her mother dispenses her anti-depressant medication to Schieler, making sure she takes the correct dose, she said.

"It is not worth it," Schieler said. "You have to open your eyes on how it affects the environment around you."

GRAPHIC: How to avoid prescription drug addiction

- Before medication is prescribed, provide a complete medical history to the doctor and a description of the reason for the visit to ensure that the doctor understands the complaint and can prescribe appropriate medication.

- Follow the directions for use carefully and learn about the effects that the drug could have, especially if a doctor prescribes a pain medication, stimulant or central nervous system depressant.

- Be aware of potential interactions with other drugs by reading all information provided by the pharmacist.

- Do not increase or decrease doses or abruptly stop taking a prescription without consulting a health-care provider first.

- Do not increase the dose on your own.

- Never use another person's prescription.

Information provided by the National Institute on Drug Abuse

GRAPHIC: Commonly abused

Although many prescription drugs can be abused or misused, the National Institute on Drug Abuse identifies three classes of prescription drugs that are most commonly abused.

Opioids, which are most often prescribed to treat pain, relief of coughs and diarrhea.

- Drugs in this group include Oxycodone (OxyContin), Propoxyphene (Darvon), Hydrocodone (Vicodin) and Meperidine (Demerol).

- In the body, opioids attach to receptors in the brain and spinal cord, blocking the transmission of the pain message to the brain.

- Possible negative effects include severe respiratory depression or death following a large single dose.

- Should not be used with alcohol, antihistamines, barbiturates, benzodiazepines, general anesthetics

Central nervous system depressants, which are used to treat anxiety, tension, panic attacks, acute stress reactions and sleep disorders.

- Drugs in this class include Mephobarbital (Mebaral), Pentobarbital Sodium (Nembutal), Diazepam (Valium), Alprzolam (Xanaz) and Triazolam (Halcion).

- In the body, these drugs slow brain activity, and therefore produce a calming effect.

- Possible negative effects include seizures following a rebound in brain activity after reducing or discontinuing use.

- Should not be used with alcohol, prescription opioid pain medicines, some over-the-counter cold and allergy medications.

Stimulants, which are prescribed to treat the sleep disorder narcolepsy, attention-deficit hyperactivity disorder (ADHD) and obesity.

- Drugs in this group include Dextroamphetamine (Dexedrine), Methylphenidate (Ritalin) and Sibutramine Hydrochloride Monohydrate (Meridia).

- In the body, stimulants enhance brain activity causing an increase in alertness, attention and energy.

- Possible negative effects include dangerously high body temperatures or an irregular heartbeat after taking high doses; cardiovascular failure or lethal seizures. With some stimulants, users experience hostility or feelings of paranoia after taking high doses repeatedly over a short period of time.

- Should not be used with over-the-counter cold medicines containing decongestants; antidepressants, unless supervised by a physician; some asthma medications.

Source: National Institute on Drug Abuse