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The skyrocketing use and abuse of prescription narcotics in Las Vegas is accompanied by a similarly startling increase in the number of fatal overdoses, a Sun analysis has found.

Fatal overdoses involving prescription painkillers more than quadrupled in a decade and now exceed those involving illicit drugs, according to data compiled by the Clark County coroner’s office.

The trend reflects the extraordinarily high use of narcotic painkillers by Nevadans. The Sun reported Sunday that its analysis of Drug Enforcement Administration data shows that Nevadans per person use more hydrocodone — the potent ingredient in the drugs Vicodin, Lortab and Norco — than residents of any other state. Nevadans rank fourth nationally in per person consumption of methadone, morphine and oxycodone, the main ingredient in OxyContin.

The increased use and availability of the drugs are primary factors in the rise of addiction, illegal distribution and fatal overdoses, experts say.

In 1997, there were 57 fatal overdoses in Clark County in which prescription narcotics were a contributing factor, a rate of about five per 100,000 people. In 2007, 258 people died in Clark County from overdoses of prescription narcotics, a rate of 13 per 100,000 people.

In contrast, the number of deaths caused by illicit drugs has plateaued. Street drugs such as cocaine, methamphetamine and heroin were involved in a combined 197 fatal overdoses in 2007.

Deaths involving prescription narcotics exceeded or rivaled those caused by firearms (321) and motor vehicle accidents (234) in Clark County in 2007.

Clark County Coroner Mike Murphy called the prescription drug deaths a “dire situation.”

Doctors who specialize in pain management, and pharmaceutical companies that make the drugs, emphasize that many people are helped by prescription narcotics while acknowledging that a small percentage may become addicted.

Prescription drug overdoses draw national attention when the victims include such celebrities as Heath Ledger and Anna Nicole Smith, but aside from the sensational anecdotes, little is reported about the overall toll of overdoses.

Poisoning, usually caused by unintentional drug overdose, is the second leading cause of injury death in the United States, surpassing firearms in 2004, according to the National Center for Health Statistics.

Prescription narcotics deaths accounted for 56 percent of poisoning deaths nationally in 2005, according to the Centers for Disease Control and Prevention, and their absolute number increased by 84 percent from 1999 to 2005.

Some regional data compiled by medical examiners further illustrate the problem:

• In King County, Washington (Seattle), prescription opiates killed 148 people in 2006, a 572 percent increase since 1997.

• In Virginia, prescription narcotics took 399 lives in 2006, compared with 146 deaths from cocaine and amphetamines.

• In Oklahoma, of 603 drug-related deaths in 2006, more than half, 327, were attributed to hydrocodone, methadone or oxycodone.

• In Florida, people who died of drug overdoses in 2007 had prescription drugs in their systems more often than illicit drugs.

No prescribed narcotic is involved in more deaths among Nevadans than methadone. The long-acting painkiller was named in a third of the 1,771 prescription drug overdoses in Clark County from 1991 to 2007, according to the Clark County coroner’s office. The number of deaths involving methadone climbed from three in 1993 to 20 in 1998 and 105 in 2007. (Cocaine was a factor in 116 Clark County deaths in 2007.)

Methadone, widely used to wean addicts off other drugs, has grown in popularity as a painkiller in recent years. Several doctors said it’s preferred by insurance companies because it’s inexpensive — though insurers dispute this, saying there are many low-cost generic narcotics so there would be no reason to favor methadone.

But methadone is a challenging drug to prescribe because it stays in a person’s system for five to 11 days, even after its effects have worn off, said Las Vegas pain specialist Dr. Jim Marx. That means a patient could take multiple doses of methadone over time to keep pain in check, allowing potentially lethal amounts of the drug to build up in the body. In comparison, hydrocodone leaves the body within hours.

“It’s trickier to prescribe because of its persistence,” Marx said.

Methadone deaths have increased more than those involving any other narcotic, the Centers for Disease Control and Prevention reports.

Its data show Nevada had almost four methadone deaths per 100,000 people from 1999 to 2005, the fourth-highest rate in the United States, behind Maine, Utah and Washington.

The CDC said it’s hard to determine whether the increase in opioid-related deaths is due to prescribing practices, a failure by patients to take drugs properly, or illegal abuse.

CDC medical epidemiologist Leonard Paulozzi told Congress in March the drug overdose deaths correspond to the rapidly rising rates of prescription narcotic use reported by the Drug Enforcement Administration, and the overdose deaths are expected to continue.

Statistics through 2005 “probably underestimate the present magnitude of the problem,” Paulozzi said.

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There are many ways to get prescription narcotics illegally, said Matt Alberto, deputy chief of investigations for the Nevada Public Safety Department, the state’s lead prescription drug policing agency.

Unscrupulous doctors sell prescriptions for cash. Abusers shop for doctors who prescribe narcotic painkillers without asking many questions. Children fish around in their parents’ medicine cabinets. Patients forge prescriptions. Pharmacy workers, clinic workers and hospital employees steal the drugs.

The most notorious criminal case of a doctor in Las Vegas illegally providing narcotic drugs involves Dr. Harriston Bass Jr., who, according to evidence at his trial, made house calls to prescribe and distribute prescription narcotics.

Bass drove to patients’ homes, conducted 10-minute exams and then sold the patients two or three bottles of 100 pills each — even though he had no license to distribute controlled substances, according to testimony at his trial. He also wrote prescriptions for patients to fill at pharmacies.

Among his patients was Gina Micali, who received about 300 hydrocodone tablets from Bass every other month, plus a prescription for another 180 and one refill. On each visit she also received the muscle relaxant Soma and the anxiety medication Xanax, plus prescriptions for each. In pills and prescriptions, Bass sold Micali a total of about 1,400 pills per visit, said Conrad Hafen, the chief deputy attorney general, who prosecuted the case.

On Oct. 5, 2005, Micali, 38, died after ingesting too many painkillers she got from Bass.

Hafen told the jury that when police searched Bass’ home, they found $150,000 in cash and large quantities of hydrocodone in bottles labeled with the name of his company — DOCS-24-7 — and a wholesale prescription drug company in Illinois.

Alberto said the Illinois company offered no good explanation for why it was selling drugs to a doctor who didn’t have clearance from the Drug Enforcement Administration.

In March, Bass was convicted of second-degree murder in Micali’s death and was found guilty on more than 50 drug-related charges. He was sentenced to 25 years to life in prison.

A more typical case of illegally diverting prescription painkillers involves Stephanie Ortiz, a former pharmacy technician at four Smith’s grocery stores in Las Vegas. She admitted to the pharmacy board that she gave unauthorized refills of Lortab — a painkiller made with hydrocodone — and free drugs to friends posing as patients. Ortiz filled out refill requests but never faxed or phoned them to physicians for approval, the complaint against her says. She admitted illegally diverting 10,680 doses of the painkiller.

In a letter she wrote admitting her guilt, Ortiz says she started giving the purloined drugs to people she knew, and then got text messages and phone calls saying a random person would come by for another pickup. In exchange for the drugs, Ortiz said, she received VIP tables at nightclubs and access to hotel rooms on busy weekends.

Authorities say young people are cavalier with prescription drugs, sharing them among themselves or sneaking them from their parents and passing them around to their friends. Such a transaction ended in death two years ago this week in Mesquite.

According to an affidavit filed by the Nevada Public Safety Department, Brett Sawyer, 19, was found dead in his bedroom on July 8, 2006. Hidden in a gym bag by his bed was an empty bottle of hydrocodone pills prescribed by a dentist in St. George, Utah, to one of his friends.

Sawyer’s family told investigators he was a drug user. “Brett was the type — if one aspirin worked, three would work better,” his mother said.

Police learned that Sawyer was addicted to OxyContin and often obtained drugs from Cody Morris, who was also an addict and dealt the drugs to his friends.

On July 7, 2006, Morris sold Sawyer three 80 mg OxyContin pills — what some call the Cadillac of prescription narcotics — for $45 each. Morris said he warned Sawyer not to take more than one at a time and to avoid mixing them with alcohol.

Sawyer was dead the next day.

Morris pleaded guilty to manslaughter and was sentenced to three years’ probation.

Alberto, the investigator, said it’s as common for drug dealers to sell prescription narcotics as it is methamphetamine or cocaine — and more profitable. An ounce of methamphetamine might sell wholesale in Las Vegas for $700, he said, but the same weight in OxyContin pills would be $3,000. He guessed the illegal abuse of prescription painkillers could account for 10 percent of the state’s total use.

Alberto laments that policymakers and the public are focused on street drugs, and virtually ignore the dangers in people’s medicine cabinets. Narcotics investigators for Metro Police do not investigate prescription drug dealing and deal with the drugs only on a reactive basis, a spokesman said.

Yet prescription narcotics are becoming more popular than marijuana for new abusers. The 2006 National Survey on Drug Use and Health found that among new drug abusers, 2.2 million people chose prescription painkillers and 2.1 million preferred marijuana.

Nothing stimulates the brain with pleasure more than drugs. But doctors disagree about the threat of drug addiction. People at risk of becoming addicted to them range from 3 percent to 18 percent of the population, depending on the study or the expert.

Prescription narcotics can change the brain’s chemistry, creating a physical and psychological dependence that compels addicts to forgo career, children, money, sleep, sex and all-around well-being in pursuit of the drug of choice.

Officials with the Nevada Substance Abuse Prevention and Treatment Agency say the rise in prescription narcotic addiction in the state cannot be quantified because of the way records are kept. Nationally, a 2006 Substance Abuse and Mental Health Services Administration survey showed that an estimated 5.2 million people 12 and older took narcotic painkillers for nonmedical purposes 30 days before the survey, up from about 4.4 million in 2002.

People seem to think that because the drugs are commercially manufactured and approved by the Food and Drug Administration, their abuse is less risky than that of illicit drugs, said Steve Pasierb, president of the Partnership for a Drug-Free America.

“This is a deadly behavior,” Pasierb said of the drug abuse. “When prescription drugs are abused in the same way as illegal street drugs, they’re every bit as addictive and they’re every bit as deadly.”

(CNN) — The transitional year between child and teenager is crucial in fighting teen drug use, according to a new survey.

The research by the Columbia University’s National Center on Addiction and Substance Abuse found age 12 to 13 to be a time when children are increasingly exposed to drugs and often moving away from the control and influence of their parents.

"In no other year do teens’ perceptions and attitudes shift so markedly," the center said.

The survey found a 13-year-old is three times more likely than a 12-year-old to know how to buy drugs. It also found about twice as many 13-year-olds do not have adult supervision at home after school.

"America’s children have been crying out for help and not enough people are listening," said the center’s president, Joseph A. Califano Jr.

The annual survey of 1,000 teen-agers, 824 teachers and 822 principals found for the fourth year, teens believed drugs were their most pressing problem. In all, 39 percent of 17-year-olds said they drank alcohol, 23 percent said they smoked in the last 30 days, and 41 percent said they have smoked marijuana.

Teenagers who used one substance such as alcohol were more likely to use another such as marijuana, and marijuana uses were more likely to drink.

The survey documented a wide gap between the students and principals in perceived drug use in their schools. More than half of teen-agers and 41 percent of teachers said the drug problem at their schools is getting worse, but just 15 percent of principals saw an increasing problem.

Eighteen percent of principals, compared with 78 percent of teen students, said their schools were not drug-free.

"Principals make monkeys of themselves as they reveal their see no evil, hear no evil, speak no evil posture," said Califano, a former secretary of Health, Education and Welfare in the Carter administration.

The survey did find some hopeful statistics. It reported teen-agers who attend religious services are less likely to smoke cigarettes or marijuana or spend time with those who do.

It also found teen-agers who have never smoked marijuana are more likely to heed their parent’s opinions.

WASHINGTON (AP) — Sure, exercise is good for your waistline, your heart, your bones — but might it also help prevent addiction to drugs or alcohol?

There are some tantalizing clues that physical activity might spur changes in the brain to do just that.

Now the government is beginning a push for hard research to prove it.

This is not about getting average people to achieve the so-called runner’s high, a feat of pretty intense athletics.

Instead, the question is just how regular physical activity of varying intensity — dancing, bicycling, swimming, tae kwan do — might affect mood, academic performance, even the very reward systems in the brain that can get hijacked by substance abuse.

What first caught the attention of National Institute on Drug Abuse chief Dr. Nora Volkow: A study found tweens and teens who reported exercising daily were half as likely to smoke as their sedentary counterparts, and 40 percent less likely to experiment with marijuana.

Volkow knows — from her own 6-mile daily runs and from her scientific experiments — that the brain literally likes physical activity. Exercise seems to invigorate neurochemicals that sense and reinforce pleasure.

"In children, it’s innate," she notes. "Children want to move."

But the nation’s children are becoming more sedentary, as illustrated by the obesity epidemic, "screen time" replacing outdoor play and a drop in school P.E. And as youngsters approach adolescence, the run around the yard that used to be fun too often becomes a chore — the dreaded jog around the school track or the nagging to get off the couch. The sedentary teen turns into the sedentary adult.

"Why do we lose the ability to experience pleasure from physical activity?" asks Volkow.

Last week she brought more than 100 specialists in exercise and neurobiology to a two-day conference to explore physical activity’s potential in fighting substance abuse, and announced $4 million in new research grants to help.

Drug treatment programs often include exercise, partly to keep people distracted from their cravings, but there’s been little formal research on the effects.

The best evidence: Brown University took smokers to the gym three times a week and found adding the exercise to a smoking-cessation program doubled women’s chances of successfully kicking the habit. The quitters who worked out got an extra benefit: They gained half as much weight as women who managed to quit without exercising, says lead researcher Dr. Bess Marcus.

She now is working with the YMCA on a larger, NIDA-funded study to prove the benefit.

Marcus cautions that people trying to kick an addiction have a powerful incentive to exercise. Could that possibly translate into prevention? Among the clues:

– Rats were less likely to ingest amphetamines if their cages had running wheels, suggesting exercise stimulated a reward pathway in the brain to leave them less vulnerable to the drug’s rush.

– In people, exercise acts as a mild antidepressant and relieves stress. Depression, anxiety and stress increase risk of alcoholism, smoking or drug abuse.

– Volkow is intrigued that attention deficit disorder and obesity both involve problems with the brain chemical dopamine, one system that drugs hijack to create addiction.

– Baby monkeys who don’t play enough in childhood have problems controlling aggression when they’re older. The most aggressive tend to have defects involving the feel-good brain chemical serotonin — and binge-drink when researchers offer them alcohol.

– Back to rats, physical activity increases production of growth factors and stem cells in key brain regions important for learning and mood; increases formation of blood vessels; and strengthens communication networks between brain cells.

Together, that’s far too little research to know if exercise really matters for substance abuse, scientists at the National Institutes of Health meeting cautioned.

But, a few studies of school-age children suggest physical activity predicts better performance on math, verbal and other tests — and better school performance in turn is linked to lower risk for substance abuse.

And getting sedentary seniors moving improves brain function — research aimed at preventing dementia, not drug abuse, although the improvement is in an area that in younger people is linked to risky decision-making.

A caveat: If your own youth includes memories of parties with beer-guzzling athletes, well, the research concurs. A major study that tracks adolescent risk behaviors found that by 12th grade, exercise offers no protection against binge-drinking.

"Now the kids who exercise the most actually drink the most," says Dr. Lloyd Johnston of the University of Michigan. It may have to do with the celebratory nature of team sports, or getting revved for college — or, other researchers suggested, even that competition is to blame.

WASHINGTON (AP) — Marijuana potency increased last year to the highest level in more than 30 years, posing greater health risks to people who may view the drug as harmless, according to a report released Thursday by the White House.

The latest analysis from the University of Mississippi’s Potency Monitoring Project tracked the average amount of THC, the psychoactive ingredient in marijuana, in samples seized by law enforcement agencies from 1975 through 2007. It found that the average amount of THC reached 9.6 percent in 2007, compared with 8.75 percent the previous year.

The 9.6 percent level represents more than a doubling of marijuana potency since 1983, when it averaged just under 4 percent.

"Today’s report makes it more important than ever that we get past outdated, anachronistic views of marijuana," said John Walters, director of the White House Office of National Drug Control Policy. He cited baby boomer parents who might have misguided notions that the drug contains the weaker potency levels of the 1970s.

"Marijuana potency has grown steeply over the past decade, with serious implications in particular for young people," Walters said. He cited the risk of psychological, cognitive and respiratory problems, and the potential for users to become dependent on drugs such as cocaine and heroin.

While the drug’s potency may be rising, marijuana users generally adjust to the level of potency and smoke it accordingly, said Dr. Mitch Earleywine, who teaches psychology at the State University of New York in Albany and serves as an adviser for marijuana advocacy groups. "Stronger cannabis leads to less inhaled smoke," he said.

The White House office attributed the increases in marijuana potency to sophisticated growing techniques that drug traffickers are using at sites in the United States and Canada.

A report from the office last month found that a teenager who has been depressed in the past year was more than twice as likely to have used marijuana than teenagers who have not reported being depressed — 25 percent compared with 12 percent. The study said marijuana use increased the risk of developing mental disorders by 40 percent.

"The increases in marijuana potency are of concern since they increase the likelihood of acute toxicity, including mental impairment," said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which funded the University of Mississippi study.

"Particularly worrisome is the possibility that the more potent THC might be more effective at triggering the changes in the brain that can lead to addiction," Volkow said.

But there’s no data showing that a higher potency in marijuana leads to more addiction, Earleywine said, and marijuana’s withdrawal symptoms are mild at best. "Mild irritability, craving for marijuana and decreased appetite — I mean those are laughable when you talk about withdrawal from a drug. Caffeine is worse."

The project analyzed data on 62,797 cannabis samples, 1,302 hashish samples, and 468 hash oil samples obtained primarily from seizures by law enforcement agencies in 48 states since 1975.

The prescription drugs allegedly found in Al Gore III’s possession this week are favorites among young people, according to drug abuse experts, who say prescription drugs may soon overtake street drugs in popularity.
 

Some young people perceive that prescription drugs are safer than street drugs, experts say.
 

"I wouldn’t be surprised if right now at this point in time, there are more kids abusing prescription drugs than abusing marijuana," said Joseph A. Califano Jr., chairman and president of CASA, the National Center on Alcohol and Substance Abuse at Columbia University.
 

Gore was arrested on charges of possessing — in addition to marijuana — Vicodin, Xanax, Valium and Adderall.
 

According to a CASA report, between 1993 and 2005 the proportion of college students abusing Vicodin and other opiods went up 343 percent, about 240,000 individuals. The numbers increased 450 percent, or by 170,000 students, for tranquilizers such as Xanax and Valium, and 93 percent, or 225,000 students, for stimulants, including Adderall.
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Prescription drug abuse is particularly common among upper middle class students, according to Lisa Jack, a clinical psychologist at Augsburg College in Minneapolis, Minnesota.
 

"It just goes to show that where you’re from doesn’t matter," Jack said.
 

And young people don’t have to go far to get these drugs. "Prescription drugs are very easy for kids to get," Califano said. "They can get them from the Internet. They can get them from their parents’ medicine cabinets. They can get them from their friends."
 

He said often students get them from friends who were prescribed these drugs legitimately.

"Kids sell them to each other," Jack said. "Drug trading happens all the time."
 

Experts say it’s particularly a problem with Adderall, a drug prescribed legitimately to millions of young people with attention-deficit hyperactivity disorder.
 

According to CASA, more than a third of children ages 11-18 in Wisconsin and Minnesota who’d been prescribed Adderall and other ADHD medications reported being approached to sell or trade their drugs.
 

And often they say yes, according to one Canadian study that found one out of four teens who’d been legitimately prescribed Ritalin gave or sold some of their drugs.
 

Another appeal to prescription drugs, besides the easy access, is that young people often perceive them as safer.

"They don’t have to go to the streets and deal with some guy they don’t know and get marijuana where they don’t know what’s in it," Califano said. "Also, they see their parents using these drugs, so they seem safe."

Jack said prescription drugs can be more challenging to treat than addiction to street drugs. "In traditional drug abuse, addicts can say, ‘I’ve been using meth or coke or pot,’ and an addiction specialist knows what to do," she said. But with prescription drugs, "sometimes the kids don’t even know what they’ve been taking. They just pass the pills around."
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Part of the solution would be for drug makers to formulate their products so they’re harder to abuse, said Califano, adding that anti-drug campaigns also should focus more on prescription drug abuse.

Parents need to do their part as well, he said. "When I was a kid in Brooklyn, when parents had liquor, they locked up the liquor cabinet," he said. "Maybe parents need to lock up the medicine cabinet."

OMAHA, Nebraska (AP) — Only an anti-anxiety medication turned up in toxicology tests done on the body of the 19-year-old gunman who fatally wounded eight people before killing himself last month at a shopping mall.

 The autopsy report on Robert Hawkins revealed diazepam in his system. The tranquilizer is better known by its market name, Valium. Douglas County Attorney Don Kleine told the Omaha World-Herald in a copyright story Tuesday that authorities sometimes "see people who have abused drugs or alcohol to give them the ability to carry out their misdeed."

"In this case, it doesn’t appear he had abused either," he said.

The teen’s blood revealed only therapeutic levels of the medication.

The autopsy report also said Hawkins killed himself December 5 by a single shot from his assault rifle from under his chin.

Before committing suicide, Hawkins went into the Von Maur store at Westroads Mall and took an elevator up to the third floor. There he opened fire, fatally wounding eight people. Five other people were hit by bullets or bullet fragments, injuring two seriously.
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Investigators will try to find out whether Hawkins had a prescription for the Valium, he needed Valium Detox, Kleine said.  Diazepam is often given to people who have anxiety attacks or insomnia, said Dr. Todd Stull, director of the University of Nebraska Medical Center’s drug and alcohol program.

"It’s a calming kind of medicine," Stull said. "A lower dose can help with anxiety."

People can get high on it, he said, but "it’s not a very common addiction."

Court records and friends say Hawkins regularly smoked marijuana, but Kleine said there was no evidence of it or any other drugs in his blood.