Summer House

New York Times — From “Scarface” to “Miami Vice,”Florida’s drug problem has been portrayed as the story of a single narcotic: cocaine. But for Floridians, prescription drugs are increasingly a far more lethal habit.

An analysis of autopsies in 2007 released this week by the Florida Medical Examiners Commission found that the rate of deaths caused by prescription drugs was three times the rate of deaths caused by all illicit drugs combined.

Law enforcement officials said that the shift toward prescription-drug-abuse, which began here about eight years ago, showed no sign of letting up and that the state must do more to control it.

“You have health care providers involved, you have doctor shoppers, and then there are crimes like robbing drug shipments,” said Jeff Beasley, a drug intelligence inspector for the Florida Department of Law Enforcement, which co-sponsored the study. “There is a multitude of ways to get these drugs, and that’s what makes things complicated.”

The report’s findings track with similar studies by the federal Drug Enforcement Administration, which has found that roughly seven million Americans are abusing prescription drugs. If accurate, that would be an increase of 80 percent in six years and more than the total abusing cocaine, heroin, hallucinogens, Ecstasy and inhalants.

The Florida report analyzed 168,900 deaths statewide. Cocaine, heroin and all methamphetamines caused 989 deaths, it found, while legal opiods — strong painkillers in brand-name drugs like Vicodin and OxyContin — caused 2,328.

Drugs with benzodiazepine, mainly depressants like Valium and Xanax, led to 743 deaths. Alcohol was the most commonly occurring drug, appearing in the bodies of 4,179 of the dead and judged the cause of death of 466 — fewer than cocaine (843) but more than methamphetamine (25) and marijuana (0).

The study also found that while the number of people who died with heroin in their bodies increased 14 percent in 2007, to 110, deaths related to the opioid oxycodone increased 36 percent, to 1,253.

Florida scrutinizes drug-related deaths more closely than do other states, and so there is little basis for comparison with them.

It has also witnessed several highly publicized cases in recent years that have highlighted the problem. Only last year, an accidental prescription drug overdose killed Anna Nicole Smith in Broward County.

Still, the state has lagged in enforcement. Thirty-eight other states have approved prescription drug monitoring programs that track sales. Florida lawmakers have repeatedly considered similar legislation, but privacy concerns have kept it from passing.

As a result, federal, state and local law enforcement officials say, Florida has become a source of prescription drugs that are illegally sold across the country.

“The monitoring plan is our priority effort, but that is not enough,” William H. Janes, the Florida director of drug control, said in a statement accompanying the study. He said Florida was also looking at ways to curb illegal Internet sales and to encourage doctors and pharmacists to identify potential abusers.

Some local police departments have taken a more novel approach.

In Broward County on May 31, deputies completed a “drug takeback” in which $5 Wal-Mart, CVS or Walgreens gift cards were distributed to 150 people who cleaned out their medicine cabinets and turned in unused drugs in an effort to keep them out of young people’s hands.

“The abuse has reached epidemic proportions,” said Lisa McElhaney, a sergeant in the pharmaceutical drug diversion unit of the Broward County Sheriff’s Office. “It’s just explosive.”

Utah — “Methamphetamine addiction has the worst long-range organic effect on the brain of any drug,” said Glen Hanson, University of Utah Addiction Center director.

Hanson’s blunt comment defines extent of the the public health problem in meth-damage control in Utah.

He was speaking at an all-day meth workshop before 30 participants; family members, caregivers and health care professionals in Roosevelt on June 21.

Addiction of any kind is a learned repetitive behavior, but meth is the worst, ” explained Hanson, “It alters the brain biology in ways similar to Alzheimer’s or Parkinson’s disease.”

Why would anyone choose to damage their brain to such a degree? The answer, because “it feels good,” may be the best an addict can offer after treatment.

Simplistic as it sounds, it is not wrong. Meth over-stimulates the “feel-good” portion of the brain and can severely damage a person’s cognitive abilities.

“The brain is a network of 100 billion cells that transmit information by making 2,000 connections individually,” Hanson said, telling the group why an addict’s ability to communicate has been compromised.

“Stimulated brain cells respond by releasing dopamine to anything that feels good” he continued. “Over-stimulated brains release too much dopamine. Then the free radicals that are chemically abundant in dopamine will eventually destroy portions of the brain.”

Meth stimulates the release of dopamine in excess. The more an addict uses the more they crave. It affects the cognition system in the brain by “turning-off” the prefrontal cortex.

As a consequence, meth addicts loose inhibitory control, tending to act on impulse rather than reason. They overreact to situations, tending toward rage.

This is partly due part to the “damage to the orbitofrontal cortex which ultimately inhibits saliency,” said Hanson. “The addict becomes motivated most by getting and using meth over anything else.”

It fouls up the meth addict’s ability to appreciate consequences like taking care of their children, themselves or being cognizant of others.

“Meth addicts may steal from or abuse their family members with little conscience,” the researcher explains. “All they think of is the drug, because the reward portion of their brain is on all the time.”

Hanson referred to the amygdala reward-region of the brain, which processes memory and emotional control. Damage to the region and the adjacent hippocampus region leaves the addict agitated and often aggressive.

Once these areas are damaged the memory portion of the addict’s brain often fails to recover even with treatment.

“Rehabilitating cognitive systems requires exercise,” explained the researcher. “Sometimes that means establishing new pathways in the brain around damaged portions that will never return.”

“Treatment is lengthy,” he continued, “requiring five to seven months for brain function to stabilize and restore saliency. It’s hardest for meth addicts because their familial support systems are often irreparably damaged. They’ve hurt the very people they need most.”

In the end, there are successful treatments to re-develop cognitive skills through mental exercise. One way, Hanson explained is through literacy education, which seems to help re-establish cognitive functions.

So, why with all this wreckage would anyone choose to use meth? Hanson’s research suggests that there is a strong sociocultural component contributing to the meth scourge in Utah.

“Meth abuse demographics indicate that it is the primary drug of choice among women,” he explained. “Thirty-seven percent of all women in treatment are addicted to meth. Men use it too, but represent fewer addicts in treatment than women.”

Some women are attracted to meth as it is readily available, cheap and long-lasting in effect. Others discover more energy, weight loss or help with social inhibitions through meth abuse.

“In Utah, there’s a sociocultural tendency of women toward perfection,” said Paul Smith, eastern Regional Director of the Division of Child and Family Services. “Perfect wife. Perfect mother. Perfect beauty. Too much pressure toward perfection drives the social component of meth abuse.”

“Whatever the cause, abuse is only part of addiction,” Hanson said. “Only 15 percent of users become severely addicted, which means 85 percent of users are out there managing their drug use.”

Why people become addicted may, in part, be genetic. For example, researchers found that many women in treatment suffer from other repetitive disorders like smoking or alcoholism.

The most interesting connection was re-occurrence of attention deficient-hyperactivity disorder. The familial connection of ADHD or alcoholism may include a predisposition toward drug addiction among family members.

There’s also the social aspect of addiction. Meth tends to stay in the family. A documentary shown at Saturday’s seminar showed women frankly admitting that, “My daughter introduced me to meth and then I gave it to my sister, and so on.”

Hanson notes that addictions like alcoholism re-occurs in families, but there is hope. Children removed from addictive families show no greater addiction rates than children from non-drug abuse families.

However, children left in addictive families are almost certainly going to experiment with drugs. Addictions, particularly those with long-term treatment requirements like meth are a burden on Utah society.

“Forty-seven percent of women in treatment for meth addiction have children,” Hanson continued. “Worse still, 45 percent of female meth addicts end up in prison. Incarcerated women cost the state $30,000 each and an additional $33,000 for each child placed in foster care. All totaled, jailed addicts cost the state about $100,000 a year.”

Treatment, on the other hand, costs the state about $15,000 per person. More recently, the treatment alternative has become policy in the criminal justice system of Utah. The effort is to stop the revolving door of prison addicts.

“New strategies for treatment are highly successful, but the addict must remain in rehabilitation,” said Hanson. “Judges are learning that success requires mandated, long-term compulsory treatment. I guess they figured that success means more taxpaying Utahns.”

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.

•••

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.”

"You just have to know the right person. It’s about as easy as any other drug. You just gotta ask for it," says Nick, who asked that his last name not be used. "It’s easy to get."

Law enforcement officials say stories like these highlight a disturbing trend they’re seeing across the country. Most alarming, they say, is not only is ecstasy back after years of decline, but most of the time it’s laced with meth.

More than 55 percent of the ecstasy samples seized in the United States last year contained meth, according to the Office of National Drug Control Policy, compared with 44.5 percent the previous year. And the drugs are coming in at rapid pace from Canada.

Almost 5.5 million pills of ecstasy were seized in the states bordering Canada in 2006 (the most recent year for which full statistics are available) — an almost tenfold increase since 2003, top drug enforcement officials say.

"They drive them in. They bring them in by boat. They bring them in by plane. They bring them across by people just carrying them across their back much like the southwest border," says Ed Duffy, an assistant special agent in charge for the Drug Enforcement Administration’s northern region.

Because meth is less expensive than ecstasy, mixing the two saves producers money, but it also makes it more dangerous, officials say.

Ecstasy can cause sharp increases in body temperature and can result in liver, kidney or heart damage. When laced with meth, officials say, the combination can cause more severe harm because meth can damage brain functions, as well as lead to an increase in breathing, irregular heartbeats and increased blood pressure. The National Institute on Drug Abuse says meth — or methamphetamine — is a "very addictive stimulant drug."

Law enforcement officials say European countries cracked down on ecstasy production in the early 2000s and manufacturing moved to Canada. And now, Asian gangs in Canada have been smuggling the chemicals needed to make ecstasy from China and India, officials with the Royal Canadian Mounted Police tell CNN.

Finished pills are then pushed in vast quantities into the United States, a flow that’s difficult to stop because of the vast, largely unpoliced border, officials say.

Those on the front lines in Canada and the United States say they are working closely and sharing intelligence to try to stem the flow. Canadian officials also say they have a good relationship with Chinese law enforcement.

The Mounties have created teams across Canada focused on identifying the criminal organizations producing ecstasy and meth and say they have shut down 17 labs in the past year.

"The labs that we’re finding now are what you refer to in the United States as super labs. We call them economic-based labs," says Raf Souccar, assistant commissioner of the Royal Canadian Mounted Police.

Each lab produces more than 10 pounds of ecstasy in one batch, he says. "It’s not your mom and pop operation. It tells me that it is criminal organizations that are, yes, more sophisticated and producing it for profit as opposed to producing it to fuel their habit."

It’s then finding its way into schools, like Nick’s in Albany, New York. "I have been seeing an increase in pill use among the teens in general," says Greg Reid, a counselor at Equinox Community Services Agency, which sponsors drug counseling and other activities for youth in Albany. "They do something called ‘pharming’ where they throw a bunch of pills into a bowl and kind of choose or take out the pills they want. Ecstasy pills are often among the drugs of choice in the bowl. "I have seen that increase in the past two years," Reid says. "Ecstasy … can be very dangerous, especially if you don’t know what it is getting mixed with."

WASHINGTON (AP) — About 3.1 million people between the ages of 12-25 have used cough and cold medicine to get high, the government reported Wednesday.

 The number of young people who abused over-the-counter cold medicines is comparable to use of LSD and much greater than that for methamphetamine among the age group, according to the federal Substance Abuse and Mental Health Services Administration.

The agency’s 2006 survey on drug abuse and health found that more than 5 percent of teenagers and young adults had misused cough and cold medicines and indicated that these people also had experimented frequently with illicit drugs. Nearly 82 percent also had used marijuana. Slightly less than half also used inhalants or hallucinogens, such as LSD or Ecstasy, the agency said.  The cough suppressant DXM is found in more than 140 cough and cold medications available without a prescription. When taken in large amounts, DXM can cause disorientation, blurred vision, slurred speech and vomiting.

Health Library  -  MayoClinic.com: Robotripping — abusing cough medicine

 
Among all persons aged 12 to 25, the rate of past year misuse among whites was 2.1 percent, which was three times higher than the level for blacks, 0.6 percent, and also significantly higher than the level for Hispanics, 1.4 percent.

"While increasing attention has been paid to the public health risk of prescription drug abuse, we also need to be aware of the growing dangers of misuse of over-the-counter cough and cold medications, especially among young people," said Terry Cline, the agency’s administrator.

About 1 in 20 high school seniors now acknowledges taking OxyContin, a prescription drug for managing severe pain that, when abused, can be powerfully addictive. In its annual survey of teen drug use, the National Institute on Drug Abuse reports that OxyContin use by 12th graders is up 40 percent nationwide in just three years. Five times as many 12th graders report using OxyContin than report using methamphetamine. The results have been tragic.

Fast-Forming Addiction

Prescription drugs are the second-most used drugs among teens, behind marijuana. Teens are doing stimulants, barbiturates and painkillers. Many don’t realize how highly addictive and dangerous some of these pills can be — OxyContin in particular.

“I was sick as a dog and I was in bed and I couldn’t believe it. I was actually scared,” recalls 17-year-old Ryan, a high school senior from Tewksbury, Mass.

Ryan, who asked that NPR use only his first name, is enrolled at a drug-treatment clinic at Children’s Hospital in Boston. He says he first tried OxyContin at a party when he was 16. Kids crush up the 12-hour time release pills and snort them, so they get hit with all the opiate at once. Ryan says pot made him feel “weirded out.” OxyContin just made him feel good — warm and relaxed. And it’s easy to get.

“There’s always someone who has it,” he says. “There’s kids selling it. I know alone, like, 10 kids selling it themselves.”

But just a week after he started using OxyContin, Ryan realized that if he didn’t get a pill every day or two, he’d start to feel sick. So he kept using it. He says he had no idea how bad he was hooked until the next time he tried to stop.

“It was like somebody was inside of your head with a hammer,” Ryan recalls. “You feel like you’re going to die. Just laying there in the bed, sweat pouring off of you… Then five minutes later, you’re freezing… then you’d be throwing up.”

A Pricey Habit

OxyContin is very expensive on the street: $80 for one pill. To pay for his habit, Ryan says he cashed $7,000 in savings bonds his aunts had given him on birthdays. He sold his PlayStation, leather jackets, cell phone — everything he had — just to stay high and keep from getting sick. He finally broke down and asked his parents for help. Looking back on it, Ryan says he didn’t think using OxyContin would be that dangerous because it was a prescription pill — that made it seem safe. Many different kids at his high school were playing around with it, he says: “People from every sort of group — the burnouts, athletic kids, the geniuses and, like, girls playing wicked-good softball [who were] offered scholarships to places — they would be using it.”

That sentiment is echoed by 18-year-old Mike, a recovering OxyContin addict in Winthrop, Mass. Mike says he was always an athlete and played football. Until his sophomore year in high school, he attended a prep school with wealthier students; he later transferred to the local public school. He says that, if anything, he saw more OxyContin at the prep school.

“All the popular kids — that was the cool thing to do,” Mike says. “It seemed like it was cool because it was so expensive, this big rich drug. And a lot of rich kids were doing it because the poor kids couldn’t afford it.”

OxyContin is so expensive that many teens turn to stealing to support their habit.

“I stole so much money from my parents,” says Katie, 18, who is also a recovering OxyContin habit. She says she and a friend both stole their parents’ ATM cards to support their habits. “I stole $5,000 from my parents in two months.”

Katie also wrote checks from her mother’s checkbook. Katie’s parents say she and her friends stole cameras and jewelry from their house. Somebody stole her father’s wedding ring out of his top drawer.

“It’s like someone just punched you in the stomach,” Katie’s father said in an interview with NPR. “You know you’re never going to get it back. And what did it get used for? The addiction.”

Gateway to Heroin

Katie’s parents say they feel lucky to still have their daughter. More than a year has passed since they enrolled her into a treatment program. She’s relapsed twice. Doctors say OxyContin addiction can plague people for years. And some users move on to heroin. It is much cheaper than OxyContin, and it satisfies the same craving. Instead of $80 a pill, heroin costs about $5 a bag around Boston. One night when Katie was getting sick and desperate, she called a women she’d used OxyContin with before whom she knew also used heroin.

“I didn’t think if she had heroin I would do it,” Katie recalls, “but then when I had that option — to be sick or do this — I did that.”

Deadly Consequences

All the teens interviewed for this story said they knew at least one young person who had overdosed and died recently either on OxyContin or on heroin after first getting hooked on OxyContin. Cheryl Oates of the middle-class suburb of Burlington, Mass., knows the deadly repercussions of OxyContin addiction all too well. Two months ago, her 19-year-old son, Christopher, died of a heroin overdose.

Oates says her son was not the kind of teen one would expect to become a drug addict. He was a captain of his football and wrestling teams at Burlington High School and popular among his teammates. He got good grades and didn’t have behavior problems, Oates says.

“He was the kind of kid who would walk through the mall with me and hold my hand,” Oates says. “He didn’t care what other people thought and said. Christopher was just his own person.”

But by his junior year, Christopher was experimenting with Percocet, another opioid painkiller. It had been prescribed to him for a football injury. By his senior year, he and some friends were using OxyContin; they got hooked. Soon after he graduated, he started using heroin, too.

“The night before Christopher overdosed, we sat in the kitchen and we talked until three in the morning,” Oates says. “And he said he knew he needed help. He was such a good kid and he loved so much. And he got grabbed by something that was greater than him.”

Oates says she’d tell other parents to keep all prescription medications in a locked cabinet, just to make it harder for teens to start experimenting with them. She says it is frightening that more than 5 percent of high school seniors nationally now report using OxyContin in the past year.