Summer House

(CNN) – Drug enforcement authorities are concerned about the use of potent new drug cocktails that combines prescription medicine and street drugs.

The new type of abuse, which drug experts call "pharmacological roulette," is being noticed among high school and college students, and is potentially deadly. Police in Hartford, Connecticut believe the death of a Trinity College student may have involved mixing various prescription medicines with other types of drugs.

Although experts don’t know if the pattern of abuse is growing, one survey at the University of Wisconsin found one in five students had tried illicit prescription drugs.

Both drug experts and recovering teen-agers at the Phoenix House Treatment Center in Lake Ronkonoma, New York, tell CNN’S Frank Buckley that obtaining the drugs is as easy as going to the drugstore, buying from sellers on the street or ordering from the Internet.

DALLAS, Texas (CNN) — A cheap, highly addictive drug known as "cheese heroin" has killed 21 teenagers in the Dallas area over the past two years, and authorities say they are hoping they can stop the fad before it spreads across the nation.

"Cheese heroin" is a blend of so-called black tar Mexican heroin and crushed over-the-counter medications that contain the antihistamine diphenhydramine, found in products such as Tylenol PM, police say. The sedative effects of the heroin and the nighttime sleep aids make for a deadly brew.

"A double whammy — you’re getting two downers at once," says Dallas police detective Monty Moncibais. "If you take the body and you start slowing everything down, everything inside your body, eventually you’re going to slow down the heart until it stops and, when it stops, you’re dead." (Audio slide show: A father describes his teen son’s death)

Steve Robertson, a special agent with the Drug Enforcement Administration in Washington, says authorities are closely monitoring the use of "cheese" in Dallas.

Trying to keep the drug from spreading to other cities, the DEA is working with Dallas officials to raise public awareness about the problem. Authorities also are trying to identify the traffickers, Robertson says.

"We are concerned about any drug trend that is new because we want to stop it," he says.

Why should a parent outside Dallas care about what’s happening there?

Robertson says it’s simple: The ease of communication via the Internet and cell phones allows a drug trend to spread rapidly across the country.

"A parent in New York should be very concerned about a drug trend in Dallas, a drug trend in Kansas City, a drug trend anywhere throughout the United States," he says.
Middle schoolers acknowledge ‘cheese’

"Cheese" is not only dangerous. It’s cheap. About $2 for a single hit and as little as $10 per gram. The drug can be snorted with a straw or through a ballpoint pen, authorities say. It causes drowsiness and lethargy, as well as euphoria, excessive thirst and disorientation. That is, if the user survives.

Authorities aren’t exactly sure how the drug got its name "cheese." It’s most likely because the ground-up, tan substance looks like Parmesan cheese. The other theory is it’s shorthand for the Spanish word "chiva," which is street slang for heroin.

By using the name "cheese," drug dealers are marketing the low-grade heroin to a younger crowd — many of them middle schoolers — unaware of its potential dangers, authorities say.

"These are street dealers, dope dealers," Moncibais recently warned students at Sam Tasby Middle School. "They give you a lethal dose. What do they care?"

Moncibais then asked how many students knew a "cheese" user. Just about everyone in the auditorium raised a hand. At one point, when he mentioned that the United States has the highest rate of drug users in the world, the middle schoolers cheered. (Watch middle schoolers raise hands, admit they know drug users Video)

"You know, I know being No. 1 is important, but being the No. 1 dopeheads in the world, I don’t know whether [that] bears applause," Moncibais shot back.

Authorities say the number of arrests involving possession of "cheese" in the Dallas area this school year was 146, up from about 90 the year before. School is out for the summer, and authorities fear that the students, with more time on their hands, could turn to the drug.
‘Cheese’ as common a problem as pot

School officials and police have been holding assemblies, professional lectures, PTA meetings and classroom discussions to get the word out about the drug. A public service announcement made by Dallas students is airing on local TV, and a hotline number has been created for those seeking assistance.

Drug treatment centers in Dallas say teen "cheese" addicts are now as common as those seeking help for a marijuana addiction. "It is the first drug to have even come close in my experience here," says Michelle Hemm, director of Phoenix House in Dallas.

From September 2005 to September 2006, Phoenix House received 69 "cheese" referral calls from parents. Hemm says that in the last eight months alone, that number has nearly doubled to 136. The message from the parents is always, "My kid is using ‘cheese,’ " she says.

Phoenix House refers them to detoxification units first, but Hemm says at least 62 teens have received additional treatment at her facility since last September.

Fernando Cortez Sr. knows all too well how devastating cheese heroin can be. A reformed drug user who has spent time in prison, Cortez had spoken to his children about the pitfalls of drug use. He thought his 15-year-old son was on the right track.

But on March 31, his boy, Fernando "Nando" Cortez Jr., was found dead after using cheese heroin. "I should have had a better talk with him," he says. "All it takes is once. You get high once and you die, and that’s what happened to my son." He knows it’s too late for his son. Now, he is using his son’s story to help others. "All I can do is try to help people now. Help the kids, help the parents."

VANCOUVER, British Columbia (CNN) — I didn’t know quite what to expect when I entered the injection room at Insite, the world’s busiest supervised drug clinic.

Inside the Vancouver facility, I found more than a dozen people taking illegal drugs, such as heroin and cocaine, under the watchful eye of trained nurses. These drug users were among the more than 700 people who visit the facility every day, bringing their drugs with them. Insite’s goal is to reduce the risk of overdose and limit the spread of diseases like HIV by giving addicts clean needles and a safe place to use them.

"People need to be kept alive long enough in order to get treatment," said Liz Evans, a nurse and founder of Insite.

The clinic, which is sanctioned by Vancouver’s health department, opens each day at 10 a.m. and stays open until 4 a.m. the following day. Many of the people in the clinic on the day we visited had tattered clothes, missing teeth and glassy eyes. They swayed as they struggled to keep their balance. Video Watch people shoot up in the Vancouver clinic »

Outside of the clinic, police patrolled the streets to keep people from buying and selling illegal drugs. Inside, patrons were given access to Insite’s clean needles, injection booths and nurses. Similar facilities can be found at 65 locations in eight different countries. San Francisco health officials recently held a day-long conference on the Vancouver drug clinic, with an eye toward possibly opening a similar one. But San Francisco Mayor Gavin Newsom said the city is unlikely to do so.

"You had a lot of health officials there that did participate in the pros and cons. But my director of the department of public health doesn’t feel the city should move forward," Newsom said.

Defenders of the Vancouver clinic say more than two dozen peer-reviewed studies have shown its benefits. One study found a 45 percent reduction in public drug use as a result of the clinic; another showed 33 percent of addicts are more likely to go to drug detox after using Insite. Dr. Thomas Kerr, a University of British Columbia research scientist who has studied the program, believes Insite benefits the wider community.

"In the absence of such a facility, not only would [drug users] be high out on the street, but they would be leaving their syringes in school yards, in parks and on city streets," Kerr said.

Dr. David Murray, chief scientist for the White House Office of National Drug Control Policy, opposes opening drug injection clinics in the United States. He believes they do little to help addicts overcome their additions.
Don’t Miss

"It is a cruel illusion because they are still addicted, trapped, trying to get out and dying by the virtue of the drug itself," he said.

Nurses at the Vancouver clinic say they get all kinds of people using their facility, from an old grandma who comes to inject her pain medication to men in business suits hiding their addictions from their families.

At the clinic, we met Lorraine Trepanier, 50, a longtime drug user. Trepanier said she used to sell her body for drugs, but now relies on a friend to give her the $20 she uses every day to buy cocaine and heroin.

"I get up in the morning and I make sure I have one down or half a down," she said, referring to her heroin fix. Trepanier believes Insite has helped keep her alive by giving her a supervised setting in which she can take drugs.

Evans and other operators of Insite say that rather than chase addicts from corner to corner and alley to alley, it is more effective to encourage them to use their drugs in a supervised setting.  In the more than four years Insite has been open, there have been roughly 800 overdoses at the facility, but there have not been any deaths. When someone does overdose, nurses try to revive them. If the drug user is in critical condition, they are sent to a hospital.
advertisement

Trepanier doesn’t care what critics have to say about Insite. All she wants is a chance to get her next fix in a clean facility, until the day she finally works up the willpower to kick her drug addiction.

"I don’t want to be down here all my life," she said. "I don’t want to be chasing this all my life."

WASHINGTON (CNN) — Methadone-related deaths have skyrocketed, fueled by a jump in theft and misuse of the addiction treatment drug, according to a Justice Department report released Wednesday

The report said methadone-related deaths jumped from 786 in 1999 to 3,849 in 2004. By contrast, during the same period, deaths related to cocaine increased 43 percent from 3,822 to 5,461.

The National Drug Intelligence Center, an arm of the Department of Justice, says it published the assessment because of its concern over the sharp increases stemming from the diversion and methadone abuse.  The center, which analyzes and dispenses strategic drug intelligence, noted methadone is safe and effective when prescribed and used correctly to treat opiate addiction, but is deadly when misused –"particularly in combination with other prescription drugs, alcohol, or illicit drugs."

The report said physicians dispensed the drug more frequently in the management of pain during the years studied.

"Methadone thefts from manufacturers, distributors and retailers have increased the amount of methadone available for abuse," the report said.

"Diversion from pain management facilities, hospitals, pharmacies, general practitioners, family and friends, and to a lesser extent narcotics treatment programs, increased availability, primarily at the retail level," the study said.

The study said Florida had by far the most methadone deaths during the past three years of the study — 2002 to 2004. Four hundred deaths occurred in Florida during 2004. North Carolina was second with 245 deaths, followed by California, New York, Washington, Texas, Virginia and Kentucky. Officials say the problem continues to get worse, with the Florida Department of Law Enforcement reporting as many as 716 methadone deaths in 2006.

Problems associated with an individual’s drug addiction can vary significantly. People who are addicted to drugs come from all walks of life. Many suffer from mental health, occupational, health, or social problems that make their addictive disorders much more difficult to treat. Even if there are few associated problems, the severity of addiction itself ranges widely among people.

A variety of scientifically based approaches to drug addiction treatment exists. Drug addiction treatment can include behavioral therapy (such as counseling, cognitive therapy, or psychotherapy), medications, or their combination. Behavioral therapies offer people strategies for coping with their drug cravings, teach them ways to avoid drugs and prevent relapse, and help them deal with relapse if it occurs. When a person’s drug-related behavior places him or her at higher risk for AIDS or other infectious diseases, behavioral therapies can help to reduce the risk of disease transmission. Case management and referral to other medical, psychological, and social services are crucial components of treatment for many patients. The best programs provide a combination of therapies and other services to meet the needs of the individual patient, which are shaped by such issues as age, race, culture, sexual orientation, gender, pregnancy, parenting, housing, and employment, as well as physical and sexual abuse.

Medications, such as antidepressants, mood stabilizers, or neuroleptics, may be critical for addiction treatment success when patients have co-occurring mental disorders, such as depression, anxiety disorder, bipolar disorder, or psychosis.

Treatment can occur in a variety of settings, in many different forms, and for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment often is not sufficient. For many, addiction treatment is a long-term process that involves multiple interventions and attempts at abstinence.

Why can’t drug addicts quit on their own?

Nearly all addicted individuals believe in the beginning that they can stop using drugs on their own, and most try to stop without treatment. However, most of these attempts result in failure to achieve long-term abstinence. Research has shown that long-term drug use results in significant changes in brain function that persist long after the individual stops using drugs. These drug-induced changes in brain function may have many behavioral consequences, including the compulsion to use drugs despite adverse consequences the defining characteristic of addiction. Long-term drug use results in significant changes in brain function that persist long after the individual stops using drugs.

Understanding that addiction has such an important biological component may help explain an individual’s difficulty in achieving and maintaining abstinence without treatment. Psychological stress from work or family problems, social cues (such as meeting individuals from one’s drug-using past), or the environment (such as encountering streets, objects, or even smells associated with drug use) can interact with biological factors to hinder attainment of sustained abstinence and make relapse more likely. Research studies indicate that even the most severely addicted individuals can participate actively in treatment and that active participation is essential to good outcomes.

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.