ORLANDO, Fla. — When Bryan stopped taking drugs six months ago, he got through the worst of his heroin withdrawal in a week. It was Xanax that tortured him for a full month.

He longed for the "benzos," slang for benzodiazepines, the class of drugs that includes Xanax, to take the edge off his skittishness, sleeplessness and anxiety.

Although Bryan used a variety of drugs for about 12 years, the Orlando man found Xanax one of the hardest to let go.

"Once you get fixated on downers like that, you don’t stop easily," said Bryan, 29, who asked not to be identified by last name to protect his business. "Especially if you’re a high-strung individual, it just gives you an extremely relaxing feeling. It’s slows down your thought process; you take everything in stride."

Xanax is a prescription medication used to treat anxiety. But it also is a highly abused, easily addictive tranquilizer and the focus of a fraudulent prescription drug charge against Gov. Jeb Bush’s 24-year-old daughter, Noelle.

If convicted, officials said, Noelle Bush likely would be given probation as a first-time offender.

She will not be required to appear in court personally until after formal criminal charges are filed, a process that generally takes four to six weeks, Leon County Assistant State Attorney Owen McCaul said.

Xanax and other prescription drugs are becoming increasingly popular with younger people, according to the National Institute on Drug Abuse. A government survey in 2000 found that about 5 million Americans have abused Xanax or a similar anti-anxiety drug at some point.

" It ’s basically the modern-day version of a Quaalude,  the mother’s little helper," said Lui Delgado, a certified addictions professional and executive director of Quest Counseling Centre in Altamonte Springs. " It ’s very common with young people, and it ’s very easy to find."

Xanax is the brand name for alprazolam, a drug developed at least 20 years ago as an alternative to Valium, a widely prescribed sedative that was considered too easily addictive.

But both drugs can create powerful addictions, and some say Xanax is worse than Valium.

"Xanax, in particular, is abused because it has a fairly quick uptake into the system, and many people get a buzz from it, " said Dr. Herndon Harding, medical director of Florida Hospital ’s Center for Behavioral Health.

Xanax works by depressing the central nervous system, enhancing the effects of a chemical in the brain that slows down the firing of neurons and reduces brain activity.

Bryan said taking Xanax felt like having a few drinks, minus the dizziness. He could get 100 pills for about $200, but the drug sells for up to $5 a pill on the street.

Most prescriptions call for no more than 2 mg of Xanax total a day. Because he had built up a tolerance, Bryan needed about 10 mg to get the desired effect.

The body’s reaction to the removal of a substance it has become dependent on is called withdrawal. Withdrawal causes craving for more of the substance being removed. The period of time when the body is trying to overcome its addiction is called detoxifica-tion (detox). Detox is the first step in overcoming a substance addiction such as drugs or alcohol. Detox is a pertinent step for the patient is to be successfully rehabilitated.
 

Opiate drugs such as heroin and methadone, and prescription medications including Hydrocodone, Oxycontin, Xanax, Vicodin and Lortab, require medical detox supervision. There are however, other illegal drugs such as marijuana, crystal methamphetamine, and cocaine that do not require medical detox. Since there is psychological dependence associated with these drugs, it would be wise to complete a period of stabilization. The process of drug detox requires the patient to be closely monitored by keeping vital signs, giving support and administering medications if needed. There are numerous withdrawal symptoms or side effects when a patient stops or dramatically reduces drugs after heavy or prolonged use. Those side effects include: sweating, shaking, headaches, drug cravings, nausea, vomiting, abdominal cramps, diarrhea, sleeplessness, confusion, agitation, depression, anxiety, and other behavioral changes.
There are two commonly used drugs to enable the patient to feel relief from these symptoms. First, Klonepin, which reduces physical symptoms, and Buprenophex, which is an anticonvulsant. These drugs must also be monitored as cessation produces withdrawal symptoms. Generally, the time period for drug detox is three to seven days under medically monitored supervision.
 

Alcohol detox, like drug detox, is usually accomplished in an inpatient medical facility. Duncan Raistrick identifies the key to a successful, planned detoxification is preparation. Raistrick goes further to detail that the first job of therapy is to bring the patient to a point of readiness to change their drinking behavior. Second, patients need to be given accurate information about what to expect during detoxification.
 

There are two withdrawal categories: minor, meaning early withdrawal and major, meaning late. The severity of withdrawal depends greatly on the duration of alcohol used. Alcohol Withdrawal Syndrome (AWS) falls into three main categories: central nervous system (CNS) excitation, excessive function of the autonomic nervous system (ANS), and cognitive dysfunction.5 Richard Saitz, M.D., M.P.H., states, since alcohol enhances gamma-aminobutyric acid’s (GABA) inhibitory effects on signal-receiving neurons, neuronal activity is lowered. This lowering leads to an increase in excitatory glutamate receptors. Tolerance occurs as GABA receptors become less responsive to neurotransmitters, which in turn requires more alcohol to produce the same inhibitory effect. During detox, the GABA is ineffective and unable to suppress the excitatory glutamate receptors. Detox is intended to relieve physical symptoms such as: shaking or tremors, headaches, vomiting, sweating, restlessness, loss of appetite, sleeplessness, Delirium Tremens (DT’s), hyperactivity, and convulsions. Alcohol detox medications are similar to drug detox medications: Buprenophex, certain benzodiazepines and anticonvulsant medications. Alcohol detox completion can take from three to fourteen days.
 

Norman S. Miller notes that medical management of alcohol and drug withdrawal during detoxification often is not sufficient to produce sustained abstinence from recurrent use. Therefore, further addiction treatments are needed to prevent relapse to alcohol and drug use following treatment of withdrawal.
 

In conclusion, drug and alcohol detoxification can effectively prepare the addicted abuser for rehabilitation and treatment.
 

Some physicians believe the withdrawal phase is related closely to the drug addiction – the worse the withdrawal, the more likely the continued use of the chemical to prevent withdrawal. Several factors are key to successful detoxification.
 

1. Acknowledge that there is a problem and decide to do something about it.
2. Get rid of all the drugs and paraphernalia.
3. Drop friends and associates that are tied to our drug problem.
4. Seek and accept spousal support, or support from friends, or relatives.
5. Prepare for symptoms with the support of a professional.
6. If tranquilizer drugs are needed for a few days or longer, they must be handled sensitively, as one addiction can easily replace another.

Xanax is a Central Nervous System (CNA) depressant known as benzodiazepine, which is commonly prescribed by physicians to treat panic attacks, nervousness, and tension. Xanax, also known as alprazolam, is considered to be a Schedule IV controlled substance under the Controlled Substance Act (CSA). Xanax has been used as a tranquilizer since the 1960s. With strong opposition to the use of benzodiazepines in the 1970s, there was a 25 percent drop in the number of prescriptions written and today, with approximately 3 million Americans (1.6% of the adult population) having used benzodiazepine on a daily basis for at least 12 months, they are the most controversial of all psychotropic medicines.

According to the United States Department of Justice Drug Enforcement Agency (DEA) and under the CSA, all controlled substances are rated on a five-schedule system. Schedule V, the lowest, for the potential for abuse and dependency and I, the highest. Xanax is a Schedule IV. All Schedule IV controlled substances have the following attributes: a low potential for abuse, a currently accepted medical use in treatment in the United States, and if abused, may lead to limited physical dependence or psychological dependence. Other examples of drugs included in schedule IV are Darvon®, Talwin®, Equanil®, Valium®, and Xanax®.

Although there are many benefits to taking Xanax and other Schedule IV drugs, many patients are becoming addicted and therefore require an intervention and drug treatment program to overcome their addictions. The patient’s body can also build up a tolerance to the drug and require larger doses if taken for long periods of time. With these increases in Xanax use come physical and psychological dependencies. Xanax is not drug to quit cold turkey. The Journal of Postgraduate Medicine stated that up to 25 percent of patients who stop taking their medication experienced withdrawal symptoms such as: nausea, vomiting, dizziness, headache, anxiety, irritability, insomnia, chills, lethargy, fatigue, moodiness, crying, dystonia, paresthesia, tremor, vivid dreams, and myalgias.

The National Institute on Drug Abuse found during a two-year treatment outcome study that 15 percent of heroin users also used benzodiazepines daily for more than one year, and 73 percent used benzodiazepines more often than weekly. Studies also indicate that from 5 percent to as many as 90 percent of methadone users are also regular users of benzodiazepines.

With this information in mind, the Xanax abuse treatment involves careful monitoring and counseling in an in-patient or outpatient treatment facility. The American Psychiatric Association’s (APA) report on benzodiazepines revealed that 11 to 15 percent of the adult population has taken a benzodiazepine one or more times during the preceding year, but only 1 to 2 percent have taken benzodiazepines daily for 12 months or longer. However, in psychiatric treatment settings and in substance-abuse populations, the prevalence of benzodiazepine use, abuse and dependence is substantially higher than that in the general population. Treatment encompasses a patient’s thought process, behavior, and helps them to cope with everyday life. Patients suffering from Xanax addiction should be tapered off gradually. There are basic outpatient plans available for discontinuation of the drug including: gradual discontinuance over a six to 12 week schedule, monitoring and helping the patient to feel in control of their dosage, and supplying a helpline when the patient needs reassurance. Other plans include inpatient treatment centers and 12-step programs such as Narcotics Anonymous, and drug treatment exchanges such as, Clonidine, propranolol, or carbamazepine. Although these substitutes can be dangerous, an inpatient setting where dosages can be physician monitored until the patient can reach a zero dose of the benzodiazepine is recommended.

In conclusion, Xanax and other benzodiazepines can be addictive drugs that are hard to discontinue however, they are also drugs of great benefit to patients who suffer from anxiety, depression, fear of open spaces (agoraphobia), premenstrual syndrome, and panic attacks. The patient and the physician should work together to regulate long-term usage, monitoring side effects, and any signs of abuse.

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.”

Sun Sentinel — South Florida is tops in all the wrong things again, this time in prescription drug overdose deaths, with Palm Beach County leading the state in fatal methadone overdoses last year, and Broward ranking second in deaths involving the anti-anxiety drug Xanax and third in oxycodone fatalities.

No one knows why South Florida owns this tragic distinction, but one thing is clear: It proves why crackdowns on doctor shopping and unscrupulously run "pill mills" are so essential. And why they deserve an even higher ranking on the law enforcement priority list.

Drug addiction is not a victimless problem. Even if it’s not your loved one who’s hopelessly hooked, your safety may be affected because addicts often turn to crimes like burglary or robbery to feed their habit.

So combating addiction, and reducing the incidence of overdoses, is a societal, not just a personal, responsibility.

Fox News — A warning from the Colorado Springs Police Department. Detectives with Metro Vice Narcotics said more and more teens are throwing "pharm parties," or get-togethers where young adults abuse prescription drugs.

Detectives said most teens get the medications from their parents and grandparents medicine cabinets. They said from there, the prescription drugs are then taken to parties and shared with the group.

Over the past few months, police said a handful of teenagers have overdosed on the drugs. They said some of the more popular pills include Xanax, Valium, Percoset, Oxycontin, Vikatin and Adderall to name a few.

It is called "trail mix," or a bowl filled with prescription drugs free for the taking. Detectives with the Colorado Springs Police Department said "trail mix" is the new party favor at many teen get-togethers.

"Then the kids just take turns taking a pill of their choice to see if it affects them and to see if they like it or not," an undercover officer with Metro VNI said.

Detectives with VNI said they have seen youth ages 12 to 22 abuse the drugs.

"I have had reports of pills being taken from grandma and grandpas when they go visit, aunts and uncles, friends going over to another kids house and taking from that medicine cabinet," a VNI Detective said.

The most popular pills detectives said are schedule II medications, or drugs that are highly addictive.

"Cocaine and meth are schedule II, Adderall, Oxycontin and Percosit are all schedule II as well, so they have the same abuse and addiction potential," a VNI Detective said.

Police said the internet has only made things worse by spreading information.

"They did an interview with a youth who overdosed, and the way he chose what medication to take was if it said ‘do not use with alcohol,’ that meant to him it was a great drug to use," a VNI Detective said.

They said many teens think prescription drugs are safe because they are prescribed by a doctor.

"Definitely, we have seen overdoses," a VNI Detective said.

To keep your kids safe, police said treat your pills like a gun, lock them up and put them away.

Detectives with VNI said prescription drug abuse is a nationwide problem that also affects millions of adults. If you or someone you know is abusing prescription pills log onto the website below for help.

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.”

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."

The ruling comes two weeks after the 28-year-old was found dead in his New York apartment. Police found six types of prescription drugs, including pills to treat anxiety and insomnia, in his bedroom and bathroom.
    

Heath Ledger Ledger was found dead on January 22, A spokesman for the medical examiner said Ledger died as a result of "acute intoxication by the combined effects" of the drugs oxycodone, hydrocodone, diazepam, temazepam, alprazolam and doxylamine.

The drugs are the generic names for the painkiller OxyContin, the anti-anxiety drug Valium, Xanax, an anti-anxiety drug, and the sleep aids Restoril and Unisom.

Hydrocodone is a widely used prescription painkiller.

"We have concluded that the manner of death is accident, resulting from the abuse of prescription medications," the statement added.

Meanwhile, Ledger’s former fiancée Michelle Williams has flown into Australia ahead of the actor’s funeral in the western city of Perth. Dressed in black, Williams was carrying the couple’s two-year-old daughter Matilda as she arrived in Perth on a Qantas flight from Los Angeles.

Matilda clutched a white stuffed rabbit, as the pair was escorted from the terminal amid tight security.

Williams refused to answer questions about plans for Ledger’s funeral, which is expected to take place this week.

The Brokeback Mountain star’s parents, sister and other family members have also arrived back home in Perth after attending two memorial services in the US.

Ledger’s memorial service in Los Angeles drew an A-list of mourners including Tom Cruise and wife Katie Homes.

The Australian won critical acclaim and an Oscar nomination for his performance as a gay cowboy in Brokeback Mountain in 2005, and was regarded as one of Hollywood’s rising stars.

According to the United States Department of Justice Drug Enforcement Agency (DEA) and under the CSA, all controlled substances are rated on a five-schedule system. Schedule V, the lowest, for the potential for abuse and dependency and I, the highest. Xanax is a Schedule IV. All Schedule IV controlled substances have the following attributes: a low potential for abuse, a currently accepted medical use in treatment in the United States, and if abused, may lead to limited physical dependence or psychological dependence. Other examples of drugs included in schedule IV are Darvon®, Talwin®, Equanil®, Valium®, and Xanax®.

Although there are many benefits to taking Xanax and other Schedule IV drugs, many patients are becoming addicted and therefore require an intervention and drug treatment program to overcome their addictions. The patient’s body can also build up a tolerance to the drug and require larger doses if taken for long periods of time. With these increases in Xanax use come physical and psychological dependencies. Xanax is not drug to quit cold turkey. The Journal of Postgraduate Medicine stated that up to 25 percent of patients who stop taking their medication experienced withdrawal symptoms such as: nausea, vomiting, dizziness, headache, anxiety, irritability, insomnia, chills, lethargy, fatigue, moodiness, crying, dystonia, paresthesia, tremor, vivid dreams, and myalgias.

The National Institute on Drug Abuse found during a two-year treatment outcome study that 15 percent of heroin users also used benzodiazepines daily for more than one year, and 73 percent used benzodiazepines more often than weekly. Studies also indicate that from 5 percent to as many as 90 percent of methadone users are also regular users of benzodiazepines. With this information in mind, the Xanax abuse treatment involves careful monitoring and counseling in an in-patient or outpatient treatment facility. The American Psychiatric Association’s (APA) report on benzodiazepines revealed that 11 to 15 percent of the adult population has taken a benzodiazepine one or more times during the preceding year, but only 1 to 2 percent have taken benzodiazepines daily for 12 months or longer (4). However, in psychiatric treatment settings and in substance-abuse populations, the prevalence of benzodiazepine use, abuse and dependence is substantially higher than that in the general population. Treatment encompasses a patient’s thought process, behavior, and helps them to cope with everyday life. Patients suffering from Xanax addiction should be tapered off gradually. There are basic outpatient plans available for discontinuation of the drug including: gradual discontinuance over a six to 12 week schedule, monitoring and helping the patient to feel in control of their dosage, and supplying a helpline when the patient needs reassurance. Other plans include inpatient treatment centers and 12-step programs such as Narcotics Anonymous, and drug treatment exchanges such as, Clonidine, propranolol, or carbamazepine. Although these substitutes can be dangerous, an inpatient setting where dosages can be physician monitored until the patient can reach a zero dose of the benzodiazepine is recommended.