U.S grapples with rising prescription drug addiction

BOSTON (Reuters) - When Sarah Roisman was 11 years old, herdoctors prescribed Klonopin, a muscle relaxant, for apsychiatric disorder that caused her to have seizures. Sheliked how the drug made her feel. Her seizures went away.

But that's where her trouble with addiction began.

By age 14, the teen from an upper middle-class Philadelphiasuburb led a dangerous double life. Editor of her school paper,strong student and popular athlete, Roisman was also hooked onpainkillers and other drugs in an addiction that illustratesthe rapid expansion in prescription drug abuse in America.

"My friends and I would take a bunch of different pills andbreak them up and put them all together and call it confetti.It could be any combination of anything. We could learn fromit, and continue to take it," said Roisman, who is now 17.

The issue of prescription drug abuse shot to prominencewith January's death of 28-year-old Hollywood actor HeathLedger after he took six different prescriptions. The death ofLedger, who plays the Joker in the new Batman film "The DarkNight," adds to a growing list of prescription drug overdosesthat includes Playboy model Anna Nicole Smith in 2007.

Other deaths are less celebrated. In the 45-54 age group,overdose deaths fueled by prescription drugs now surpass motorvehicle deaths as the nation's No. 1 cause of accidental death,federal data show.

The federal data also show nearly 7 million Americansabused prescription drugs in 2007 -- more than cocaine, heroin,hallucinogens, Ecstasy and inhalants such as marijuanacombined. The figure is up 80 percent since 2000.

Definitions of abuse vary but refer typically to nonmedicaluse of prescription drugs.

The number of Americans treated for abuse of painkillerssurged 321 percent from 1995 to 2005, federal statistics show-- a trend some health experts link to another stunning figure:the 180 million prescriptions dispensed legally by U.S.pharmacies each year for pain medication.

In Florida, whose reputation for cocaine and other harddrugs was burnished in movies such as "Scarface" and "MiamiVice," the rate of deaths caused by prescription drugs wasthree times the rate of death caused by all illicit drugscombined, according to an analysis of 2007 autopsies by theFlorida Medical Examiners Commission released in June.

'LOW SOCIAL DISAPPROVAL'

"What you have among over the counter and prescription druguse is a very low perception of risk," said Stephen Pasierb,president and chief executive of the Partnership for aDrug-Free America, a nonprofit advocacy group.

"There's very low social disapproval. In fact, there areparents who almost relieved that their kid is using Vicodin andnot smoking marijuana," he said.

Len Paulozzi, an epidemiologist with the National Centerfor Injury Prevention and Control, testified recently inCongress that he believed physicians were improperly trained inthe long-term dangers of therapy involving opioid painkillers,or drugs containing opium.

"There are guidelines out there, but we don't think thatthey're being routinely followed," he said.

Sen. Joseph Biden, a Democrat from Delaware, proposed tomake August 2008 "National Medicine Abuse Awareness Month" in aresolution now before the Senate Judiciary Committee, sayingthe Internet had become "an information superhighway" for abuseof medicine in the United States.

But containing the abuse is notoriously difficult.Thirty-eight states have passed legislation for prescriptiondrug monitoring programs to trace the source of drugs, andpolice in some states have had success in reducing pharmacybreak-ins.

A University of Maine program provides pre-addressed,postage-paid pouches to the elderly so they can mail theirsurplus prescription drugs to state authorities for disposal ina bid to reduce the amount that get into the wrong hands.

None of the measures has stopped the growth nationwide, andexperts point to several stubborn problems, including thephenomenon of "doctor shopping," in which patients go tomultiple doctors to get several prescriptions.

Hundreds of online pharmacies also offer drugs that includegeneric versions of opiates like Purdue Pharma's OxyContin,methadone and Abbott Laboratories Inc's Vicodin, which arelegitimately prescribed as painkillers, along with stimulantslike Ritalin made by Novartis, and benzodiazepines likePfizer's Xanax.

It is as easy in the United States to buy opiates or otherabusable prescription drugs online as it is to purchase a book,said David Festinger, a scientist who has studied online drugsales at the Treatment Research Institute at the University ofPennsylvania. Regulating such trade is tough, he said.

"These Internet enterprises set up a bank account in onecountry, buy their drugs from another country, and do theirmerchandising and sales from another country," he said."Everything is spread all over the globe. And in an instant, ifanybody's on their tail, they can switch everything around."

RAIDING MEDICINE CABINETS

For many children, getting the drugs is simple.

In Philadelphia, Roisman and her friends raided familymedicine cabinets for the big prizes -- OxyContin, a kind ofsynthetic morphine also known as "hillbilly heroin," along withRitalin and Vicodin -- until she eventually passed out one dayin school. A drug test showed she had seven drugs in hersystem.

"People think that it's OK because it's a prescribed pill.It comes from a credible source. Even if a doctor has not toldyou it's OK, they've told someone else it's OK," said Roisman,who became sober two years ago after treatment at a rehabcenter run by the nonprofit Caron organization.

She blames doctors for failing to "watch what they areprescribing" and parents for failing to understand "just howhard people will work to get what they want when they are anaddict," adding many teens use the drugs to help study.

On college campuses, popping Adderall, Ritalin and otherprescribed amphetamine-like psychostimulant drugs is a popularway to help cram for tests and cope with academic pressure.

Some are legitimately prescribed for Attention DeficitHyperactivity Disorder, helping sufferers increase alertness,attention and energy. But many use it without prescriptions.

Almost 60 percent of students have been offered anopportunity to try prescription stimulants by their junior(third) year of college in the United States, said AmeliaArria, a senior researcher at the University of Maryland'sCenter for Drug Abuse Research, which surveyed 1,253 studentson drug usage.

Health insurers are also feeling the effects. Some facemounting pressure to expand coverage to include substance-abusedisorders. Others are grappling with swindlers who obtainillicit prescription narcotics through fraudulent insuranceclaims for bogus prescriptions, treating phantom injuries.

Such fraud costs health insurers up to $72.5 billion (36.6billion pounds) a year, according to a 2008 report by theCoalition Against Insurance Fraud, an advocacy group based inWashington.

(Editing by Philip Barbara)