Teenage Drug Diversion—Part 2

Last month we started withpart 1 of the advent ofteenager prescription drugabuse issues. Discussed in the articlewas the problem with teenagersobtaining some of thesedrugs through their own medicinecabinet or that of a friend orneighbor. In addition, teenagershave been able to procure potentopiates through legitimate suppliesfor chronic pain patients.

One other significant sourcecan be the Internet, through thenumerous national and internationalWeb sites that offer a varietyof CIII and CIV pharmaceuticalsillegally. Recent news reportsshow that millions of dosageunits are making their way intothe United States in this way.When this practice first began,the drugs were obtainable almostexclusively by providing a valid credit card. Although asmall percentage of teens may have access to their parents'credit cards, most do not.

With the added concern about bogus sites and identitytheft, some of the Web sites allow orders to be paid whendelivered, or Cash on Delivery. In addition to solving the 2problems for adults, this potentially opens the door forteenagers to order supplies of these drugs and then pay forthem with cash. Even with hydrocodone prices reaching $3per pill from the Internet sites, this investment can be doubledin the current market.

Teenagers with ready cash through parents or employment,especially in the more affluent neighborhoods, canorder and sell these pills at will. One teenager, knowing thathis 2-box order was due to be delivered in the afternoon,would find the delivery driver in the morning. He would tellthe driver he wanted to purchase one of the boxes now andwould have enough cash to pay for the second box in theafternoon.Teenagers have paired up with "doctor shoppers"andthose involved in passing bogus prescriptions to assist themin their criminal acts. Sending younger accomplices into thepharmacy to fill a prescription allegedly for an ailing parentcan be a lucrative business thatmay fall under the radar of thenormally vigilant pharmacist.

Probably the most dangerousmethod of obtaining illegal pharmaceuticalsfor teenagers involvespurchasing them from street dealers.This usually means travelinginto high-crime-ridden neighborhoodsthat teens are not as familiarwith, and dealing with traffickerswho have long criminal records.This can leave naïve youngstersopen to a variety of scams, orworse, assault and robbery.

Pharmacists need to be cognizantof teenagers working in thepharmacy as cashiers or even emptyingwaste baskets or moppingfloors. Peer pressure can be significanton these teenagers from theirfriends, once their friends knowwhere they are employed.

The days of teenagers having limited involvement in prescriptiondrug abuse seem to be long gone. Extra concernsinvolve teenagers driving under the influence of prescriptiondrugs, and/or combining them with alcohol, their historicallyfavorite substance of abuse. These combinationscan create incredible highs and, sadly, overdoses leading todeaths in some cases.

The answer to this emerging problem is the same as for theproblems with other substance abuse issues with teenagers.Know as much as you can about what your teens are doingand with whom they are associating, and do not be afraid toask questions and place parameters on their activities.

Parents need to become educated on prescription drugabuse, and realize that the source may be close to home.One of the best Web sites to provide this kind of educationis Purdue Pharma's Painfully Obvious site. Interested parentsand others can access this at www.painfullyobvious.com.

John Burke, director of the Warren County, Ohio, drugtask force and retired commander of the CincinnatiPolice Pharmaceutical Diversion Squad, is a 32-year veteranof law enforcement. For information, he can bereached by e-mail at burke@choice.net, via the Web sitewww.rxdiversion.com, or by phone at 513-336-0070.