Last month we started with part 1 of the advent of teenager prescription drug abuse issues. Discussed in the article was the problem with teenagers obtaining some of these drugs through their own medicine cabinet or that of a friend or neighbor. In addition, teenagers have been able to procure potent opiates through legitimate supplies for chronic pain patients.
One other significant source can be the Internet, through the numerous national and international Web sites that offer a variety of CIII and CIV pharmaceuticals illegally. Recent news reports show that millions of dosage units are making their way into the United States in this way. When this practice first began, the drugs were obtainable almost exclusively by providing a valid credit card. Although a small percentage of teens may have access to their parents' credit cards, most do not.
With the added concern about bogus sites and identity theft, some of the Web sites allow orders to be paid when delivered, or Cash on Delivery. In addition to solving the 2 problems for adults, this potentially opens the door for teenagers to order supplies of these drugs and then pay for them with cash. Even with hydrocodone prices reaching $3 per pill from the Internet sites, this investment can be doubled in the current market.
Teenagers with ready cash through parents or employment, especially in the more affluent neighborhoods, can order and sell these pills at will. One teenager, knowing that his 2-box order was due to be delivered in the afternoon, would find the delivery driver in the morning. He would tell the driver he wanted to purchase one of the boxes now and would have enough cash to pay for the second box in the afternoon. Teenagers have paired up with "doctor shoppers"and those involved in passing bogus prescriptions to assist them in their criminal acts. Sending younger accomplices into the pharmacy to fill a prescription allegedly for an ailing parent can be a lucrative business that may fall under the radar of the normally vigilant pharmacist.
Probably the most dangerous method of obtaining illegal pharmaceuticals for teenagers involves purchasing them from street dealers. This usually means traveling into high-crime-ridden neighborhoods that teens are not as familiar with, and dealing with traffickers who have long criminal records. This can leave naïve youngsters open to a variety of scams, or worse, assault and robbery.
Pharmacists need to be cognizant of teenagers working in the pharmacy as cashiers or even emptying waste baskets or mopping floors. Peer pressure can be significant on these teenagers from their friends, once their friends know where they are employed.
The days of teenagers having limited involvement in prescription drug abuse seem to be long gone. Extra concerns involve teenagers driving under the influence of prescription drugs, and/or combining them with alcohol, their historically favorite substance of abuse. These combinations can create incredible highs and, sadly, overdoses leading to deaths in some cases.
The answer to this emerging problem is the same as for the problems with other substance abuse issues with teenagers. Know as much as you can about what your teens are doing and with whom they are associating, and do not be afraid to ask questions and place parameters on their activities.
Parents need to become educated on prescription drug abuse, and realize that the source may be close to home. One of the best Web sites to provide this kind of education is Purdue Pharma's Painfully Obvious site. Interested parents and others can access this at www.painfullyobvious.com.
John Burke, director of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 32-year veteran of law enforcement. For information, he can be reached by e-mail at firstname.lastname@example.org, via the Web site www.rxdiversion.com, or by phone at 513-336-0070.
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