Dani McClain

April 30, 2007

Shira Hassan has read the research that says prescription drug use is up among young people.

But annual reports like the government-funded “Monitoring the Future” don’t often reflect what she sees working with 12- to 23-year-old women in Chicago’s sex trade, said Hassan, co-director of the Young Women’s Empowerment Project.

These young women don’t reflect the reported youth opiate craze, and painkillers like OxyContin and Vicodin aren’t in unusually high demand.

“Spikes are media-driven,” said Hassan, whose group is rooted in the principles of harm reduction. “The spike is more of a spike in the research.”

Authors of the University of Michigan study, a composite of 50,000 8th-, 10th- and 12th-graders’ disclosures about their drug use, started asking about OxyContin and Vicodin in 2002. And 2006 was the first year they included questions about over-the-counter cold medicines, as though sippin’ on some [cough] syrup were brand new.

Last year, peer outreach workers with the Young Women’s Empowerment Project talked to more than 400 girls in the Chicago area who were trading sex for money or drugs. More than half of those conversations were about drug use.

What they’re using is what Hassan has seen consistently over the years: marijuana and alcohol are most prevalent, followed by crystal meth, heroin, ecstasy, powder cocaine and other club drugs.

“I haven’t met a kid who their primary passion is pills in a long time,” Hassan said.

Where prescription drugs like Xanax, Valium and Ativan do come into play is in combination with other drugs. These pills are benzodiazepines, the “downers” that calm the nerves or ward off a crash as the high from cocaine or meth subsides.

But if this is new to researchers, it isn’t to users.

“That’s been going on since the beginning of time,” Hassan said.

What is relatively new is recreational prescription drug use among the population university researchers can access easily: middle-class teenagers who go to school.

And among this group, yes, access to parents’ pain pills and the exchange of Adderall and other drugs prescribed for attention-deficit disorder and depression are increasingly common, said Marsha Rosenbaum, a medical sociologist and director of Drug Policy Alliance’s Safety First project.

The 2006 University of Michigan study reports that 9 percent of high school seniors had used a prescription narcotic in the previous year, compared to the just over 4 percent who had used ecstasy.

One reason for this comparatively high use is the medical community’s shifting approach to pain management, Rosenbaum said.

“You have a little surgery, you get some pills,” she said of young people’s access to adult family members’ prescriptions. “To doctors these days, Vicodin is like aspirin.”

Rosenbaum doesn’t suggest restricting people’s ability to alleviate their pain, but she does say parents should throw away or lock up their unused meds. Even more important is realistic drug education that teaches young people to reduce harms associated with drugs if they do choose to use them, she said.

And because young people know exactly what they’re putting in their bodies when they use prescription drugs recreationally, Dan Bigg of the Chicago Recovery Alliance sees their use a sign that more young people are taking the principles of harm reduction to heart.

With these drugs, there’s less of a crapshoot around how much to take or potentially dangerous fillers.

“The Internet provides a wealth of information,” Bigg said. “It’s easy to read about it and understand dosage. You have an opportunity to do that, that you don’t [have) with illicit drugs.”

Of course, abuse can still be a problem. Ninety minutes north of Chicago in Racine, Wis., Sammy Rangel is seeing the young people–mostly white boys–who get caught stealing cough medicine from local pharmacies. He also sees the teenagers hooked on OxyContin.

A director of the street outreach program at Racine’s SAFE Haven youth shelter and a licensed drug and alcohol counselor, Rangel shares Hassan’s skepticism that there’s a recent spike in prescription and over-the-counter drug abuse. He doesn’t see it among the population he works with: primarily black and Latino youth between the ages of 13 and 25.

The biggest change he’s seen in the last year is the increase in young black men snorting heroin.

“That was something I hadn’t seen in a long time,” Rangel said. “You worried about a kid getting a hold of crack.”

This trend follows a boom in heroin sales in nearby Kenosha in the early 2000s, and now the drug is big among 16- to 25-year-old black men, Rangel said. They’re adamant that they never shoot the drug, but he thinks a stigma often forces injection users into silence.

“You’re a partier or a casual user if you’re snorting it, but you’re a dope fiend if you’re shooting up,” Rangel said.

Marijuana is big among the younger teenagers he works with, which is no surprise except he thinks the volume–some talk about smoking an eighth of an ounce every hour or two that can have long-lasting effects, including severe memory loss and motor skill deterioration. Rangel said the glorification of blunts in pop culture is partly to blame for skewing conversations around moderation.

“Nobody talks about joints anymore. I think they get laughed at,” he said. “It’s one thing to smoke marijuana, it’s another thing to saturate your system.”

Rangel also worries about the crack cocaine and PCP that sometimes make their way into blunts.

But Googling prescription drugs isn’t the only way to steer clear of unforeseen toxins. At the Young Women’s Empowerment Project, people do still talk about joints, and on a recent day Hassan overheard a 13-year-old girl asking how to tell whether one had been rolled using papers laced with embalming fluid.

A 19-year-old colleague of Hassan’s used the peer education model on which the organization prides itself. Without judgment, without shaming the girl into clamming up, the staffer started brainstorming ways the younger girl could stay safe.

Hassan watched the two puzzle through the problem together:

“If you’re out with a guy, don’t let him smoke you up,” the colleague suggested. “Roll from your bag. Don’t carry too much. Teach yourself how to be in charge of your drug use.”

Dani McClain is a reporter at the Milwaukee Journal Sentinel. She serves on WireTap’s advisory board.