Tuesday, Oct. 27, 2009 | The media launch of a regional task force last week marked the public recognition by law enforcement of a growing problem with prescription drug abuse, particularly among the county’s teenagers.
District Attorney Bonnie Dumanis told reporters the pain killer oxycodone was an “emerging epidemic” among youth and other officials said that description is not an exaggeration. They pointed to a rising number of prosecutions and deaths related to prescription drugs.
Despite the handful of statistics and dire warnings, authorities acknowledge that they don’t know much about San Diego’s prescription drug market. Most of their initial research has focused on conversations about overdose statistics and treatment centers, but no one has a handle on how many youth are using prescription drugs for the purpose of getting high.
San Diego’s hospitals and school districts have been mum about the problem. There have been burglaries targeted at prescription drugs and arrests, but no sweeping analysis of the region’s status quo or its enforcement efforts. Authorities say it appears to be more popular in more affluent, suburban communities, such as Rancho Bernardo, Torrey Pines and Poway.
The new Oxy Task Force hopes to improve the region’s understanding of prescription drug abuse and determine whether oxycodone — the drug behind the group’s name — is actually a widespread problem. Oxycodone, often branded as OxyContin, is a powerful opiate manufactured to relieve severe pain over a long period of time. People abuse the drug by manipulating its ingestion to negate a controlled release of medication. They snort, chew, smoke or inject it for hours of a euphoric high.
The task force wants to collect more information about oxycodone from law enforcement, hospitals, schools and treatment centers. At the same time, authorities also want to raise awareness about prescription drug abuse among teens. On Saturday, the task force organized the first countywide collection of prescription drugs that are no longer needed — no questions asked. Residents reportedly dropped off 321 pounds of medication and supplies.
Dr. Richard Clark is director of toxicology at the University of California San Diego Medical Center and leads the San Diego office of the California Poison Control System. He disagrees with the characterization that oxycodone is the county’s new drug problem. He said prescription drug abuse has been a major concern for years and oxycodone shouldn’t receive any more attention than other products.
“The epidemic was probably five to 10 years ago for oxycodone,” he said. “I think with high school kids, and kids in general, prescription drug use and experimentation is becoming more common.”
Through poison control, Clark examines the county’s overdose cases at five hospitals. He said teens have long abused oxycodone but they continue to experiment with other pain medication, like Vicodin, or sedatives, like Valium. Both have contributed to a number of teen deaths since 2007, according to the county’s medical examiner.
Although oxycodone tends to be the poster child for a generational movement toward the greater abuse of prescription medication, there are plenty of other drugs in the market. Youth involved in abusing prescription drugs can be indiscriminate when pills are freely available at home or from a friend — accessibility can play more of a role than addiction. They slam bottles of liquid Tylenol or shoulder a handful of mom’s nicotine patches.
In high school, some teenagers reportedly organize “pharming” parties. At those parties, each person grabs a random assortment of medication from their household medicine cabinet and shares it with other teens. The group pops pills and binges on alcohol with no concern or understanding of the chemical outcome.
Toxicologists in emergency rooms can struggle with complex cases of teen overdose, when finding a treatment means trying to determine what concoction of pills was mixed with alcohol at a party. Sometimes the patients don’t know what they ingested, but the result could lead to lifelong organ damage or death.
Oxycodone has been recognized as a national problem for more than a decade, but law enforcement said San Diego has been somewhat insulated from its affects. The drug spread in popularity from East Coast and Southern states while the Southwest faced larger problems with methamphetamines, which have still contributed to the death of at least 270 people since 2007.
Law enforcement in San Diego started to focus on oxycodone after they heard anecdotal stories from abusers and treatment centers that it was the preferred pill in the illicit drug market. Authorities also noted how the drug has quickly developed among urban youth in other regions of the country.
“It was the kids that started our investigation,” said Deputy District Attorney Matthew Williams, one of the Oxy Task Force’s founding members. “What they’re telling us is that this is pretty rampant in the high schools.”
“We saw this as a problem that we could jump on before it becomes a major problem,” he continued. “I think we’re now starting to see it trickle in and become a larger problem in San Diego.”
Law enforcement improved police training of prescription drug abuse in recent years, which led to an increased number of prosecutions. The county medical examiner reported 17 oxycodone-related deaths between 2004 and 2006, and at least 54 deaths between 2008 and 2009. Some have questioned whether that uptick is the result of additional testing, but Dr. Jon Lucas said the office’s practices were consistent through that period. Since 2007, only alcohol and heroin have contributed to more deaths than oxycodone for people between the ages of 16 and 25.
“We believe the abuse is at the epidemic level because people who are starting to use OxyContin do not have an underlying medical condition that led to the long-term use and eventual abuse and addiction,” said Amy Roderick, spokeswoman for San Diego’s DEA office. “Now people are using them in concert with or instead of illicit drugs, solely for the purpose of getting high.”
Authorities hope they are catching San Diego’s oxycodone market on the front end because it has exploded on the East Coast, and especially in Florida, where oxycodone is now recognized as one of the leading illicit drugs among youth. Teenagers start abusing the drug in middle school and may later turn to heroin, which has a similar euphoric high and can be cheaper.
Fred Berger is medical director at the Scripps McDonald Center in La Jolla, which focuses on alcohol and drug rehabilitation. Even without solid statistics on the table, he testifies to a greater use of prescription drugs in San Diego, especially oxycodone, by youth. They have been more of his patients.
“What’s clear is over time, it seems to be going up,” Berger said. “I don’t really dwell on the statistics. I’m focused on the 100 percent that come to us and need help.”
Please contact Keegan Kyle directly at keegan.kyle@voiceofsandiego.org and follow him on Twitter: twitter.com/keegankyle. And set the tone of the debate with a letter to the editor.