Health: Prescription Drug Abuse in Westchester County Schools

More young people are abusing prescription drugs to get ahead, lose weight, fit in, or zone out.

As a high school freshman in Westchester, Angel (not her real name), the oldest of three girls in an Italian-American family, admired how certain classmates not known for their academic prowess seemed to effortlessly turn around difficult essays overnight. It was quite obvious to her that something was stoking their productivity. That “something” turned out to be a powerful combination of amphetamines sold under the brand name Adderall.

Doctors prescribe Adderall to children, adolescents, and adults with attention deficit hyperactivity disorder (ADHD) to help them focus, stop fidgeting, and pay attention. It boosts brain levels of dopamine and norepinephrine, chemicals that promote mental alertness, motivation, arousal, and sense of pleasure. The drug has a calming effect on ADHD patients, but the opposite in everyone else. If you don’t have ADHD, stimulant medications like Adderall can pep you up, keep you awake, and squelch your appetite. When crushed and snorted or injected, it can produce a feeling of euphoria.

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For all of these reasons, Adderall has gained popularity among tweens, teens, and young adults. Some kids like the rush it gives them, while others, especially girls, take it as a weight-loss remedy. Among high school and college students, it’s mostly used as a study aid to help speed through homework or cram for mid-terms. It’s the NoDoz of the Millennial Generation.

Hoping to whip up a little academic magic of her own, Angel scored an ongoing supply of Adderall from a girl she knew at school who had her own prescription. The girl appeared depressed and felt misunderstood but willingly traded her daily dose in exchange for Angel’s friendship—and an occasional breakfast. The girl “cheeked” her pill while her mother watched and, when the coast was clear, spat it out and squirreled it away to pass off to her classmate. “That’s kind of gross,” Angel admits, “but I didn’t really care.”

The arrangement kept Angel’s drug habit intact through her sophomore year. She felt more focused and interested in school. “I hate history; that’s my worst subject,” concedes the now-17-year-old, a recent high school graduate, “but I would get amazing grades in the class because I was on Adderall.” Angel later was diagnosed with ADHD and obtained her own prescription. However, as with many kids who try stimulants, it wasn’t her drug of choice. She also had  heroin and marijuana habits. When her parents eventually caught on, she entered a drug treatment program and remains in counseling.

It’s easier than ever for young people to get their hands on all sorts of prescription medications. In fact, while Adderall abuse is troublesome, it’s merely a snippet of a wider problem. Kids are getting high on opioid painkillers sold under brand names like OxyContin, Vicodin, and Opana, and chilling out on Xanax and other sedatives, often procured from a parent’s medicine cabinet.

“Young people have access to all these types of drugs,” says Pennye W. Nash, co-owner and executive director of Sancia Health Care Inc., in White Plains, a provider of outpatient mental health and substance abuse services. “By the time the student comes out of middle school, they’re already at risk,” she cautions.

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Lillian Neuman, who runs the St. Vincent’s Hospital “EXCEL” outpatient addiction program for adolescents in Harrison, got a call one day from a concerned mother of a middle school student. An aide had caught her daughter crushing up Adderall at the lunchroom table to snort with her boyfriend. The girl got the Adderall from a friend “just to try it,” the mother told her. “A lot of kids, they might not have tried alcohol or pot, but a friend has Adderall, and since it’s pretty commonplace…kids will give it to each other to try,” she says.

Michelle Rolle, assistant clinical director at The Lexington Center for Recovery in Mount Kisco, says kids who are abusing prescription drugs do it for a variety of reasons. “Most of them usually start taking it because they just don’t want to have to deal with the stressors of school, or authority figures, or their parents,” she says.

As highlighted in the documentary Race to Nowhere, teenagers are feeling the strain of our test-obsessed, overscheduled culture like never before. The Horatio Alger Association’s most recent “State of Our Nation’s Youth” survey found that the pressure to get good grades tops all other stressors in teens’ lives. In 2008, 79 percent of high school students said the pressure for good grades created a problem for them, compared to 62 percent  in 2001.

Seventeen-year-old Yancy Carrasco, a varsity football player, International Baccalaureate Programme candidate, and member of Students Against Destructive Decisions at Yonkers High School, rarely sees students in his own school abusing prescription drugs. But he has seen students elsewhere resort to drugs “for comfort,” he says. “There are some students who can go home as late as six or seven, and they have four or five hours of work on top of that. They’re already exhausted; they’re lacking energy. Those pressures are what lead to drug and alcohol abuse.”

Kids from all walks of life, regardless of race, ethnicity, social class, guardianship, or town of residence, can—and do—get caught up in prescription drug misuse, drug counselors insist. It’s not just the stereotypical druggie—kids with tattoos, baggy pants, or poor grades—who are at risk. “It’s also that blonde-haired, blue-eyed, ponytailed, white  upper-middle-class head of the lacrosse team,” says Ann-Marie Trotta, director of outpatient alcohol and drug services for St. Vincent’s Hospital-Westchester in Harrison. “And anyone out there who thinks it’s not in their town or area should take off the blinders.”  

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Nationally, the proportion of 12th graders who have used any prescription drug without medical supervision in the past year increased to 15 percent in 2010, from 14.4 percent in the previous year, according to Monitoring the Future, an ongoing study of American youth. By comparison, 65.2 percent of 12th graders used alcohol in the past year, and 19.2 percent were smokers. Although rates of prescription drug use have fallen in recent years (it was 17.1 percent in 2005) due to greater public attention to the problem, “significant numbers of teens are still misusing prescription drugs,” the report notes. Adderall use without a doctor’s order inched upward, to 3.5 percent of high school seniors in 2010, from 3.3 percent in 2009. OxyContin and Xanax use increased slightly as well.

Ellen Morehouse, executive director of Student Assistance Services Corp. (SAS), a Tarrytown nonprofit that provides substance-abuse prevention services and training, sees a similar pattern in Westchester. “In high school, we noticed an increase in this trend about five years ago,” she says, although results from several new surveys of 8th, 10th, and 12th graders shows a decline in use of narcotics and painkillers since 2008, which may be due partly to increased efforts to combat the problem. Still, the rates of abuse are a concern, Morehouse adds. Some 3.3 percent of 10th graders and 3.6 percent of 12th graders reported using narcotics and painkillers in 2011. Use of sedatives by youth in all three grades—a tiny fraction of a percent in 2008—now ranges from 1.3 percent to 1.7 percent. Stimulant use rose from among 8th and 10th graders from 0.2 percent to 0.9 percent and from 1.1 percent to 1.8 percent, respectively.

Alarmed by these trends, SAS has held several training sessions, including one for school nurses, on recognizing and responding to signs of acute intoxication and withdrawal. “We wanted them to understand that, just because a student is sent to the nurse’s office because she appears drunk, don’t ever assume that’s the only chemical in their system,” Morehouse says. Another nurse training session on the topic is planned for January.

County Executive Robert P. Astorino and the Westchester County Coalition for Drug and Alcohol Free Youth held a news conference in August to draw attention to the problem and highlight the county’s response. In an ongoing educational effort, the coalition has recruited 80 pharmacies to distribute pamphlets advising parents how to prevent their children from abusing prescription drugs. In April, the county and coalition collected and destroyed more than 1,400 pounds of unused medication as part of the Drug Enforcement Administration’s National Prescription Drug Take-Back Day.

Adderall is easily obtainable, says Mount Kisco adolescent medicine specialist Lauren Budow, MD, who, until recently, practiced in New York City. One of her patients, a young  girl with an eating disorder, used Adderall she got from a friend in high school to squelch her appetite. “Everyone’s selling it,” the girl told her. “It’s not hard to get. You just have to ask around.”

What’s it cost? Prices vary depending on the drug, but most anything can be had for $5 or $10, Nash says. In Angel’s school, Adderall can be had for $3 per 30-milligram pill. Nash has patients who skip lunch and spend the money on drugs. Sometimes drugs trade hands from one friend to another as a favor, or for sex, drug counselors add. Some transactions are barters: a pair of sneakers or jewelry for some pills.

Marijuana use and underage drinking remain the most widely abused substances by Westchester youth. But, because the state bans smoking in the schools, young people find it easier to swallow a pill than to smoke weed, Angel says. And, because these medicines are prescribed by a physician, kids assume they’re safe—or certainly less menacing than street drugs, like heroin and ecstasy, drug counselors say.

The truth is Adderall is classified as a Schedule II Controlled Substance with the same potential for abuse as cocaine. While considered a safe drug in doses prescribed for ADHD patients, a person who misuses it may require more and more of the drug to get the same high. Also, like many stimulants, it can elevate heart rate and blood pressure. The drug carries a warning that children and adolescents with heart defects or other heart problems should not use it because of an increased risk of sudden death. At the very least, it can cause headache and insomnia.

Young people taking Adderall to study for tests generally don’t show up in the emergency room, though, because they typically use it intermittently, says Joseph Ponticiello, MD, director of the Department of Emergency Medicine at Sound Shore Medical Center in New Rochelle. “They’re abusing it, but they’re not overdosing,” he says. However, when kids mess with narcotics like Opana, Vicodin, and OxyContin, they’re playing with fire. Not only are these medicines highly addictive, but their misuse can lead to agitation, poor judgment, and dangerous behaviors, like drinking and driving or accidental overdose, Dr. Ponticiello says.

“Someone taking someone’s Adderall, they’re not going to die,” Morehouse says. “Someone taking someone’s Vicodin, depending on the strength and what else is in their system, could.”

There are legal consequences, too. Any time Little Johnny gets his hands on someone else’s prescription medication—no matter what it’s for—and is caught taking it, sharing it or selling it, may face formal charges, says attorney Kevin J. Kitson, founder and managing partner of The Kitson Law Firm LLP in White Plains. “If I’m fourteen and I’m swallowing oxycodones or hydrocodones and I get caught with them, I can be charged with criminal possession of a controlled substance,” he says. Haven’t heard of incidents in your own community? Often, these cases are either resolved in family court, or a teenager is granted “youthful offender” status in criminal court where records may be kept confidential, Kitson explains. Sometimes the school handles the offense in-house rather than notifying the police.

Because young people will go to extraordinary lengths to hide their illicit drug use, the danger is that kids will be reluctant to speak up even in a life-or-death situation, Morehouse adds. But a new state law may help. The “Good Samaritan” law, sponsored by State Senator John A. DeFrancisco, a Syracuse Republican, and signed in July by Governor Andrew Cuomo, encourages calls to 911 for help. In exchange, witnesses and overdose victims who are caught in illegal possession of small amounts of drugs are, in most cases, protected from arrest and prosecution.

Karen Pallarito is a freelance journalist whose publishing credits include Westchester Magazine, U.S. News & World Report, The Washington Post, Working Mother and Woman’s Day. When not on deadline, she’s keeping close tabs on her two school-aged kids.

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