Prescription for Trouble: Painkiller Abuse Plagues Florida

Daytona Beach News-Journal

DAYTONA BEACH -- The headlines scream more frequently now.

A mother addicted to prescription pain pills falls asleep while her son drowns in a bathtub. A group high on Xanax beat a man to death for money. An appliance repairman is arrested twice for stealing pain pills when he was supposed to be fixing appliances.

"This is the most serious problem facing law enforcement at this time," Volusia County Sheriff Ben Johnson said during a recent interview. "It's more serious than crack cocaine."

Fed by a society more medicated in general than ever before, and a system that doesn't keep track as it might on where powerful heroin-like drugs are going, the problem of prescription-drug abuse is growing.

The damage to families is clear.

According to state Health Department statistics, more than nine people die of prescription-drug overdoses each week statewide.

Florida has been at the forefront of the debate over prescription drug abuse because it has been one of only a few states that don't monitor how many prescription pills are sold.

A law passed last year could address the problem of "doctor shopping" by limiting the amount of pills that can be distributed to patients in a set time period.

Other pending legislation is aimed at preventing convicted felons from distributing pills and increasing access to patient records by the state Health Department.

Circuit Judge Joseph Will, who runs the local drug court and hears felony court cases in his Daytona Beach courtroom, said many adults start taking the drugs -- opioids like Valium, Xanax, Loritab and OxyContin -- for pain as prescribed.

"They think they still have the pain, but the pain stopped years ago," Will said. "Pretty soon, they're taking the pills just to stay normal, to be able to function."

Instead of the cocaine and heroin addiction treatment problems of years past, the vast majority of people who are enrolled in drug court these days are addicted to a prescription drug, Will said.

"Like everywhere, there are doctors in our community who over-prescribe these medications," Will said. "It doesn't take long to get hooked."

Part of the problem, he said, is that we live in a society of instant gratification. "We don't want to feel lousy."

"The thing that frustrates me is these are legal drugs being approved by the FDA and manufactured by drug companies," Will said. "The manufacturers and the FDA should be tracing where these pills are going. They ship them out in boxcars. Somebody should be accountable for how many they sell and which doctors are prescribing."

One of the most publicized local cases of prescription drug abuse was that of Crystal Giachetti, who put her 4-month-old baby son in the bath, injected a dose of Xanax between her toes, and fell asleep. Her son, Trenton, died April 6, 2009.

"When she wasn't high, she was the same old Crystal," Giachetti's cousin, Theresa Culver said. "But that was very seldom."

Giachetti, 31, who lived in a mobile home near Ormond Beach, pleaded guilty to aggravated manslaughter of a child last month in exchange for a 14-year sentence. Her abuse of Dilaudin, Xanax and Soma began a few years earlier, when she broke her back and started heavy use of prescription pills.

"She'd say, I need these drugs for my back," Culver said.

Authorities say that deaths, robberies and burglaries all highlight the intersection of powerful narcotics that are intended to be used under the supervision of a doctor and stupid things "stupefied" people do. That and the lengths addicted people will go to in order to get more drugs.

"It's off the chart," Daytona Beach Police Chief Mike Chitwood said Friday of the number of crimes that start with illegally obtained pills. "This is the new crack cocaine for this decade."

James Earl Mason was trying to be friendly when he offered prescription Xanax to a group of drifters he met at a beachside motel in Daytona Beach. Within hours of meeting Juanita Liebman, Jason Bowman and William McMinn, the three were stomping him to death on the floor.

"I can't fathom any rational explanation for why this occurred," Circuit Judge James Clayton said after he sentenced the second of two of the killers to life in prison earlier this month.

Bryan Langford, 38, was high on a mixture of alcohol, marijuana, morphine and oxycodone when he went on a rampage that ended the lives of his girlfriend, her son and himself. He was in serious need of drug detox and aloholics anonymous.

Langford also shot an Orange City police officer who was called to check on his well-being March 25, 2009. Officer Sherif El-Shami lost his eye in the shooting. As SWAT officers surrounded Langford, he put a .357-caliber revolver under his chin and pulled the trigger.

Experts say prescription drug problems have driven otherwise law-abiding people to commit criminal acts. Last year, Dr. Jerrold Ecklind, 38, was stopped by Daytona Beach police with his shoes on the wrong feet.

Ecklind, who had morphine in his car, and needed Xanax addiction treatment, was later accused of kidnapping. A jury acquitted him of that charge, but found he improperly displayed a weapon. Ecklind was ordered to enter a drug treatment center.

Judge Will said prescription drug problems can take longer to treat because for the abuser, the intended use gets in the way of understanding there is a problem.

"The cocaine addict says "I'm worthless, I'm scum," he said. "The opiate user says, "I'm better, I'm different, I just take pills because of pain."

To get help for these addicts, Will said, there must be an understanding that the substance abuse is not needed. "It's a matter of managing your life so you're comfortable without the stuff you put up your nose or up your arm."

With pill addiction, "it takes longer to get into that mind frame."

After the drug addiction grabbed hold of Crystal Giachetti, she didn't care about anything else, her cousin said.

When they told her she needed to stop taking pills and go for prescription drug treatment, Giachetti would say, "I know."

"One time we were at my mom's, the baby was just born, and Crystal went into the bathroom," Culver said. "She came out and she couldn't walk. She was instantly high. With the pills, it was like she didn't want the baby."

In Pennsylvania, Local School Board Approves Pilot Substance Abuse Program

Bucks Local News

In an 8-0 vote, the Pennsbury School Board voted to implement a peer-to-peer pilot substance abuse program in the Twilight Alternative Education program for at-risk teenagers.

The program will bring people who have recovered from addiction into the classroom to talk with students. The board could later decide to implement the program in the mainstream student population.

About 300 parents and educators applauded after each speaker gave personal testimony about the sometimes fatal effects of alcohol and drug abuse. The comments came at the regular public board meeting on Thursday, March 18.

Joe Powell, coordinator of Pennsbury’s Twilight Program, said the “genesis” of the peer-to-peer program came from a meeting with school board member Allan Weisel, who asked Powell at a polling place during the recent election whether the idea would work here. Weisel, a freshman board member, had introduced the program idea.

“I’m tired of burying students,” Powell said, who has worked in the program for five years. In that time, “we have buried four students who were directly related to the program.

“One was a junior transitioning to the senior year,” Powell explained. “One who had just graduated. Another one was a young man who had been in the program a few years before,” he said.

“I want to be clear on this -- this is not a panacea,” he said. “It’s not something for everything, but one thing Mr. Weisel asked me, ‘Did I think it would have value for our program?’ The one thing I keep kicking myself for is could we have done more? Could I have said something more clear?”

Powell said about the program, “If it saved one student’s life, to me it would be worth it. If you adopt this, we will run a program that would save our children’s lives.”

Paula McSherry fought back the tears when she sat down before the school board. A woman came to sit with her, holding her to console her.

“I had so many things written down,” she said, just managing to speak. “I lost my son, Ian, in December 2008 just a short time before he was supposed to graduate.”

Referring to the program, she said, “This to me is like a no brainer. It’s not going to cost any money. There’s nothing but a positive spin on it.”

“What’s really, really scary to me -- I know heroin is bad. It’s a horrible, horrible, horrible drug, but these pharmaceuticals available to these kids today – they’re a death sentence. And they’re out there…

“These kids are just eating them like its candy,” McSherry said. “It’s a living hell not to have my baby with me.”

She said Ian was an honor roll student. “He was a good kid…He wrote music and he’s gone and I just want to go back and I can’t get him back. It’s done.”

McSherry said the Pennsylvania substance abuse program will be “a good thing for kids. They can connect…If it will get people talking and sharing I think it would be a positive thing.”

One mother, whose son had attended Pennsbury, but transferred out, said that he had died of a heroin overdose in 2008. It started with marijuana, she said.

“Your kids might be out there experimenting,” she warned. If five are smoking marijuana, the chances are that one of them will not be able to give it up, she said.

The parent said it’s too easy to buy oxycontin. Heroin goes for $10 a bag, she said.

“I didn’t watch the money,” she said.

“My son came from a great environment,” she said, noting he was a football star and “had it all.”

“Steven went away to Bloomsburg,” she said. “He failed out his freshman year. We discovered something was wrong.”

“Years and years went by,” the mother continued. “He tried and tried at a full-time job. He really was doing well… The addiction grabbed him and when it did, it was his last injection of heroin…

“You have to stand up and admit you have a problem and take action because if you don’t, this problem will continue to grow,” she said.

She talked about the Calhoun Street Bridge in Morrisville as a path to heroin addiction in Trenton.

“We all know it exists,” she said. “We hear reports. We see it in the newspapers. These kids are going across that bridge at night and I know it because I’ve chased my son trying to find him when he snuck out at 2 in the morning.

“He was going over that bridge to get a bag of heroin,” she said. “If people here don’t think these kids are doing it, you better wake up because otherwise it is going to be one of your children and what will you do?

“Unless you’re brave enough to take action, these drugs will defeat you,” she said.

Report: Smoking in Decline while Alcohol, Drug Use Hold Steady

USA Today

A new report on substance abuse and mental health shows a small percentage of people are kicking smoking while alcohol and illicit drug-use levels remain steady.

But the report from the Substance Abuse and Mental Health Services Administration, out Thursday, also carries home the message that while all states have problems, there are big variations across the U.S. For instance, the rate of illicit drug use in Iowa (5.2%) among the 12 and older set is less than half what it is in Rhode Island (12.5%).

Many of the trends are similar to past studies, according to Art Hughes, one of the report's lead statisticians, but he cited "the adverse relationship between (perception of) risk of use and use itself" as worthy of examining at the state level.

In states where people reported having a perception of great risk about substance abuse, the problem is more often reported at lower levels than in states where risk is not as great a concern, according to the study, based on the National Surveys on Drug Use and Health. The 2006-2007 interview data is collected from 135,672 persons and is compared to the 2005-2006 data. Smoking declined from 24.96% to 24.63% with the greatest decrease among 12 to 25 year olds.

"Cigarette use continues to decline," says Hughes. "One statistic we use to try to gauge is the (perceived) risk of smoking cigarettes. If people think it's risky to use cigarettes, we tend to see an opposite effect happening."

For instance, California is among the states with highest percentage of people who regard smoking as a health hazard (77.35%) and had the second lowest smoking rate (19.79%) behind Utah (17.51%). Utah's perception of risk was slightly lower (76.93%) than California's. Nationwide, a slight drop was recorded compared to 2005-2006 (74.14% vs 73.86%). West Virginia, on the other hand, has the highest rate of cigarette users of all states (31.10%) for people aged 12 and older and has the lowest perception of risk level associated with smoking (67.88%). Oklahoma and Tennessee, which ranked No. 2 and 3 behind West Virginia for percentages of smokers, were also among states with lowest perception of risk.

"We're painfully aware of the problem," said Teresa Mace, media director of West Virginia's Office of Community Health Systems and Health Promotion. "We have a state tobacco quit line and other kinds of cessation programs that are offered to all West Virginians. We've gotten a lot better at getting our message to the people who need to know but it's hard to match the amounts spent by the tobacco industry."

Colorado is the only state showing an increase in tobacco use (from 26.5% to 29.8%) while seven states had declines: Idaho, Massachusetts, Michigan, Montana, New York, Utah and West Virginia. The Northeast region had a decrease as well (from 28.1% to 27.1%). Overall, national rates changed only slightly (24.6%) from the 2005-2006 report (25%).

Alcohol still leads tobacco as the most commonly used substance. The perceived risk associated with binge drinking (having five or more drinks once or twice a week) also played a role in levels of drinking and binge drinking among underage drinkers. North Dakota, which ranked highest in both categories, ranked a lowly 47th among states in perception of risk.

Drinking for the group of people over the age of 12 had similar results. New Hampshire, which ranked No. 3 behind Rhode Island and Connecticut, had the lowest percentage (33.21%) of perception of risk. Rhode Island and Connecticut also ranked among the lowest 10.

"We produce this as a reference document for the states, " says Joe Gfroerer, director of the division of population surveys. "It can lead to more in-depth analysis and discussion about whether drug treatment centers within the states can help with problems."

Rhode Island had the highest percentage of persons aged 12 or older who were needing but not receiving treatment for illicit drug use. The other states that ranked highest for needing but not receiving treatment for alcohol problems or drug rehab were mostly midwestern (Iowa, Minnesota, North Dakota, South Dakota and Wisconsin) or westerm (Colorado, Montana and Wyoming.) The District of Columbia and Massachusetts are in the top 10.

HOW STATES COMPARE ON SUBSTANCE USE

The new report from the Substance Abuse and Mental Health Services Administration captures states or jurisdictions with the highest and lowest levels of substance abuse. States in the top 5 and bottom 5 of various categories:

Illicit drug use in past month

Highest:
• Rhode Island: 12.5%
• District of Columbia: 12.13%
• Vermont: 11.49%
• Colorado: 10.96%
• Alaska: 10.74%

Lowest:
• Iowa: 5.2%
• North Dakota: 6.2%
• Utah: 6.43%
• South Carolina: 6.55%
• Texas: 6.65%

Marijuana use in past year

Highest:
• Rhode Island: 16.12%
• Vermont: 15.75%
• District of Columbia: 15.72%
• New Hampshire: 13.82%
• Alaska: 13.79%

Lowest marijuana use:
• Utah: 7.12%
• Mississippi: 7.79%
• Texas: 7.92%
• Alabama: 7.96%
• Oklahoma: 8.51%

Cocaine use in the past year

Highest:
• District of Columbia: 5.10%
• Rhode Island: 4.11%
• Arizona: 3.18%
• Colorado: 3.15%
• Massachusetts: 2.99%

Lowest:
• Mississippi: 1.63%
• Idaho/South Dakota/North Dakota: 1.73%
• Oklahoma: 1.86%
• New Jersey: 1.88%
• Nebraska: 1.9%

Alcohol use in past month

Highest:
• Rhode Island: 63.05%
• Connecticut: 62.17%
• New Hampshire: 61.92%
• Wisconsin: 61.54%
• Minnesota: 60.71%

Lowest:
• Utah: 30.85%.Mississippi: 36.95%
• West Virginia: 36.98%
• Alabama: 39.84%
• Tennessee: 40.22%

Binge alcohol use in past month

Highest:
• North Dakota: 32.02%
• Wisconsin: 28.84%
• Minnesota: 28.75%
• District of Columbia: 28.64%
• South Dakota: 28.34%

Lowest:
• Utah: 15.64%
• Mississippi: 18.74%
• Alabama: 18.77%
• West Virginia: 18.79%
• Tennessee: 19.19%

Cigarette use in past month

Highest:
• West Virginia: 31.10%
• Oklahoma: 30.64%
• Kentucky: 30.36%
• Tennessee: 30.48%
• Arkansas: 29.78%

Lowest:
• Utah: 17.51%
• California: 19.79%
• Hawaii: 20.57%
• Connecticut: 20.96%
• Massachusetts: 21.35%

Source: State Estimates of Substance Abuse from 2006-2007, National Surveys on Drug Use and Health

In Canada, Cough Syrup Moves Behind the Counter

Victoria Times-Colonist

A dozen pharmacies in Greater Victoria are moving cough remedies containing dextromethorphan -- known as DM or DXM -- behind the counter at the request of the College of Pharmacists of B.C.

The move follows a rash of overdoses -- in the last two weeks, four teenagers have landed in treatment after overdosing.

DXM, a cough suppressant and pain reliever, is easily accessible at drugstores. Youth use it to get high by exceeding the recommended dose.

From the U.S. DOJ Office of Diversion Control:

Dextromethorphan (DXM) is an over-the-counter (OTC) cough suppressant commonly found in cold medications. DXM is often abused in high doses by adolescents to generate euphoria and visual and auditory hallucinations. Illicit use of DXM is referred to on the street as "Robo-tripping" or "skittling." These terms are derived from the most commonly abused products, Robitussin and Coricidin.

The prime recreational users of DXM are ages 14 to 15, although there are reports that children as young as 10 also use the drug, according to the College of Pharmacists.

Signs will be placed on pharmacy shelves where cough remedies are kept directing purchasers to the dispensary for a consultation, said college registrar Marshall Moleschi yesterday.

If the spike in DXM use catches on in other areas, more pharmacies will be stowing the affected drugs behind the pharmacy counter.

"We're going to continue to monitor the situation," said Moleschi, adding consumers' need for the drug must be balanced with preventing youth from harming themselves.

Some youth see cough medicine as a harmless way to get high, said 14-year-old Sarah Hackett, who has started a Facebook page called "DXM is not cool!" that has 287 members after two weeks.

"One of my friends went to the hospital because she overdosed on it," said Hackett, who attends West Shore Learning Centre. "I just really freaked out and didn't know what to do."

The friend landed in drug detox and is now OK, but Hackett said yesterday that many of her peers don't know the dangers of abusing DMX. Overdoses can cause breathing difficulties, vomiting, dizziness and rapid heartbeat, among other symptoms.

"At first they say it's just cough medicine," Hackett said. "I went home and researched it. I found out what it does is messes up your brain and can give you brain damage. Your brain will stop telling your lungs to breathe."

The risks of exceeding the recommended dose even include death, said Cheryl Chaytors, manager of Victoria's specialized youth detox.

The four youths who recently survived overdoses were referred to drug detox by social workers and Victoria hospitals, said Chaytors, noting the detox process lasts seven to 10 days. "They will have some lasting effects from using the DXM -- dizziness ... no fine motor controls, confusion, memory loss, depression and anxiety.

"The problem is, youth see it as safe because it's something they get from the drugstore."

Young teens are going for cough medicine because it's easier to get than alcohol, she said. "It's easy to go to the drugstore and buy that kind of stuff, or it's quite easy to shoplift."

Students Among Patients at OSU Detox Center

The OSU Lantern

Brad Lander works with all sorts of drug addicts. But the most interesting category of patient, he says, are those who choose cocaine as their drug of choice.

“Coke addicts are my favorite,” said Lander, a licensed psychologist and director of Ohio State’s drug and alcohol rehab clinic at OSU East.

The clinic, located at 1492 E. Broad St., typically has about 90 people enrolled in rehabilitation programs at any given time, with 24 beds for inpatient treatment.

The clinic offers programs for people with any drug dependency, and any of age — with some patients as young as 10 to 12 years old.

In the last year and a half, Lander said, there has been a surge of young people coming to the clinic seeking treatment, including some OSU students.

“What most people don’t know is that a lot of students are alcoholics,” said Lander, who has worked at the clinic for eight years. He describes alcoholism as an inherited vulnerability, based on genetics. Although many students abuse alcohol, he said, symptoms often don’t arise until 30 years of age.

At any given time, there are at least two or three college students receiving treatment, Lander said.

Patients typically stay at the clinic for three to four days as they undergo treatment. Upon entering Talbot Hall, patients are given a thick, manila folder containing dozens of forms to sift through: registration forms, confidentiality statements, privacy reports and agreements and, last, a substance dependency assessment.

The assessment determines the extent of damage done to a person’s mental and physical health because of the drugs in their system. It is a crucial first step, Lander says, because it determines the patient’s program, and whether they will need to go through detoxification.

The inpatient detoxification program is an intensive one, according to the OSU Medical Center Web site. Patients receive medication to ease them through the withdrawal process and stabilize them.

“If you walked up to our detox floor, you would see people from all sorts of backgrounds,” Lander said. “You would be amazed how many different people are here at Talbot.”

After the patient is medically stable, he or she is required to participate in the education program. This process consists of lectures, films and discussions to help the patient learn about addiction and how to manage it. Counselors consult with patients individually and assist in developing treatment and post-discharge
plans.

After this process, each patient is given a basic 12-step program to follow.