The Female Factor

What’s worse, the transition from occasional use to abuse tends to happen more quickly in women than in men for several reasons.

One, experts say, involves perception and social acceptability. “Women who’d never dream of using a street drug, like heroin or cocaine, look at prescribed drugs and think, this has a sanctioned medical use. If it has been prescribed for my mother or my friend, it’s probably okay for me to take as well,” says Michelle McClellan, Ph.D., director of the Gender and Addiction program at the University of Michigan, US.

That perception was strengthened by the FDA’s revision of its policy on prescription-drug broadcast advertising to consumers 11 years ago, says Carol Boyd, Ph.D., director of the Institute for Research on Women and Gender at the University of Michigan, US. “These drug ads create the impression that the medications are safe no matter what,” says Boyd. However, one needs to take into account that the adverts are a part of a larger picture that is driven by the market and before you pop the pill you might want to consider the disastrous consequences of it.

Women also may be more vulnerable to the feel-good effects of drugs for purely physiological reasons. “Because women typically have more fat and less water in their bodies than men do, research suggests that drugs stay in a woman’s system longer, even if she has taken the same amount that a man has,” says Back. And some prescription drugs, like Valium, have a higher affinity for fat tissue, so they may linger in a woman’s body longer than they would in a man’s.

Hormonal fluctuations also might make drugs feel more powerful to a woman, which in turn can make it more tempting to repeat the experience. Bottom line: “Women advance more rapidly than guys do from regular use to addiction,” says Back.

The scary side of 'safe' drugs

If a pal offers friendly help in the form of prescription pills, turn her down — or risk your health.

Samantha, 21, never thought of herself as a drug abuser—after all, everything she took was perfectly legal. To her, dabbling with prescription medications was just a partying thing. She and her friends were into “heightening,” or intensifying, the effects of alcohol and marijuana by combining one or the other with a prescription drug. So, for instance, on a Saturday night, they might take the anti-anxiety drug Xanax, following it with a joint or a couple of beers to get a more intense buzz.

Then Samantha discovered that other prescription pills could help ease everyday stresses. For instance, her friend’s Adderall, a stimulant used in treating attention-deficit/hyperactivity disorder, was great for fueling late-night study sessions; her mother’s narcotic painkiller Vicodin was more effective than drugstore remedies for menstrual cramps; and Xanax, on its own, helped get her through the anxiety of a painful break-up.

“If something isn’t going right, Xanax makes it seem like it disappears temporarily,” says Samantha. 71% of people who abuse prescription painkillers get them from a friend or relative. Source: National Survey on Drug Use and Health

That casual attitude towards using, or “borrowing,” these powerful prescription drugs is shared by an increasing number of young women nowadays, many of them lulled into a false sense of security because these are not street drugs but doctor-prescribed remedies for ailments. However that “safe” drug use is actually putting them at a greater risk than most realise.

Reckless Recreation

Non-medical use of prescription drugs is rising, especially among 18-to-25-yearolds, and has increased significantly in that age-group since 2002, according to the US Substance Abuse and Mental Health Services Administration. Among women in that age group, 29 percent say they have taken prescription pain relievers, sedatives, tranquilisers, or stimulants for non-medical reasons at some point or the other and 14 percent of them have taken it within the past year.

In fact, pills are fast closing in on illicit street drugs as a health risk in young women. “The jump in emergency-room visits illustrates the growing danger of non-medical use of prescription drugs,” says Sudie Back, Ph.D., assistant professor in the department of psychiatry at the Medical University of South Carolina, US, and co-author of the forthcoming book Women and Addiction.

Between 2004 and 2005, trips to the ER related to non-medical use of the most commonly prescribed drugs, overthe-counter pharmaceuticals, and diet supplements jumped by an astounding 21 percent, according to the Drug Abuse Warning Network. In 2005, there were almost 600,000 ER visits involving these substances, compared with almost 817,000 for illicit drugs like cocaine, marijuana, and heroin. More than half were visits involving tranquilisers (such as Xanax, Valium, and Ativan) or painkillers (like Vicodin and OxyContin).

Easy-Access Addiction

All you’d have to do (and we’re not suggesting that you go ahead and try it) is peek inside your friends’ and family’s medicine cabinets to see that painkillers, anti-anxiety drugs, sleeping pills, stimulants—you name it—are almost everywhere. Americans make up only 4.6 percent of the world’s population but consume an astonishing 99 percent of the global supply of hydrocodone (the generic name for Vicodin), according to the International Narcotics Control Board. Some of these users are treating a legitimate medical problem, but many aren’t.

And once the drugs are in circulation, personal access is sure to follow. A 2007 study from the National Center on Addiction and Substance Abuse at Columbia University found that buying these drugs on the Internet is, scarily so, almost as easy as downloading songs from iTunes—all it takes at the end of a long tiring day is a credit card.

For many users, it starts as casually as a friend saying “Here, take one of these— you’ll feel better.” Eventually, abusers get crafty: One young woman admits to sneaking painkillers—just enough not to be noticed—from the medicine chests of her friends’ mothers. Another learned how to research the symptoms of various conditions, say depression or anxiety, and then go to her doctor with just the right descriptions—“I’m having trouble coping” or “I’m anxious all the time.” He would end up prescribing her something.

The way painkillers work on the brain helps explain why easy access often leads to abuse, says Charles O’Brien, M.D., Ph.D., founder of the Charles O’Brien Center for Addiction Treatment at the University of Pennsylvania, US.

Within minutes of your swallowing these medications, explains Dr O’Brien, they circumvent your body’s natural process of gradually activating the brain’s reward center (the part that registers pleasure during sex and even chocolate consumption) and, instead, head straight for it. If the pills are genuinely being taken to deaden physical pain, they do just that, but in case they are actually used in the absence of a legitimate medical problem, says Dr O’Brien, that pure hit of delight can over a period of time become “the genesis of addiction”.

Accidental Addicts

Jennifer, 31, experienced that shift firsthand. After back-to-back medical and dental procedures six years ago, she was prescribed Vicodin and Percocet. Both of them were painkillers that made her feel so unlike her regular self— extremely calm and unflappable—that she eventually started doing whatever it took to get refills of the same drug.

At first she told her doctor that she had accidentally flushed the pills down the toilet. Eventually, she was forging prescriptions at the Cancer Clinic in Boulder, Colorado, US where she worked. By the time her supervisor confronted her, a year after she had started taking them, Jennifer was swallowing up to 12 Percocet a day, the maximum dose that is prescribed for someone who’s recovering from surgery. She agreed to go to rehab, and finally, after several relapses and losing her job, she was successfully treated with a drug called Suboxone, which relieves withdrawal symptoms and cravings after use of the abused drug has been discontinued.

Giving up painkillers, especially Vicodin or OxyContin, “is similar to trying to get off heroin,” says Boyd. “These drugs are highly addictive when misused frequently and in large amounts.” And addiction is far from the only risk: Taking prescription drugs off label and, especially, taking large doses of them presents real health dangers in the long run. In large amounts, stimulants like Adderall and Ritalin can trigger an irregular heartbeat and even cardiovascular failure; narcotics can cause depressed respiration, a condition in which your breathing slows dramatically (and eventually it could stop altogether). Add alcohol to the mix—what Samantha and her friends so casually call heightening—and you risk all the above, as well as pulmonary edema (fluid in the lungs) and, in some cases even death.

Samantha started to understand those risks one day after combining a codeine painkiller with pot (a friend had a few pills left over after having a minor surgery). What had initially seemed like a pretty harmless way to have a good time began to feel like anything but. Samantha was driving back home and suddenly felt “so whacked out that I could hardly function.” Getting home safely that day seemed like a miracle, one that she wasn’t too sure would save her the next time round. “Some of my friends still love the out-of control feeling they get from combining a bunch of different drugs ,” she says, “but I’m off that. For good.”

Medicine-Cabinet Menaces

The most commonly misused* Rx drugs...and their alarming possible side effects.

OPIOIDS

Vicodin, Percocet, OxyContin

Prescribed for Pain, often following surgery.

Possible side effects when abused: Respiratory depression that can lead to death following a single large dose.

CENTRAL-NERVOUSSYSTEM DEPRESSANTS

Sedatives (Mebaral, Nembutal) and anti-anxiety drugs (Xanax, Ativan as well as Valium) Prescribed for Stress, anxiety, panic attacks, and sleep disorders (as distinct from selective serotonin-reuptake inhibitors like Prozac, which treat depression and don’t produce a high). Possible side effects when abused: Confusion or coma, seizures when abruptly stopped.

STIMULANTS Adderall,

Ritalin, Dexedrine Prescribed for Attentiondeficit/hyperactivity disorder, narcolepsy, and depression that does not respond to other sorts of treatments. Possible side effects when abused: Dangerously high body temperature, irregular heartbeat, cardiovascular failure, and lethal seizures. Source: National Institute Of Drug Abuse *used in any way that was not medically intended for you personally.