Tonawanda News

May 12, 2013

JUST A PILL

WNY 'on top of the bubble' of prescription drug abuse in state

By Neale Gulley and Jeff Gillette neale.gulley@tonawanda-news.com
The Tonawanda News

Tonawanda News — Drug addiction, once called the quiet epidemic, is no longer the stuff of back alleys or urban drug houses. No longer is it the domain of society’s fringe or a countercultural statement.

These days, the problem is much closer to home.

That’s because pharmaceutical drugs have replaced street drugs like heroin and cocaine as the single leading cause of overdose death among users nationwide, according to a report by the Centers for Disease Control and Prevention.

The drugs accounted for 60 percent of all overdose deaths in 2010, the most recent year for which data was compiled.

It marks the 11th straight year that overdose deaths in general have increased in the U.S., and three out of every four pharmaceutical overdoses in 2010 involved prescription painkillers like hydrocodone, oxycodone and methadone.

Deaths specifically involving such painkillers, commonly called opioids, were 4,030 in 1999, a number that skyrocketed to 15,597 for 2009 and 16,651 in 2010, when prescription drugs in general accounted for 22,134 of a total of 38,329 drug overdose deaths nationwide.

The CDC said the numbers confirm “the predominant role opioids ... play in drug overdose deaths.”

Unlike their illicit counterparts — drugs with street names like smack, H and blow — America’s newest addiction, prescription painkillers, doesn’t necessarily require a drug dealer or a clandestine exchange. Frequently they are the remnants of prescriptions lingering in medicine cabinets, easily accessible by anyone. 

Or they are gotten straight from the pharmacy in what can be a completely legal exchange of money for drugs.

“From my perspective it is the number one drug problem we are having, absolutely,” said Anne Constantino, president and CEO of Horizon Health Services, a counseling and addiction recovery clinic serving the Tonawandas. 

She said the problem is so big in this area that New York state’s latest budget includes a competitive grant to expand residential drug treatment services, a grant available in just two areas of the state: Staten Island and Western New York. 

“We’re at the top of the bubble,” she said.

Horizon admits about 450 people each month to its addiction treatment programs. At any given time, Constantino said there are about 1,700 to 2,000 individuals undergoing treatment, while the waiting list specifically for residential treatment is consistently about 35 people.

“It’s growing at an exponential rate. It’s taken over the majority of what we do,”  Horizon drug counselor Nicholas Gazzoli said. “One hundred percent, this was not the case 10 years ago.” 

Problem trends young

Contributing to the increase may be the fact that drug abusers in this area are trending younger than ever — now often including adolescents or young adults.

Gazzoli said some of his clients began abusing prescription drugs as early as the eighth grade.

“Younger people are taking them and not realizing how deep the rabbit hole goes,” he said. “The whole notion of doing it is less scary (than street drugs), and very few think they’ll end up badly.” 

He said “pharm parties” are common among young people, replacing street drugs or alcohol in some social groups.

Recent headlines have shouted of ordeals like the arrest of a LaSalle Preparatory school student in 2012, after police in Niagara Falls said she provided prescription drugs to six of her classmates.

Detectives identified the pills as suboxone, a powerful narcotic similar to methadone, which is in turn similar to heroin and is often used to ween hardcore junkies from the needle.

Young adults’ early exposure to such dangerous narcotics can be explained at least in part by studies suggesting that such drugs are easier than ever to obtain.

“We always served adolescents ... but they were a very, very small percentage of people coming in for the treatment,” said Constantino, who has been at Horizon since 1986. “Young adults now are between 40 and 50 percent of the people we see. And 65 percent of the young adults have an opiate addiction, many of whom began with prescription drugs.” 

One reason, recent data suggets, may be that the majority of all users — fully 55 percent nationwide according to the CDC — experience their first high by abusing medications found in someone else’s medicine cabinet. 

According to a survey by the White House Office of National Drug Control Policy, one-third of people aged 12 and over who used any drug for the first time in 2009 began by using a prescription drug not prescribed to them. The survey of drug use among young people also points to prescription drugs as the second-most abused category of drugs after marijuana.

But regardless of age, Gazzoli said the trend of prescription abuse is bolstered largely by prescription trends in recent years. More than ever, he said, the most addictive drugs originate from prescriptions — appealing because they eliminate the stigma of street drug paraphernalia like crack pipes and heroin needles. That is, at first. Once users become accustomed to the pills, it’s often not long before drugs like heroin become an attractive — and far cheaper — option.

”They go from swallowing to sniffing (crushed pills) and eventually, IV,” he said, adding the progression from one method of ingestion to another, one form of drug to the next, looks the same time and again in patients he counsels. 

“It’s 100 percent predictable,” he said.

Gazzoli runs seven group sessions each week at Horizon, and said virtually his entire caseload consists of people with an addiction to opioid drugs including heroin. They are school kids, middle-aged mothers or working professionals. Most started down the road to addiction with a single pill.

”I’ve got prep school kids in boat shoes and pressed shirts and khaki pants shooting heroin,” he said, adding most addicts don’t fit stereotypes associated with low-income, urban strife.

Supply and demand

Perhaps not surprisingly, the number of legitimately filled prescriptions for opioid painkillers in the U.S. has increased along with abuse trends. 

The quantity of prescription painkillers sold to pharmacies, hospitals, and doctors offices was 4 times larger in 2010 than in 1999, and according to CDC, enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month.

While health officials warn most prescriptions are used to treat legitimate ailments, more than once a doctor from the Buffalo/Niagara area has been arrested for dispensing pills illegally.

Dr. Matthew Bennett continues to stand accused of illegally dispensing prescription medication out of his North Tonawanda practice on River Road, as well as his Clarence home.

Federal authorities and local police swept into his office and residence last August to look for evidence, after several sales were allegedly made to undercover officers weeks earlier.

The 46-year-old family care physician was arrested on charges he did not examine many of his patients when prescribing pills and would often trade items at his home such as toiletries and even a gas grill for opiate-based prescription medications including Roxicodone, Oxymorphone and Xanax.

In 2011 a Niagara Falls doctor, Dr. Pravinchandra Mehta, known as “Doctor Feel Good” and described as a prolific pill pusher, was arrested along with 13 others in a joint local and federal investigation charging them with obtaining controlled substances at local pharmacies by presenting prescriptions they knew were fraudulent or forged. They then dispensed the medications in quantities investigators at the time called “staggering.”

The next two Sunday installments In the News’ continuing, three part Sunday series will examine the effect of such criminal cases, as well as the cause and solutions being discussed. Readers will hear from law enforcement officials here, and have the opportunity to hear from several recovering addicts from the Tonawandas who have agreed to speak to the News about their addiction, and their road to recovery. 

ABOUT THE SERIES The Tonawanda News will print and three-part series, "Prescription for Abuse" today and the next two Sunday. Still to come: PART TWO: A look at the local impact of abuse, along with insights from law enforcement officials, area politicians and care providers on the causes of the problem, and what's being done about it. PART THREE: Survivors' accounts of their slide into addiction -- what caused them to abuse drugs, the impact of abuse, hope for tomorrow.

-- Contact City Editor Neale Gulley at 693-100, ext. 4114.