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COVER STORY: Legal drugs, lethal highs
Pill partying, or “pharming.”
It’s the latest teen drug-abuse trend with potentially disastrous consequences. And it’s right at home on the North Shore, say police and public health officials.
“Youths will get together and will bring various different kinds of prescription drugs that they can find in their parents’ cabinets — these vary from Valium to Tylenol 3s and Ritalin,” says Cheryl Orlovsky, a public health nurse working within the West Vancouver school board.
“When they get to the party, they put all the different pills in a common bowl, mix them up and hand this bowl around and consume alcohol and prescription drugs,” she continues. “Obviously, it hasn’t ended well for some youth.”
Orlovsky gave the warning as part of a recent panel on pill parties and prescription drug abuse, jointly hosted by the West Vancouver School District and John Weston, Conservative MP for West Vancouver-Sunshine Coast-Sea to Sky Country.
On her left sat Michel Perron, CEO of the Canadian Centre on Substance Abuse (CCSA), and Const. Glenn Marshall, a drug recognition expert with the West Vancouver Police Department.
To her right sat emergency room physician Dr. Alec Ritchie, the former head of the Lions Gate Hospital emergency department who has had plenty of experience treating young people suffering all stages of drug toxicity.
The panelists each shared their unique insights into the pill party phenomenon; all the way up the chain from the cop coming through the door of the party, to the ER doc racing to halt the advance of an overdose, to the public health employees drafting high-level prevention strategies.
“Sadly, in our day-to-day dealings this tends to come up with the youth,” Const. Marshall says. “We will literally have a friend calling from a party, [saying] ‘It’s my friend, I don’t know what’s wrong but they can’t talk any more — they’re not drunk.’”
Too often, he says, teenagers won’t even know what kind of drug they’ve ingested or how to describe its effects, making it that much more difficult for police and first responders to render help.
“We talk to the friends and say, ‘What have they taken?’ and the honest answer is ‘I don’t know,’ because it’s whatever they’ve pulled out of the cabinet,” Marshall says.
“It’s no different than when the kids go into their parents’ liquor cabinet and they take a little of this…The problem is, you mix these two things and you don’t know how they’re going to react.”
It’s not an uncommon occurrence in West Vancouver, he says. Yet, police are powerless to do anything about it.
“We’d be very hard-pressed to find any court in the world that would charge somebody for possession of some pills that are prescription,” Marshall says. “I can get a charge to stick on somebody with three rocks of cocaine, but if it’s three Percocets [oxycodone], we’re going nowhere with it.”
First World Problem
The abuse of prescription painkillers, stimulants and sedatives in Canada has quickly crossed the “tipping point” into the realm of a public health crisis, says Perron, the CCSA chief.
In 1999, oxycodone-related deaths in Canada occurred at a rate of 1.39 per million. By 2004, that number had jumped to 7.17 per million — a fivefold increase in just five years.
Still it’s a crisis that flies under the radar for most communities because it’s not happening in the streets — as in, say Vancouver’s Downtown Eastside — but in the home, in front of the medicine cabinet.
“This is the challenge of prescription-drug misuse,” Perron says. “It’s not somebody who’s gone to the dealer to buy two oxy[codone] pills. The big problem we have in this country is over-prescribing — where a lot of people are unwittingly dependent or addicted to a substance largely through a therapeutic intervention.”
He cites the example of his own teenage son who, after minor surgery to remove his wisdom teeth, was prescribed 30 oxycodone tablets. Overkill, Perron says. Yet, when he asked the pharmacist what to do with the excess pills, the response was glib: “Don’t take them on a rainy day.”
Whether prescribed for mom, dad or for the child in question, once there’s a supply of prescription painkillers, sedatives or stimulant drugs in the home, some young people will naturally want to use them recreationally.
Perron notes an ongoing crisis in Ottawa, where the abuse of the painkiller fentanyl has recently exploded in high schools.
A powerful synthetic narcotic, fentanyl is 100 times stronger than natural opiates like morphine and is typically prescribed as a patch worn on the skin, offering time-release pain relief for cancer patients and others with severe chronic pain.
But in recent months, Ottawa youths have been habitually smoking and chewing the patches to get high, ingesting all of the fentanyl gel at once, to sometimes deadly effect.
Last August, a 17-year-old boy in the Ottawa suburb of Manotick became the latest victim of the fentanyl craze, as Ontario health officials estimated misuse of the drug has been responsible for more than 250 deaths in the province between 2009 and 2011.
“This is a problem of the rich, this whole prescription drug misuse issue,” Perron says, referring to the relative wealth of Canada compared to countries where such medicines are scarce.
In fact, according to one CCSA study, 70 per cent of young people between 12 and 18 reported taking drugs that weren’t prescribed to them from their home medicine cabinet to get high.
“There’s more youths [between 12 and 18] using opiates for non-medical purposes than smoking cigarettes,” Perron says. “So it gives you a sense of the scope of what’s going on.”
The fix: Stick to the script
To combat the fatal plague of fentanyl-patch abuse in Ottawa, many capital region pharmacies this month started demanding patients return all properly used patches before new ones were prescribed. And early indications suggest it’s working.
It’s a model MP John Weston is looking to in his recent proposal for a national Prescription Drug Take-Back Day.
A firm date has yet to be chosen — likely in May — but regardless, its time has come.
Weston and Perron are now working on a prescription drug misuse strategy paper due for release in mid-March. It’s the culmination of a year-long study involving participants at all levels of government, law enforcement and public health.
The strategy paper will take a five-pronged approach, dealing specifically with; educating prescribers, preventing abuse, treating addiction, monitoring drugs and enforcing laws on the illicit drug market. And with the support of the Canadian Association of Chiefs of Police and the Public Health Agency of Canada, it’s well on track to make a big impact.
“The recommendations are meant to be practical and ready to implement,” Perron says.
The simplest recommendation for keeping pills out of the hands of would-be abusers? Keep pills under lock and key while you still need them, and return the leftovers to any North Shore pharmacy once you don’t, the panel says.
“This crisis will provide us an opportunity to level the playing field as it relates to addictions,” Perron concludes. “Many people see the Downtown Eastside addict as the personification of addiction, when in fact many people today who are addicted as a result of therapeutic intervention are the new face of addiction.”