Teenagers and young adults in the town of Port St. Lucie, Florida "complain of having little or nothing to do, and marijuana, prescription drugs and parties often fill the void," according to them and their parents, as a story in last Sunday's New York Times reported. There is no mention of whether 17-year-old Port St. Lucie youth Tyler Hadley - charged with two counts of second-degree murder after his parents were brutally killed in their home - abused prescription drugs, but the story's allusion to such abuse raises an issue of crucial importance.

Today, one out of every five teens in the United States abuses prescription drugs, according to a 2009 survey of the Centers for Disease Control and Prevention, and OxyContin is their drug of choice. As early as 2001 the National Drug Intelligence Centre warned that the "pharmacological effects of OxyContin make it a suitable substitute for heroin."

Anthony Fernanzez, a Staten Island youth, now in his twenties, began experimenting with OxyContin when he was fourteen, as reported in a 2009 story on prescription drug abuse in the Staten Island Real-Time News. He quickly became addicted to the drug, often referred to as "hillbilly heroin," but managed to shake that addiction several years ago and is now clean. "I've gotten that phone call about 11 times," he says of the calls announcing friends' deaths from overdosing on OxyContin. "I've been to more wakes than I've been to birthday parties."

OxyContin abuse is fuelled by two factors, additional to the euphoric high it creates. First, teens tend to believe the drug is "controllable" and "safe" when compared to illicit drugs. And, second, it is easy to obtain - even easier, teens report, than buying beer. The drug is readily supplied to teens by friends, snuck from parents' medicine cabinets, and easily bought online or from illicit dealers. "The streets, the schools, all you've got to do is make a call," says one Staten Island youth. "Everybody has an unlimited amount of connections. You get more popular, make more money, and everybody knows your name [if you sell it]."

Purdue Frederick, OxyContin's maker, may have profited from the widespread abuse of its drug, but that alone does not justify the criminal charges it pled guilty to in 2007. What got the company into trouble was the fact it appears to have consciously and strategically cultivated Oxycontin abuse. For the first five years of the drug's life, from 1996 to 2001, by which time it was being widely abused, Purdue allegedly waged a marketing campaign that deliberately and illegally downplayed the drug's potential to addict and be abused. "In the process," according to John Brownlee, a Virginia United States Attorney who helped prosecute the case against the company, "scores died as a result of OxyContin abuse and an even greater number of people became addicted to OxyContin."

Purdue ended up paying more than half a billion dollars in criminal fines and civil penalties after pleading guilty to the federal charge that "certain Purdue supervisors and employees, with the intent to defraud or mislead, marketed and promoted OxyContin as less addictive, less subject to abuse and diversion, and less likely to cause tolerance and withdrawal than other pain medications." Three executives also entered personal guilty pleas but were spared imprisonment when they agreed to pay $34.5 million in penalties.

Drugs other than OxyContin are, of course, also being abused by teens. But the threat posed to youth's health and well-being by prescription drug abuse often gets overshadowed by the ongoing war against illicit drug use. It is time for this important issue to come out from under that shadow.

Childhood Under Siege

How big business targets children
Joel Bakan

Joel Bakan is an author and professor of law at the University of British Columbia in Vancouver, Canada.

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