What Did She Want With Xanax?

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Like most doctors, I've watched with concern the growing use of so-called club drugs--psychotropic substances that catch on from time to time among teenagers and young adults and become the rage at dance clubs and all-night raves. I know about ecstasy, Rohypnol and ketamine. But I was taken by surprise last week when Noelle Bush, daughter of Florida Governor Jeb Bush (and the President's niece), was arrested in Tallahassee trying to buy Xanax, having allegedly borrowed the name of a retired doctor and called in a bogus prescription. Xanax, after all, is a widely prescribed antianxiety medication--a cousin of Valium--and hardly fits the profile of a Gen X party drug.

Xanax is usually used to relieve panic and anxiety, which may be why Noelle wanted it. But though it ranks low on the scale of drugs most likely to be abused (heroin is termed a Schedule I drug; Xanax is a Schedule IV), the Drug Enforcement Administration has been keeping a close eye on it for years. Like other benzodiazepines, it acts on the neurotransmitter gamma-aminobutyric acid, decreasing brain activity and producing a drowsy or calming effect. "It's like being drunk, without the toxicity of alcohol," reports a helpful chat-room participant.

It's also quite addictive. "Xanax is extremely potent," says Dr. Steven Juergens of Virginia Mason University, who was the first to write about Xanax addiction, in 1988. "It acts quickly on the brain and has a short half-life." Users of such drugs tend to come back for more and more. Xanax is also used by partygoers as a "parachute" drug to bring them down from the effects of stimulants such as ecstasy. It's this combination of drugs, suggests Dr. Herbert Kleber, a professor of psychiatry at Columbia University, that may account for the current interest in Xanax.

Benzodiazepine abuse is on the rise, according to the Health and Human Service's Drug Abuse Warning Network. But so is prescription-drug abuse generally. From 1990 to '98, National Institute on Drug Abuse statistics show, the number of Americans who started misusing sedatives nearly doubled, while abuse of pain relievers rose 180%.

We don't really know what Noelle Bush planned to do with those 40 Xanax pills in the prescription or even whether she was getting them for herself. Her parents issued a terse statement acknowledging that the family is "deeply saddened" and reminding Americans that "substance abuse is an issue confronting many families across our nation." Noelle's mother Columba should know. As a board member of the Center on Addiction and Substance Abuse at Columbia University, she has helped raise awareness about the problem. Sadly, nothing she's done over the years has attracted nearly as much attention as her daughter's arrest.

--With reporting by Jonathan D. Lynch

Dr. Gupta is a neurosurgeon and CNN medical correspondent