Trading for a High

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Unfortunately, prescription drugs are often far easier to obtain than illegal ones. Some teenagers come by their pills legitimately but trade them for others, like painkillers, that hold more appeal because of their more potent high. Others order from shady Internet pharmacies where prescriptions aren't always required. Still others take advantage of the fact that neither doctors nor parents tend to think of prescription medications as drugs of abuse. That makes it a fairly easy proposition to fake or exaggerate symptoms in order to persuade physicians to write prescriptions, or to pillage medicine cabinets for pills left forgotten on shelves. "When adults and medical professionals treat medications casually," says Dr. Francis Hayden, director of the adolescent mental-health center at Mount Sinai Hospital in New York City, "we need not be surprised that adolescents are treating them casually."

Worse yet, many of these kids are abusing illegal drugs at the same time. According to the CASA report, about 75% of prescription-drug abusers are so-called polysubstance users who also take other drugs or drink--most of the New Jersey kids, for instance, were downing their pills with Miller Lite. "My friend told me to save the painkillers for when I'm drinking or getting high," says the 17-year-old with a chuckle as she smokes her last cigarette and flings the empty pack into the backyard. She doesn't think of herself as an addict. But she recognizes the signs of addiction among her friends. "I know a lot of people who live by pills," she says. "They take a pill to wake them up, another pill to put them to sleep, one to make them hungry and another to stop the hunger. Pills can dictate your life--I've seen it."