An early look at the opioid crisis. Originally published in The Daily News June 3, 2007, a multi-story package co-reported with Stephanie “Stevie” Mathieu that won a 2008 first-place award in the “health” category from the Society for Professional Journalists. My one regret is that Stevie and I believed a doctor when he said patients couldn’t get addicted if they took opioids only as prescribed. In August of that year, Stevie and I rode along with the drug cops on a massive sting operation that rounded up 20 suspected opioid dealers, many of whom had no previous crimes on their record. That story won an honorable mention from SPJ in the “comprehensive coverage” category.
Our Teens’ Pill Problem
By Stephanie Mathieu and Leslie Slape
Kelso High School senior Chad Holtman had anxiety and panic problems, and his prescription for Prozac wasn’t working.
So when a classmate told him prescription pain-relief patches would help calm him down, the two made a trade: Holtman’s pills for two patches of fentanyl, an opiate painkiller dozens of times stronger than morphine.
The last things Holtman remembers that December day was slapping the two patches on his back after school and driving to his girlfriend’s home in Longview. There, he became too incoherent to drive home and fell asleep, others later told him.
He had vomit in his lungs and an 80 percent chance of never waking up, doctors later told him. He was in a coma for three days.
“I’ve never been a drug user,” a now-healthy Holtman said during a phone interview last month. “I didn’t know anything about the fentanyl patch. … I was told that it would relax me.”
Holtman’s brush with death highlights a rising problem with prescription drug abuse, especially among young people, that is alarming medical experts across the country and community members in Cowlitz County.
Recent surveys suggest that today’s teenagers — raised in a culture that seems to pop a pill for any ailment — abuse prescription medications because they incorrectly believe they aren’t as dangerous as illegal drugs and because they’re easier to get — by duping doctors, stealing from parents or buying or trading with friends.
Nationwide, the rate at which teens abuse prescription drugs is increasing while their use of street drugs — from marijuana to heroin — is declining.
Prescription drug abuse can be fatal. In 2006 in Cowlitz County three young adults — an 18-year-old Longview man, a 26-year-old Kelso man and a 26-year-old Longview woman — died of accidental prescription drug overdose, according to the coroner’s office.
The most common cause of death was a chemical reaction from combining drugs, much like Holtman’s Prozac interaction with the fentanyl.
Since his recovery, Holtman said he has become a walking example at his high school of just how dangerous prescription drugs can be when used without a doctor’s permission or direction.
“They’re not out there just to buy, because they will kill you,” Holtman said. “To me, it’s like that should make them sound more dangerous.”
A growing problem among teens
Prescription medications are becoming a drug of choice for teens, according to a White House Office of National Drug Control Policy study released in February.
During the past five years, the use of illicit drugs among teens declined 23 percent, but the rate of teens purposefully abusing prescription drugs to get high is growing, according to a 2006 University of Michigan survey. Their abuse is second only to marijuana, according to the Michigan report.
In Cowlitz County, students abuse prescription painkillers more than their Washington peers, according to the 2006 Healthy Youth Survey, which is distributed every two years to middle and high school students by the state’s Department of Health. More than 3,000 students in the county answered questions about prescription drugs.
In 2006, 4.8 percent of 10th graders in Cowlitz County reported illegally using Ritalin — a stimulant commonly used to treat attention deficit hyperactivity disorder — in the past 30 days, according to the Healthy Youth Survey. That rate was 3.6 percent in 2004.
And 4.8 percent of Cowlitz 12th graders last year illegally used Ritalin in the past 30 days — nearly double the 2.5 percent of 12th graders who reported using the drug illegally in 2004.
The Daily News attempted this year to conduct its own, more detailed survey in the public schools about prescription drug abuse, but several nearby school districts denied access, citing federal privacy laws, a burden on the teaching staff and the availability of the Healthy Youth Survey.
Local high school and middle school students interviewed about prescription drug abuse said they have either seen students swap and pop pills in school or heard about weekend parties where students take medications to get high.
They said their peers turn to prescription drugs because they are easy to get and easier to hide from teachers, parents and police.
Toutle Lake High School freshman Samantha Thurman said she knows at least two friends who use prescription medications to get high, and word “gets around fast” when a student brings pills to school to sell or hand out. Sometimes students swipe painkillers from a parent who just had surgery, or from a sibling who takes a stimulant to control attention deficit disorder.
“I think some people think it’s not as harmful because it’s medication,” said Thurman, 15.
Cowlitz County Sheriff’s Capt. Mark Nelson said many people who abuse prescription drugs don’t consider themselves drug addicts. Some people who refuse to try street drugs put legal medications in a different category. Young people grow up watching family members share prescriptions — which is illegal — to save a trip to the doctor, he said.
“I think that happens more frequently in families than anyone would care to admit,” he said. “Probably 98 percent of the time, no harm, no foul. But there’s the other percentage where there are drugs that interact with other drugs … and cause serious injury and sometimes death.”
As harmful as street drugs
Prescription drugs are safe when a doctor gives them in the correct dosage to a person who needs them, but when taken recreationally, the drugs can be deadly, said Brian Hoyt, an emergency room doctor at St. John Medical Center.
On a weekly basis, emergency room doctors deal with prescription drug problems, including overdoses and withdrawal symptoms, Hoyt said. When a person addicted to prescription painkillers or stimulants runs out of pills, they react with symptoms that are similar to food poisoning but last at least five days, Hoyt added.
“It doesn’t have the stigma of a street drug,” Hoyt said. “They can be just can be just as dangerous or lethal or addictive as street drugs.”
When a teen comes in for an overdose, they are usually “scared and screaming,” Hoyt said. They don’t recognize their own family. Sometimes they are blue because they’ve stopped breathing.
“They’re sitting there in their own vomit, gurgling,” Hoyt said. “We are seeing more of it, and that is very disturbing.”
There are many myths about prescriptions drugs, Hoyt said. Sometimes athletes pop a Vicodin painkiller before a game thinking the drug will help them physically push themselves without feeling any pain. In reality, he said, the drug causes drowsiness, constipation and slow reflexes.
Stimulants used to treat attention deficit hyperactivity disorder also are abused, Hoyt said. Overdoses on those drugs cause a fast heart rate or heart palpitations, anxiety, paranoia or hallucinations, he said, and teens sometimes graduate from these stimulants to using methamphetamine, which gives a similar yet stronger high.
Designer prescription drugs — extra-potent medicines for patients with a resistance to typical doses — are especially dangerous, Hoyt said. “These are designed for somebody who’s having to take 20 pain pills a day.”
Just a locker or medicine cabinet away
According to the National Drug Control Policy study, 56 percent of teens say prescription drugs are easier to get than illegal drugs, and more than three in five teens say prescription painkillers are easy to steal from parents.
Half of teens say it’s easy to obtain the painkillers by using another person’s prescription, and 39 percent said it’s easy to order prescription drugs over the Internet or phone.
Thurman, the Toutle Lake freshman, said other students pop pills during weekend parties and come back on Monday to brag, asking, “Guess what I did this weekend?”
Thurman has seen students pop pills at school, too, she said. They will linger around a friend’s locker, scoot in close and hand the pills off, she said. Athletes will take pain medication before a game to be able to overexert themselves and play through pain.
That was the case in 2004, when a 17-year-old Kelso High School student tricked four of the school’s football players into buying an over-the-counter painkiller, telling the athletes that it was Vicodin. When they discovered their bags of 30 pills — purchased for $15 — weren’t Vicodin, they planned to beat the seller up. He pleaded guilty to four counts of delivery of a counterfeit substance in Cowlitz County Juvenile Court.
This year, in Kelso’s alternative Loowit High School, a teacher caught students passing medications during the lunch period in a “surreptitious manner,” according to a police report. One student had a prescription for Adderall and passed a pill to a classmate who asked him on several occasions for the drug.
Mark Nelson, the sheriff’s captain, said it’s not unusual for students to ask their sick or injured peers to sell them their medications. The culture has changed from “Can I sign your cast? to Can I buy your drugs?” he said.
R. A. Long High School freshman Dusty Minkler said she has seen students pass around pills in the lunchroom, telling their friends it will make them feel “so much better.”
“Anybody can do it if you know where to go,” said Minkler,15.
Teen dealer sold meds to students
A former high-school drug dealer who used to sell oxycontin, Vicodin, methadone, Xanax and other prescriptions says fellow students approached him about 30 times a day for pills. His customers ranged from preppies to grungers to athletes, he said, and “I always made at least a couple hundred dollars a day.”
“People have to have it (medications) to feel good,” he said. “You feel like you’re going to die, you go through such bad withdrawals. … you’d be sick all day until you find a way to get money or get drugs.”
He dealt for several years to support his own habit before he was caught selling drugs in a school zone and became an undercover drug informant for police. The Daily News agreed to not use his name.
Now 20, the young man spent two years at Mark Morris and nearly two at Kelso High School before dropping out (he later earned his GED). He said he kept his drugs in his car and sold them before school, during lunchtime, or he forged excuse notes so he could leave campus to deal. When he attended Kelso, “I had people coming into the parking lot from Mark Morris to buy drugs” because Mark Morris students typically had money to burn, he said.
Most of his customers used drugs at school, he said. He recalled doing drugs during class behind the shield of an open book.
“I used to … crunch down pills on my desk and snort in class,” he said. “Teachers don’t pay good enough attention.”
Secret life of prescription drug abuse brings death
By Leslie Slape
In September 2005, Teia Brindley received a shock.
Her daughter, Jennifer Prestegard — with whom she talked at least three times a day, worked as a nurses aide and never went partying — was a drug addict under investigation by Longview police for using dead people’s prescriptions.
“The detective was wanting to talk to Jennifer about forging prescriptions from her job out at Heron Crest,” Brindley said. “She lost her job. And that’s when she told us about the drugs.”
Prestegard, then 25, had been working since she was 18 at Heron Crest, an assisted living facility for Alzheimer’s patients in Longview. Her addiction to painkillers started around the same time.
“I couldn’t believe it. Jennifer was my girl,” said Brindley in a recent interview at her Longview home. “She didn’t lie. She was very straightforward. That was just totally out of character for her. That floored me.”
Before her drug problems, “She was a kick in the pants,” her mother said. “She was a fun girl. We’d always get a kick with Jennifer. And she had so much love, I’ll tell you.”
After police began investigating Prestegard, her life rapidly spiraled out of control. By September 2006, at age 26, she was dead of an accidental overdose.
“You know, in her heart, she truly was a good girl,” Brindley said. “And it’s hard, hard.”
Brindley agreed to share her daughter’s story because she is concerned about the rise in prescription drug abuse. She encouraged people to watch for signs of suspected drug use in family members and get them immediate help, such as Narcotics Anonymous or Celebrate Recovery.
“I want to make an impact on our community,” she said. “People are dying.”
Her inner light went out
Prestegard began working as a certified nurses’ aide for Heron Crest shortly after graduating from R.A. Long High School in 1998.
At the same time, she began abusing Vicodin, a narcotic painkiller, said her younger sister, April Sizemore.
A Vicodin user experiences a relaxing mood lift as the pain eases. It’s an opioid, a derivative of opium, and like all opioids it’s addictive if abused.
“To me she wasn’t any different,” Brindley said. “I guess I just couldn’t see it. I know she was sleeping a lot more. … I thought she was tired. She was working all the time, working 12-hour shifts. On her days off, I’d think, ‘She’s just dead tired, she’s been working.’ ”
Sizemore, however, did notice something in the sister she adored.
“She wasn’t herself. Her laugh was different, and her attitude toward things,” Sizemore said. Her glow wasn’t natural, Sizemore said.
But Sizemore, six years younger than Prestegard, was just a kid, and she didn’t realize how serious things really were. She didn’t see her sister take pills until around 2002 or so. She chided Prestegard for it, but as sisters will, she kept her secret.
When Brindley found out in 2005, she realized she should have seen it herself.
“She seemed so normal most of the time, except she lost her light,” her mother said. “She lost her spark.”
Drugs made her numb
Prestegard’s pain was emotional, not physical.
“She told me (drugs) made her numb and she wouldn’t have to feel or think,” Brindley said. Her daughter’s vibrant personality masked her depression.
More sensitive and easily hurt than her siblings, Prestegard was deeply affected by her early childhood. She and her older sister, Ann, and younger brother, Jeremiah, were put in foster care after their parents split up, said Brindley, a recovering alcoholic.
“She had a hard childhood because of my background,” Brindley said. “There was so much that happened.”
“That was better, but … she was the middle child, and she didn’t feel as loved,” Brindley said.
A green-eyed strawberry blonde, she was a bright copper penny in a family of brunettes.
Sizemore, who was a child of a later marriage, said Prestegard never felt that she fit in.
“She never liked herself,” Sizemore said. “She just felt so much pain, she wanted to bury it.”
Feeding the addiction
Prestegard’s job at Heron Crest gave her easy access to medication. Sometimes she stole painkillers from patients, she admitted to Longview police. She also developed a clever scheme to refill patients’ prescriptions after they died.
According to the police report, she used her position as a Heron Crest employee to fax phony prescription orders for Hospice patients — interspersed with legitimate orders — to Medical Arts Apothecary in Longview.
A Hospice employee told him the patient in question died in December 2004.
“When I found out, I was shocked we were filling this prescription,” Patel told The Daily News in late 2005. Prescriptions coming from adult care homes and similar places are automatically assumed to be legitimate, he said.
He notified Longview police and continued to investigate on his own.
All told, Patel and the Hospice found that the pharmacy filled 16 prescription orders (including refills) for five dead people between July 6 and Aug. 22, 2005, mostly for Vicodin.
Police interviewed Prestegard on Sept. 20, 2005, and said she admitted forging the prescriptions to supply her drug habit.
Patel said the pharmacy had to refund Hospice, which they had billed $80 for each bottle of 120 pills. Sizemore said her sister told her she was taking 40 to 60 pills a day. (The recommended dosage for Vicodin is generally one to two pills every four to six hours.)
While police and prosecutors investigated and considered the case, Prestegard began another addiction: methamphetamine.
Treatment didn’t work
Out of a job and deeply depressed, Prestegard began hanging out with a different crowd. She started using meth in November 2005, according to her mother and sister.
The Washington State Patrol arrested her on Feb. 2, 2006. She pleaded guilty to methamphetamine possession and was sentenced to 25 days in jail and 30 days of drug treatment. (She never was charged in the prescription forgery case, which was dismissed upon her death.)
“I forgot about the pain pills ’cause she got on that meth,” her mother said. “It was the most ungodly experience in my life, seeing my baby like that. We couldn’t allow her to hold our children (her littlest sister, Emma, and her nephews Alex and Drew, all born in 2002) because it goes through your skin. And those were her life — she loved those babies.”
Brindley tried to get Prestegard back into church, although she knew prayer wasn’t enough on its own. She said her daughter needed more jail time and longer inpatient treatment to separate her from the drugs.
“Right before she died she was really making a turnaround, or so we thought,” Brindley said. “She rededicated her heart back to God. She … was wanting to put her life back together and get a job. She started going to church with me. She was at my house every day. She got out of treatment on Saturday … On Thursday, she called and said, ‘Mommy, I’m too sick. I can’t come today.’ I prayed with her. That was the last time I talked to her. She died that evening at 7 o’clock.”
Prestegard, who was living at Hudson Manor Inn & Suites in Longview, died Sept. 15, 2006, after illegally taking the powerful painkiller Kadian (morphine sulfate), her family said. She also had been taking prescribed medication for anxiety and high blood pressure.
Toxicology tests showed she died of “polypharmaceutical intoxication,” or a lethal combination of prescription drugs, according to the coroner’s office.
“I just don’t want anybody to ever feel the way we felt when (Chaplain) Steve White came to our door. … That was terrible,” her mother said.