Crushed dreams: doctors use drugs to heal, but in the wrong hands, drugs can wreck lives.

While 17-year-old Ryan Curry slept, visions of OxyContin danced in his head. Ryan was thrilled to see Oxy pills scattered under the bed, until unbearable cravings jarred him awake. New, he could see that there were no pills. Drenched in cold sweat, Ryan's body convulsed and he began a frantic search for more OxyContin.

Ryan never thought he'd become addicted to OxyContin, a powerful drug that's prescribed for people with severe pain. Like most prescription medications, when OxyContin is used for the medical reasons prescribed and taken in the dosage and form prescribed, it can ease suffering for millions of Americans. When abused, prescription drugs can push people over the edge into addiction, injury, or even death.

"Medications can be dangerous. Prescription drugs need to be taken by people who are under medical supervision," says Jerry Frankenheim, Ph.D., a pharmacologist at the National Institute on Drug Abuse (NIDA). "Drugs that are abused can change the way your brain functions for a very long time."

OxyContin, whose active ingredient is oxycodone hydrochloride, was hailed as revolutionary in 1996 when it appeared on the market. Like some other painkillers, oxycodone is an opioid. It works as heroin does, quieting pain messages by slowing the central nervous system. OxyContin is unique in that each pill releases medication over a 12-hour period. When crushed and snorted, however, the drug acts differently. Then, a day's worth of painkiller hits the user's brain at once, upsetting the normal flow of brain chemicals.

Ryan, who lives in Newport, Maine, had smoked marijuana for four years before experimenting with prescription drugs. "Pot didn't have the same kick that it used to," he says. "I was bored, looking for a thrill, and trying to be cool."

Ryan quickly got hooked on oxycodone. "I felt so euphoric--like I could be happy sitting in a trashcan in the dark somewhere," Ryan says. He turned his girlfriend on and together they joined the small number of teens who abuse OxyContin. According to NIDA, 4 percent of high school seniors reported using OxyContin in 2002, along with 3 percent of 10th-graders and 1.3 percent of 8th-graders.

Ryan quit college to work for an electrician to earn cash to buy pills. He began to use more and more OxyContin. "When I had pills, I'd feel like a king," he says. Ryan was building a physical tolerance for the drug and needed more to avoid going through withdrawal. "I'd wake up and snort 30 or 40 milligrams of Oxy--not to get high, but to feel normal, not sick." Over the next two years, Ryan went from that first 20-milligram rush to a 240-milligram-a-day habit.

Opioids that are abused can take over the emotional center of the brain called the limbic system. Craving for the drug replaces other Craving for pleasures like food, friends, and achievement. "The drug becomes the most important thing in people's lives," Frankenheim says.

Ryan's mom had pleaded with him to get help, but Ryan denied ec was doing drugs. Finally, Ryan hit bottom when his girlfriend left him. He let his mom take him to a drug treatment center.

Ryan has finally kicked his addiction to OxyContin. He has been drug-free for six months. As treatment, he attends weekly counseling sessions, where he deals with intense feelings that were turned off by Oxy. "Drugs short-circuit the brain," Frankenheim explains.

"When a person comes off the drug and the brain starts coming back to normal, it can feel like a rebirth."

True, says Ryan, who sometimes feels like a beginner in his own life. "I cry at movies I've seen before. Yesterday, I put a grape in my mouth and spit it out because it tasted more bitter than I remembered."

"I feel sad that I lost those years of my life and would give anything to get them back," Ryan says. "But now I have a life other than drugs, I'm taking college classes. I have clean friends and support.... I actually feel.... That's a big change."

CAUTION: CENTRAL CONTROL PROBLEM

The brain controls Everything the body does. The spinal cord carries messages between the body and the brain. Together they make up the central nervous system (CNS). Some prescriptions drugs slow down, or depress, the CNS. Others speed up, or stimulate, the CNS. People who abuse CNS stimulants or depressants give control of their bodies to the drug, sometimes with dangerous consequences.

DEPRESSANTS slow messages between the body and brain.

Signals from the eyes and other senses reach the brain slowly.

Heart rate drops, leaving the body with less energizing oxygen.

Breathing rate decreases; risk of long infection rises.

Messages to muscles are slower, arms and legs can't move well.

RESULTS: The body can't sense--or respond to--danger quickly.

STIMULANTS create fake messages in the brain, telling the body that it's under stress.

Blood to skin decreases; the body is less able to cool itself. Overheating is a risk,

Heart rate speeds up. Blood vessels to the heart constrict.

The liver releases sugar into the blood, reducing the body's energy stores.

RESULT: If real stress occurs, the body won't be able to respond.

HELPFUL WHEN NEEDED

People with attention deficit hyperactivity disorder (ADHD) have lots of trouble concentrating. For them, the GNS stimulant drugs Ritalin and Adderall have a calming effect, helping them focus. "When they are taken in the dosage and form prescribed by a physician, these are sale drugs that help a lot of kids," says Dr. Cindy Miner, deputy director of the Office of Science Policy and Communications at NIDA.

Research shows that people with ADHD don't get addicted when they take these drugs as prescribed. "The theory is that those kids have a brain chemistry imbalance that is stabilized by the medication," says Dr. Miner. But some teens steal or buy the drugs on the street. "If you're buying those drugs from other kids, you're playing with potent drugs. You're really putting yourself at risk," warns Dr. Miner. Effects of high doses tan include paranoia, convulsions, muscle twitching, and addiction. Withdrawal symptoms include depression.

Dangerous Mix

When a doctor prescribes medications to treat disease, he or she knows the patient's weight, warns of side effects, and prescribes a specific dose and form or the drug. When an abuser buys the medication on the street, he or she knows none of this, and problems--sometimes lethal--can occur. Emergency room doctors see many patients who have taken the wrong dose of a prescription drug or mixed over-the-counter (OTC) medications or prescription drug with alcohol or other drugs.

Alcohol is especially dangerous when mixed with drugs. Alcohol slows the heart and respiratory system, and changes the way messages travel in the brain. Alcohol can also intensify the effects of drugs in the body. Mixed with opioid painkillers such as Valium and Vicodin, or CNS depressants such as Valium and Xanax, alcohol can slow breathing, causing respiratory failure and death.

Many OTC medications are combinations of drugs and should never be mixed with other medications or alcohol. For example, when cough syrup containing the CNS depressant dextromethorphan (DXM) is abused or mixed with other drugs, the syrup can contribute to car accidents when the abuser is slow or unable to react.

RELATED ARTICLE: Cause and effect.

Prescription drugs are strong medicine.

Read the article "Crushed Dreams" and the sidebars about the effects of prescription drugs that speed up, or stimulate, the central nervous system and those that slow, or depress it. Then, draw a line from each of the drugs on the left, below, to its effects on the right. Each drug or cause has three effects. Some effects may have more than one cause.

CAUSE                 EFFECT

Stimulants            intensifies effects of
                      drugs in body

                      Slow(s) breathing rate

                      Constrict or tighten
                      blood vessels

Depressants           Reduce or lessen
                      blood flow to skin

                      Slow or block signals from
                      nerves and senses

Alcohol               Raise or speed up
                      heart rate

                      Lower(s) heart rate

Stimulants: Constrict or tighten blood vessels; Reduce or lessen blood flow to skin; Raise or speed up heart rate

Depressants: Slow breathing rate; Slow or block signals from nerves and senses; Lower heart rate

Alcohol: Intensifies effects of drugs in body; Slows breathing rate; Lowers heart rate

Learn more

For more Information and useful links, go to

* www.scholastic.com/HEADSUP

At the Heads Up site, you'll find quotes from teens in recovery, pop-up activities, information about other drugs, and more.

* www.teens.drugabuse.gov

NIDA's Web site for teens focuses on the science behind all drugs of abuse. Find out how nicotine, prescription drugs, club drugs, and other substances act on the brain.

* www.thecoolspot.gov

Get the facts you need about alcohol at this Web site for teens, sponsored by the National Institutes of Health.

Friend in Need

If you are concerned that someone you know is abusing medications or other drugs, talk to a trusted adult (a teacher, parent, guidance counselor, etc.) for advice. Or, if your friend is ready to seek help, you may wish to offer the following resource: www.findtreatment.samhsa.gov or 1-800-662-HELP.