In 2005, Sean Nicholson didn’t know that prescription opioids could lead to street drugs. He had never met another addict, or received any warning from a doctor. So when the Middletown resident suffered a cataclysmic injury at a construction site in West Virginia — falling off the roof of a house and into a pile of cinder blocks, shattering his legs — he wasn’t concerned about the 110 milligrams of OxyContin he was prescribed to take twice a day.
“I had no idea what I was getting myself into,” said Nicholson, who now works as an outreach coordinator for the Up and Out Foundation in Frederick County. “And I was in pain, so I was taking them as prescribed. But in a matter of months, I was totally dependent.”
After time, though, Nicholson’s tolerance for the pills also rose. He found himself experimenting with the dosages and accumulating multiple prescriptions, trying to replicate “the feel of that first high.” But as his injuries began to heal, his doctors also stopped prescribing the drugs. His next step was to find heroin in Baltimore.
That experience, Nicholson said, can be seen as a microcosm for the larger risk that prescription drugs present across Frederick County and across the country. According to data from the National Institute on Drug Abuse, about 80 percent of heroin users started with prescription medication. The pills are also widely available — about 1 in 5 patients across the country are prescribed opioids for pain-related diagnoses, according to the Centers for Disease Control and Prevention.
Figures also show that prescription pill theft is fairly common. In a 2016 Maryland Opioid Misuse Prevention Survey, 39 percent of survey respondents aged 18 and older reported that people steal prescription opioids from family members. Twenty-six percent of respondents got painkillers from friends. The consequence, Nicholson said, is often a downward spiral for many drug abusers, who start with legitimately prescribed medication and end up hooked on heroin and fentanyl.
“Prescription meds are somewhat of a gateway drug,” he said. “They’re found in your aunt, your uncle, your grandmother’s medicine cabinet, and they’re pretty easily accessible. But when those pills run out, then what?”
Those same concerns have prompted Frederick County’s regular participation in the National Prescription Drug Take Back Day, sponsored by the Drug Enforcement Administration. On Oct. 28, from 10 a.m. to 2 p.m., residents can drop off expired or unused medications — including prescription pharmaceuticals, over-the-counter treatments, and medicated lotions and ointments — at three locations across the county.
The last four disposal events in Frederick County have yielded 5,533 pounds of medication, all of which is taken by the DEA and incinerated, said Todd Crum, spokesman for the Behavioral Health Services Division of the Frederick County Health Department. For health officials and their law enforcement partners, it’s an easy way to get potentially risky pharmaceuticals out of the community. But it’s also a way to keep children and teens from accessing the drugs, a growing problem.
According to the most recent Maryland Youth Risk Behavior Survey, in 2014, just over 9 percent of Frederick County high school seniors reported taking a prescription pill without a prescription one or more times in the past 30 days. About 7 percent of middle schoolers said the same.
Anecdotally, Nicholson said the Up and Out Foundation is beginning to serve an increasingly younger population, most of whom start with prescription pills.
“What’s common is that it’s more youth,” he added. “When you hear about a 16- or a 17-year-old with addiction, they either started with or are still using prescription opioids and haven’t graduated yet to heroin. It’s a big issue, especially in high school.”