From bacterial infections to mood disorders, the world of medicine continues to grow and evolve as new medications are introduced to help treat people’s ailments. However, as new medications are brought onto the market and people seek help for mental and neurodevelopmental disorders, there’s always the possibility of misuse and shortage. With recreational drugs, there’s the possibility of people using them for the wrong reason. Addiction is something that everyone has heard about, but there’s always a sense of detachment from the idea until it directly impacts your life. With the current drug problem that the United States is facing, regulations on how much of a drug can be produced, how many a patient can get, and when they can get it have increased. These regulations on controlled substances have prevented many people from obtaining their prescribed medications. As such, an interesting dynamic to analyze is the relationship between the situational consequences of certain drugs and how people are affected by them.
Nicotine
Vaping is an unfortunate part of high school culture, despite the many school regulations and incentives to fix that. Approximately 13% of SHS students used a nicotine or tobacco product in an electric cigarette or vaping device and 11.3% of SHS students said they had used a THC or cannabis product in the past 12 months according to a 2024 school survey.
“That seems low. But, if you think about it, if you’ve got 800 students, that’s still quite a few. And we know that those surveys are always a little under reported. Because of that, we know that it’s an issue. And I think, at [SHS] we see it in the bathrooms, and it’s something that’s becoming more and more of a problem each year,” said Adam Peters, project coordinator for the Stoughton Wellness Coalition.
The Stoughton Wellness Coalition focuses on reducing substance use among youth. They work with the city, school, and community to adopt policies to enact change. However, the receiving end of those policies, students, have a different perspective on substance use.
“I started [vaping] my junior year mostly because everyone else was,” said an anonymous student about their vaping experience. “I was just like, ‘oh, I’ll just buy one, right? It’s just nicotine, I can’t get that addicted, right?’ But that one got me stuck on it.”
“The data is always changing. I think they said since 2017 the potency of a nicotine vape has increased about 70%. So if you think about even just using something one time, by the time you’re done using that vape, there’s a good chance you might be addicted to it,” said Peters.
This, combined with environmental factors like peers and social media, make Stoughton and other places in America ripe for teenage vaping. Ultimately, most students begin vaping because their friends do it too. With social media normalizing the practice and “bathroom vaping” being an open secret, it doesn’t seem like much of an issue for many others to join in, too.
“It’s not a good thing. I would not recommend it. I would say don’t buy one, because then you buy one, and now I bought more than I’m willing to admit. It’s not a good thing, but it’s not going to kill me right now. Obviously there’s going to be lasting impacts later in my life, but that’s not a problem right now,” said anonymous.
The FDA hasn’t reviewed any E-cigarettes and their ingredients as of 2024, so the contents vary depending on the pod. Because of the lack of regulation, there are lots of additions to the pods that aren’t exactly advertised. Acrolein, propylene glycol, carcinogens, diacetyl, cadmium, benzene and more have all been found in vapes according to the American Lung Association, and none of them have proven to be healthy. Several are linked to cancer and lung disease, and many of the long-term effects can’t be studied due to how new vaping is.
“When I first tried it, when you’re not really used to nicotine, it makes you feel like jittery, and it feels really good. I’m not gonna lie, getting a nicotine high feels great. It’s amazing, but the more you use, the weaker that feeling gets. So I’m at the point where I don’t even get that high anymore. It’s just to avoid the withdrawals,” said anonymous.
According to a study done by the National Library of Medicine “54.2% [of young vapers] reported general intentions to quit, 15.3% reported intention to quit within 30 days, and 33.3% reported a past-year quit attempt.” However, when quitting, it’s difficult to attempt when it comes with taxing symptoms that make attending school and quitting at the same time near impossible.
“I know quitting is really hard. I’ve tried. It’s not easy. It sucks … You feel like sh*t, because when you get super addicted to it, you’re used to having it in you constantly, and when you take it away, you start to shake and your vision gets weird. It just feels really bad,” said anonymous.
With the number of students vaping, it’s difficult to focus on the solutions instead of the problems. If you or someone you know is struggling with an addiction, do not hesitate to reach out to your counselors.
“If you come and say, ‘I’m struggling and I need help,’ [the counselors] are going to work with you. If you’re caught with a vape on school grounds that changes things, right? But even if you’re caught, they’re still going to work with you to help you get the support that you need,” said Peters.
Counselors do not have a duty to report vaping or smoking. The school doesn’t want you to hesitate when it comes to receiving help for any struggles you’re facing. Additionally, the Stoughton Wellness Coalition has online resources and processes to help students quit. The Wisconsin Tobacco Quit Line also has resources available. If you are 18 years or older, you “can get free medications shipped … from the Quit Line. This includes a choice between the nicotine patch, lozenge or gum.” They also have a free quit line for anybody 13 years or older at 800-QUIT-NOW.
“If you want to just text somebody, if you want to call somebody, you have lots of different options. If you want to, they even have an app. There’s a quit start app where you can create your own quit plan and walk through it, if you’re on your own and you’re wanting to quit. But there’s also tons of resources at the school as well. All the counselors will be able to help you with these resources as well, like creating a quit plan, and providing support while you’re here at the school and beyond as well,” said Peters.
ADHD Meds
Amphetamine was discovered over a hundred years ago. Just as with any drug that is fifty years or older, there has been a shift in the regulation and how easily obtainable it is to the general public. It was first introduced to the general public under the brand name Benzedrine to treat narcolepsy, mild depression, and other disorders. As people were getting prescribed Benzedrine, they also started to notice that the drug provided cognitive-enhancing properties. As such, there was an increase in people using Benzedrine to assist in intelligence tests. During World War II, around 150 million Benzedrine tablets were supplied to the Allied Forces and used as ‘energy pills.’ It wasn’t until 1937 that psychiatrist Charles Bradley found that Benzedrine could be used to help what he would call ‘problematic kids’ (ADHD). However, many would ignore his findings until later on. In 1955, Ritalin (Methylphenidate) was used to treat chronic depression and fatigue, but it was one of the first meds to be considered a treatment for what would be known as ADHD.
As time went on, drugs were brought onto the market to treat ADHD. In 1961, Ritalin was FDA-approved to help kids with ‘behavioral problems’ (ADHD). Adderall (Dextroamphetamine/Amphetamine Salts) was initially introduced as Obetrol to help lose appetite but was reintroduced as Adderall in 1996. Focalin (Dexmethylpenidate) was approved for medical use in 2001. In 2007, Vyvanse (Lisdexamfetamine) was approved for mainly ADHD but could also work for binge-eating disorders. Not all ADHD meds have to be controlled substances, as Intuniv ER (Guanfacine) and Catapres (Clonidine) can be used to help with ADHD symptoms. In 2021, Qelbree (Viloxazine) was re-introduced to the United States as a non-controlled ADHD med.
“[ADHD] made day-to-day tasks much harder. This makes me unable to clean my room at times, especially when I was a kid, and it makes doing homework extremely difficult.” SHS Senior Xavier Vogt said as he explained how ADHD has impacted him. “It feels like the motivation I need to do these tasks is non-existent. Although these aren’t difficult tasks by themselves, I feel like no matter what I do, I can’t start them. Even though, logically, I know I need to.”
Eventually, Vogt was diagnosed and prescribed medication to help with his ADHD. “It’s made it a lot easier. I can clean my room and do my homework without jumping through mental hoops. My grades have improved, and my cleanliness at home has improved as well. My room is much better now, and I can remember to clean it without my parents telling me they can’t see the floor, and it’s starting to smell like mold.”
Even with lots of ADHD medication available in the market, many people who rely on these medications have had to face months without their prescription. Pharmacist Patrick Frey of Lakeside Pharmacy mentioned, “There were two things happening. The supply was limited, and the prescribing habits, or the prescribing volume, increased quite a bit. So those two situations crossed paths and created a crisis.”
YouTuber Benn Jordan released a video, This is Why You Can’t Get ADHD Treatment, about his experience with the shortage and explored why the shortage was happening in the first place.
“In a study published earlier this year, it was found that people receiving treatment for ADHD in the form of medication had a 19% lower risk of death than those not being treated,” Jordan said as he explained the impact that the shortage had on adults with ADHD. “Adults with ADHD who are not treated as children suffer from anxiety, depression, and physical ailments 30% more than adults without ADHD do. Adolescents with ADHD who are left untreated are twice as likely to abuse alcohol, marijuana, cocaine, and unprescribed drugs, such as stimulants than adolescents who are adequately treated and prescribed those stimulants…it’s pretty easy to say that having untreated ADHD is incredibly dangerous.”
As Jordan shared how he tried to get his Adderall XR prescription from multiple pharmacies, his doctor had him switch to a different type of stimulant called ADZENYS, “ADZENYS [wasn’t] exactly cloaking their opportunism when it comes to marketing to people who can’t get Adderall. When you go to their website, a popup literally shows a dosage comparison chart in your face.”
Jordan found out that the CEO of Aytu BioPharma, the company that produced ADZENYS, would be hosting a Q&A live Stream for investors. He bought some equity in the company and was able to join the Q&A. “Ultimately, we made the critical decision starting a couple [of] years ago that we are going to wind down any operation that we don’t believe can drive near-term shareholder value and ultimately what that has netted the US is an opportunity to become exquisitely focused over the last 12 months, specifically looking at the prescription business. Most notably, Attention Deficit Hyperactivity Disorder, ADHD. We’ve had tremendous revenue growth specifically [in] the RX segment…We’re taking advantage, still to this day, of the fact that Adderall, Concerta, Ritalin, these products have been intermittently in and out of supply for various reasons.” Said the CEO.
OxyContin
From a small plant that originated in the Middle East to a Schedule Two drug, opioids have had a lasting impact. People realized that extracting opium from poppies can result in feelings of euphoria and pain reduction. Records dating as far back as 3,000 years ago have shown ancient Egyptians using opium, and in the 20th century, experiments done on opiates led to the development of opioids.
For over the last two decades, the Opioid Epidemic has affected millions of Americans and killed thousands. While the emergency wasn’t officially declared until 2017, many believe that traces of the epidemic can be found in the late 1990s.
“I think the products that were developed were very effective for pain relief, but I think some of the information about how dependent people became on them or how addicting that they were was not fully understood at the time,” Frey added.
“The U.S. and New Zealand are the only nations in the world that allow direct-to-consumer marketing to consumers. There are a few other countries where it’s allowed, but with significant restrictions. I think the increase in medication prescribing & use in the last few decades is directly linked to this concept,” Pharmacist Erin Roberts explained. She pointed out that the ads we see on TV and in magazines would not be allowed in Europe.
In the 1990s, there was a major shift in opinion on opioids. The Drug Enforcement Agency (DEA) released a statement saying that physicians wouldn’t receive much scrutiny if they prescribed opioids. The American Pain Society had a campaign for standardized treatment for pain symptoms. Purdue Pharma, which manufactures OxyContin, marketed the drug as a less addictive and milder form of opioids.
As Roberts added, “The biggest impact I’ve noticed personally with the opioid crisis would be in the introduction of OxyContin. By the time I got into pharmacy, the drug sales reps providing ‘lunch & learn’ opportunities were a thing of the past. Until doing a deep dive into Purdue Pharma and the Sackler family, I hadn’t realized how significantly the sales representative model impacted prescribers & increased patient use of medications.”
With how OxyContin was marketed, opioid prescriptions increased from 670,000 to 6.2 million from 1997 to 2002. Many have claimed that Purdue Pharma intentionally downplayed the addictiveness of OxyContin, which caused many healthcare workers to be misinformed about the effects of the drug.
In 2007, Purdue Pharma pled guilty to the false advertisement of OxyContin and paid $634.5 million to resolve the Justice Department investigations and $19.5 million to settle disputes to 26 states and the District of Columbia. From there onwards, there would be multiple lawsuits and settlements as lawyers tried to get justice for the thousands of Americans who suffered.
People have also tried to come up with ways to combat the opioid crisis. Medication-assisted treatment (MAT), which uses medications with behavioral therapies and counseling, has been used to suppress urges, prevent withdrawal symptoms, and help with the recovery process. Two medications that are popularly used to treat opioid addiction are Suboxone (Buprenorphine) and Dolophine (Methadone). There have been community programs that allowed people to drop off needles and help make sure unused opioids are properly dealt with.
Conclusion
Whether from the expectations placed upon us or the comfort in routine and fitting in, society has placed great importance on ensuring that things return to normal. As such, when a person gets a significant injury, gains lots of weight, or experiences a sudden change in mood, it’s not surprising that they want to return to how things were. It’s the reason why people fall for death mediums, psychics, and so-called ‘miracle drugs.’ They are lured in by the potential what-if that’s provided by these services. Prescriptions, in their most basic concept, are medications that are supposed to help treat a condition a patient may have, and that is a fact that has been held true to the present day. However, the problem lies within the businesses that produce these medications. Many businesses profit from some of our most vulnerable groups, and there is barely any protection to help prevent them from being in these situations in the first place. Health insurance companies are notoriously known for rejecting claims that would offer life-saving services to patients, and drug companies have a blatant strategy of marketing their products to people with known insecurities and unstable living conditions. It is no shock that we have a problem with drug abuse. The institutions that were meant to serve the people were the ones that let these problems exist in the first place.
