By Meghan Vivo

“Pharm parties” and celebrity overdoses are the big attention grabbers in the media, but much of the damage inflicted by prescription drugs stems from their daily, run-of-the-mill use. Chronic abuse of prescription medications can lead not only to dependence and addiction, but also to health problems such as depressed breathing, irregular heartbeat, seizures and slowed brain function.

The following are the most commonly abused classes of prescription medications:

• Opioids (such as Vicodin, OxyContin, Darvon, Dilaudid, Demerol and Lomotil)
• Central nervous system depressants (such as Nembutal, Valium and Xanax
• Stimulants (such as Dexedrine, Ritalin, Concerta and Adderall)

Prescription painkillers are now to blame for the majority of fatal drug overdoses in the United States, according to the Centers for Disease Control and Prevention. Although teenagers are one of the fastest growing groups becoming addicted to prescription medications, the problem extends to parents, teachers and other adults.

The Source of the Problem

The reasons for the prescription drug epidemic aren’t a mystery. Prescription drugs are easy to get from doctors, friends and parents. Their easy availability means users don’t have to hook up with a drug dealer or sneak around, which minimizes the guilt and shame associated with the abuse of these drugs.

A prescription drug problem is also easier to hide than an illicit drug addiction because there is no paraphernalia required – the only indicator is a pill bottle in a medicine cabinet, which wouldn’t raise red flags in most households. This makes identifying and treating a prescription drug addiction more difficult.

People don’t necessarily start out taking prescription drugs with the intention of getting high. Adults often start using prescription and over-the-counter drugs to manage the pain of an illness, accident or injury, while adolescents may start using drugs to treat a legitimate condition or because they are curious about the drugs’ effects. Many teens cite school stress as the reason for their drug use, while others may be self-medicating an undiagnosed mental health disorder such as depression, anxiety or Attention Deficit Disorder.
 
“Adolescents who abuse prescription drugs often don’t feel like they have a drug problem,” explained Ryan Anderson, Ph.D., a clinical field therapist at Outback Therapeutic Expeditions, a wilderness therapy program for troubled teens. “For most teens, prescription drug abuse starts with curiosity and expands from there. Before they know it, prescription medications have become their drug of choice, they may start pill trading at school and their lives begin to fall apart.”

Once an individual has developed a prescription drug problem, it looks like any other drug problem, according to Anderson. Like other types of addictions, prescription drug abuse often expands into abuse of other drugs and using larger amounts of drugs in riskier situations. One of the most common patterns is for teens to progress into abusing prescription drugs and alcohol simultaneously – a potentially lethal combination.

“Even though teens think they’re smart about their drug use, once they’re high on drugs their good judgment goes out the window,” said Anderson.

Wilderness and Therapy: A Winning Combination

Wilderness therapy is highly effective in treating teens who abuse prescription medications and other drugs. As a first step, the therapists at Outback work with students to examine their patterns of rationalization, denial and self-deception and the way those patterns lead to self-destructive behaviors.

“While some teens are fully aware of their drug problem, others come into wilderness therapy utterly unabashed about their prescription drug abuse,” said Anderson. “They believe they are knowledgeable and responsible with their drug use, to the point that it doesn’t even come up when they share their drug history. Some teens don’t even consider prescription medications to be drugs.”

Wilderness Detox

The wilderness is a peaceful environment in which teens can detox from prescription drugs. By hiking every day, eating a healthy diet, getting plenty of sleep, and receiving support from staff and peers, teens live in a setting that makes the uncomfortable detox process more bearable.

In addition to physical withdrawal, there is also a psychological detox that takes place when teens stop using prescription drugs. Most adolescents begin using prescription drugs for emotional reasons, and the more they use, the faster their ability to regulate their emotions deteriorates. As a result, teenagers who stop using prescription drugs sometimes feel anxious and hostile.

Detox is just the beginning of the process of change that occurs in the wilderness.

“Recovery is not as simple as not taking drugs anymore,” Anderson explained. “Prescription drug abuse has to be unlearned.”

Learning Healthy Ways to Cope

In the wilderness, teens face a number of challenges such as making fire with a bow drill. This activity quickly reveals how teens deal with frustration, particularly because they can’t turn to drugs or alcohol to relax. Instead, they come face to face with the feelings they’ve numbed and must develop a new skill set to overcome these challenges.

During their first attempts at building fire, many teens get angry and blame others for their struggles. But the students quickly discover that they can’t bust a coal while they’re angry and that their attitude can either help or hinder their progress. The act of building fire helps teens realize that avoiding their emotions or letting their emotions get the best of them doesn’t help them accomplish their goal. With guidance from staff and their peers, teens move beyond the negativity and find their internal drive to succeed.

Hiking presents additional opportunities for teens to learn about their emotions and the impact drugs have had on their lives.

“Every hike is an opportunity to run into yourself,” said Anderson.

Using the calming power of nature and a wide range of therapeutic interventions, teens in wilderness therapy learn new ways to cope. In addition to developing new skills, teens find their own motivation to change so that their progress continues after they complete the program.

A Nurturing, Student-Driven Approach

The staff at Outback uses a no-resistance approach that allows teens to recognize the consequences of their drug use without judging, shaming or arguing with them.

“Our students are looking for a reason not to listen,” Anderson said. “During the detox process, their body is proving to them that their drug abuse has had a negative effect on them. While we guide students to this realization and support them through the process, we don’t approach them with a judgmental attitude or act like we know it all. If we did, we would lose all influence.”

Rather than lecturing, the therapists and field instructors at Outback create opportunities for students to experience for themselves the way prescription drugs have impacted their lives. This new way of thinking creates a paradigm shift and can be a turning point for life to be different in the future.

“That’s really what wilderness therapy is all about – having experiences that help teens make connections on their own,” said Anderson. “In most cases, the students know the facts about prescription drugs, but they haven’t seen how that information applies to them. The beauty of the wilderness is that even though you can’t control it, it never fails to hand you something that can be used as a learning opportunity.”