Bad breakup? Pop a Xanax. Can’t keep up at work? Trade a Klonopin for an Adderall. Friends are helping friends get a grip (and get ahead).
At a time-of-day-theme bridal shower on New York’s Upper East Side, the guest assigned to brought the ride-to-be a wafflemaker. The guest in charge of went with a set of martini glasses. The mother of the bride had drawn and when her hour came up she produced a tower of boxes. The naughty Cosabella lingerie was nice, but the gift that got the most “oohs” from the crowd of thirty-something was the last: Inside a square box was a makeup bag, and inside the makeup bad was a supersize bottle of pills. “Ambien!” shouted the bride. To the uninitiated she explained, “I haven’t been sleeping well.” But there was no need. Not only was the sedative’s name already in everyone’s vocabulary (if not their medicine cabinet), guests immediately began lying claim to extras. It was, everyone noted hopefully, a very big bottle.
Prescription medication used to be as unsexy as an AARP chapter meeting. In today’s post-Prozac culture, however, where the under-40 demo accounts for an increasing number of ‘scripts from antianxiety pills to sleeping aids, drugs (of the nonrecreational sort) haven’t just lost their stigma – they’ve become social staples. An expert of personality disorder notes, “As psychiatric phenomenology becomes more accepted, there’s also a medicalization of symptoms – like it’s just a headache.”
And so people have grown emboldened about taking meds – even if they have only a vague understanding of their function or have had no contact with the doctor who prescribed them (and not just at those much-discussed pill-swapping parties). They’re scoring – or sneaking – pills from parents or friends who don’t finish a prescribed course of post-wisdom-teeth painkillers, or are buying them over the Internet or while on a vacation. “They’re legal,” notes a trader: “And even if they’re not prescribed to you, someone prescribed them to you, so it’s acceptable. We have this saying: ‘Never hesitate to medicate.’”
Or medicate one another: Amateur diagnostician are doling out their contra-band like breath mints and swapping them like baseball cards. “In college,” says Sara, “everyone has prescriptions for 10 different things. When I got dumped, a friend gave me Xanax (a tranquilizer). When I had cramps, another friend said, ‘Don’t bother with the Aleve,’ and gave me Percocet” (which contains the sane active ingredients as OxyContin, the highly addictive painkiller that’s been making news headlines). One 33-year old paralegal, recounts, “Soon after I started my job, this girl next to me had been out all night and needed help staying awake. I traded her a Ritalin (a stimulant) for a Xanax. Three hours later I was talking to this other girl who was freaking out about having just put down a huge security deposit on a new apartment. She was slumped at her desk, clutching her head. I was feeling really maternal so I said, ‘You really should take this Xanax.’” (The downside: the coworker went to MTV Awards that night and fell asleep.)
“It’s not like they’re real narcotics,” says a 23-year old law student. She sees a big difference between street drugs and the prescription variety. “A friend of mine does cocaine, and she was telling us the other day how she didn’t remember how she got home. She’d take all this coke, then two Tylenol to sleep. Now, that’s dangerous.” (Of course, Percocet and Vicodin are narcotics, and can be nearly as addictive as heroin.)
But the more routinized pill popping these days is not as much about getting high as it is about functioning at a high level in a stressful environment. According to the law student, “I didn’t need to be anxious about my productivity because I could take Adderall. When I was done, I could take Xanax to relax. I knew I’d fall asleep because I’d take an Ambien. A few people had prescription,” she says, including a friend whose dentist father scribbled whatever he asked for. “I had a boyfriend who had a lot of them, so during finals I’d get (drugs) from him. That was pretty much the best thing about him.”
Indeed, what makes all this pill popping possible is the sheer quantity of stuff in circulation. Drug companies are feverishly producing new versions of their products and sinking millions of rupees a year into marketing them directly to potential patients – encouraging them to request certain brands just as they’d ask a shop clerk for the latest brand of jeans. And with all the competition in the health care industry, users don’t even have to find a shrink to get what they think they need.
A psychologist notes, gynecologists, pediatricians, and oncologists are also writing prescriptions. “I’m not saying they shouldn’t or that they’re unqualified, but some doctors are willing to prescribe whatever patients say they want.” A 27-year-old floor broker at the stock exchange saw his general practitioner after his anxiety level kept him from sleeping Sunday nights and getting through the workday. She put him on Ambien, which helped him sleep but didn’t lessen the anxiety, so he approached another GP. “She wanted to put me on Zoloft and Klonopin,” he says. He found her willingness to prescribe almost frightening. “I don’t think I’ve gone to her and left with less than two prescriptions at a time,” he says.
One reason twenty – and thirty-somethings are willing to self-medicate is that so many grew up swallowing pills on a daily basis, like Ritalin in elementary school. Soon many girls are going to take birth control pills before they get their high school diploma. It’s a generation taught to seek shortcuts to everything from wealth to celebrity, so why not happiness? “There is impatience,” says a psychiatrist, who notes that about 40 percent of his patients are on a psychotropic medication, “unwillingness to tough it out and go with uncomfortable feelings.”
“It was different for our parents,” says a 31-year old stylist who put herself on Zyban (aka the antidepressant) to avoid other drugs. “They were on a set path where the choices were clearer. With us, every second you feel like you should be doing something to improve your situation, whether it’s changing the guy you’re with or changing your jobs. Drugs help you get there.”
As a result, what is considered a “normal” way to get through the day has changed. In addition to her daily vitamin, calcium, and cranberry pills, the law student drowns an anti depressant, anti-allergic, sleeping pill and two other pills for good measure.
Feedback on the efficacy of particular medication is easy to come by. “Its word of mouth,” says the broker. “If one person has a good experience on something, I’ll absolutely try it.” Or trade for it: one painkiller for the other. “At work, there are a lot of volatile people who can turn a simple problem in to a big issue by yelling, then there’s the crowd on floor. I like it but my heart starts racing. So occasionally, I’ll swap something for Xanax to calm my nerves.”
The best birthday present Sumeha, a senior at university, says she ever got was a book called ‘Te Complete Pill Guide’, an encyclopedia tome with a color photo chart of pills. She assumed the role of master diagnostician for her friends, advising them on what to take for their ailments. She also became something of a prescription profiler, helping friends size up potential mates by what they’d spy in their medicine cabinets. “You can learn a lot about a person that way,” she says. “One time, I’d just started seeing this guy and I didn’t know much about him yet, so I looked up what he had: antidepressants and painkillers. Then it came out that he had all these family issues.”
As with many drugs prescribed off-label, however, Risperdal is sometimes given to patients for post-traumatic stress disorder. Clearly, knowing a pill’s approved usage is a far cry from understanding how a drug works, much less how to take it. Selective serotonin reuptake inhibitions (SSRIs) like Prozac, Celax, and Lexapro are very popular, but the trouble is that people don’t understand the difference between SSRIs and one-shots like Ambien and Vicodin. They’re not something you can take just once. You being gradually with 10 to 20 mg, but the therapeutic dose of, say, Prozac for major depression is as high as 80 mg. when you go off, you go of gradually. Taking a therapeutic dose right away can cause nausea, lethargy, and anxiety, and suddenly stopping the drug can have equally nasty side effects.
Another risk that often goes unconsidered is that Adderall and Xanax are highly addictive.
“They are like uppers and downers of the ’70s and ’80s,” says a psychiatrist. People think prescription drugs are as benign as antibiotics, but they’re not, by any stretch. Ironically, using them regularly causes the same mood problems that lead people to take them in the first place, including insomnia and irritability. If you get addicted to Xanax, you can have serious seizures. If you stop taking it abruptly, you can die. Withdrawal from Xanax can, in rare cases, literally kill you.
With less-addictive pills, the dangers are subtler, but still very much real, with side effects ranging from liver to stomach problems.
(Some side effects are sought after: Our stylist, who is still indulges in the drugs that she meant to avoid, found that the drug helped her lose weight because she was constantly thirsty ad drank more water.)
Moreover, by medicating yourself to deal with every annoyance that arises – one young lawyer takes an antidepressant every day to read our local newspaper – people end with very little capacity to tolerate distress or to find non pharmaceutical ways to cope with it. “We’re raising a population of young adults who are not getting the practice they really need,” says the psychiatrist. “If you don’t practice at that age, you can have a lot of problems later.”
Millions of years have gone into structure of our brain so that we feel the feelings we do. By instinctively reaching for pills at the slightest discomfort, we miss a whole channel of information that could help you lead a better life. Growing and changing requires suffering a little bit. I’m not saying suffering is good. But learning to put up with moderate levels of discomfort is important.
Obviously, that may be easier said than done. Not everyone’s so tough anymore. After a traumatic accident, Aisha never leaves home without Valium, even though she knows two guys went to rehab for addiction to Vicodin and Percocet. The more she resists the medication, the more, it seems, they are being offered. The other day someone offered her a Sarafem (marketed for premenstrual dysmorphic disorder).
“All the girls in my office have it – they say it’s for PMS,” she says. When on a vacation she got bad sunburn, she walked into a pharmacy, “the guy said to me, ‘Hey, you want something for that sunburn?’ I said ‘Okay, what do you have?’ And he said, ‘Prozac’!”
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