Abuse of prescription drugs is most common among those who enjoyed the most advantages in adolescence, causing some to rethink the consequences of privilege.
By sophomore year Evan was sleeping on a blowup mattress in an empty house off campus. He had no bed. No furniture. No posters or mini-fridge or shelf fraught with textbooks. He had no friends. He had sold the former, severed ties with latter, and now spent his hours curled up on an Aerobed until his dealer came through.
This is where the police found him. They wanted to know why he had purchased 43 calculus books when there wasn't a single calculus class on his course load. He had been buying them on his parent's credit card and selling them back for cash. When his parents called after having words with the police, his feebleness dislodged the truth:
"I've been an Oxycontin addict for the past two years, and I need help."
* * *
Prescription drug abuse is now recognized as a page in our catalogue of national issues. The stories of its victims elicit both sympathy and rage. Fingers are pointed all over, but only recently has the government begun to act. The FDA is pushing for stricter regulations. Industry literature is being reevaluated. "Take-Back" initiatives designed to dispose of unused drugs are being implemented in many states, and prescription drug monitoring programs are already being used in most.
These tactics, however, almost exclusively deal with the supply side of the problem. As we've seen with marijuana and psilocybin mushrooms, and several Schedule I drugs sprinkled like pixie dust over many an adolescent memory -- regardless of how fortified the supply becomes with federal red tape, demand almost always comes out victorious.
The question is, why is there a hot demand for prescription drugs to begin with? And who, exactly, is doing the demanding?
This would have been fairly easy to answer some years ago when the opioid abuse so regnant in low-income, rural communities (pigeonholed as "hillbilly heroin") was the role prescription drug addiction seemed to be playing on the national stage. Painkillers promise a quick metaphysical escape for those living in insufferable states of poverty. They also provide a lucrative business with a street price tag of a dollar per milligram. But what of the most recent demographic to come to the forefront of disheartening statistical surveys? What of white, affluent, youth -- a social group which, historically, has it better than anyone else?
Kids born between the years 1984 and 1990 abuse painkillers (the cause of three of every four overdoses) 40 percent more than any other age group or time before them. A study published in Health Affairs on Wednesday suggests that the increase in fatal drug overdoses among youth has grown so severe that it is a "major contributor" in the gap between life expectancy in the U.S. and other high-income countries. In 2011 alone, close to 1.7 million people between the ages of 12 and 25 (over 4,500 young people per day) abused a prescription drug for the first time; three-fourths of them were white. According to a 2009 survey, 88 percent of those admitted to treatment for the abuse of opioid-based medication, and 66 percent of those admitted for stimulants, were also white. Those who abuse prescription drugs in college are more likely to be white, as well as male, have a mother with a bachelor's degree or more, and perform poorly academically.
* * *
Evan was all of the above.
"I remember sitting by a fire in the eleventh grade and taking the medication and thinking to myself that if I had this every day in infinite amounts for the rest of my life I would use it all," he said. "I would take it every day, and I wouldn't have any problems. My life would be fine."
Evan had just gotten his wisdom teeth removed. He had been prescribed twenty 7.5 hydrocodone's and had taken his first two. He was sitting beside the fireplace in his four-story house with a central staircase that spiraled up. He admired his parents, and they were thoroughly devoted to him. He attended a prestigious private school and had the camaraderie of a pack of plucky friends. To an outsider, he would appear to have no real "problems" apart from the bloody pits in his gums. But as he approached college, Evan had become increasingly distressed.
"I didn't understand what the meaning of life was," he said. "I still don't, but I thought that everyone else did, that there was this big secret that everyone was in on that I wasn't. I thought everyone understood why we were here, and that they were all secretly happy somewhere without me."
These words may sound like the petty cry of a trite existential crisis, but for those who have been dosed with superficial happiness for the duration of their plush childhoods, such thoughts can become unbearable. For someone like Evan, who "never had to work for anything," the inevitable adversities of life seemed insurmountable. So he turned to Roxycodone, 60 milligrams of rapid-release a day -- euphoria that money can buy.
* * *
It's a narrative that has been written about often in the past five years, and few have done it better than the psychologist Dr. Madeline Levine. She was one of the first to theorize that an elite lifestyle could be detrimental to the character of a child, with her New York Times bestseller, The Price of Privilege. She wrote of the "enormous amounts of attention and resources that adults pour" into many of today's children, and how "paradoxically, the more they pour, the less full many of [her] patients seem to be."
"Indulged, coddled, pressured and micromanaged on the outside," she writes, "my young patients appeared to be inadvertently deprived of the opportunity to develop on the inside."
This deficit in individual autonomy is precisely what makes these drugs so attractive. They allow young adults to continue their lifestyles of overdependence and reliance even once they leave the crust-less sandwich comfort of their homes. Their lack of experience in failure, unpleasantness, or dealing with various forms of hardship also paints the "quick-fix" as the optimum solution. You just have to pop a pill, and the magic carpet slips right back beneath your feet.
The unparalleled pressure to succeed, brought to bear by parents and educational institutions, is often another part of the prosperous lifestyle package. This too can become a catalyst for drug abuse. Privilege may appear to provide the foundation for a propitious future, but of course, the expectations are that much higher, the competition that much steeper, and satisfaction is far less easy to attain. When your adolescence has been bombarded with endless barometers of achievement -- the BMW's and the wrap-around porches and the clean blue pools and the boats bobbing up and down -- the ladder appears to have less to do with internal gratification, and more with an expensive, material obligation.
It's no wonder that a recent study found that millennials are significantly more stressed than the rest of society. Failure haunts them like an ill-willed specter, and prescription drugs, with their various remedial powers, seem like a convenient charm to wish it away. The irony is that even while such substances are being "abused," they are technically still being swallowed for medicinal purposes.
Bereft of any authentic sense of self and the grit it takes to form one, and relentlessly pushed to socially defined ends, a privileged adolescence becomes the consummate breeding ground for self-harm, however unintended.
Such a notion catches most parents entirely off guard. After his initial confession and subsequent return home, Evan remained an addict for a half-decade longer. He found a hook-up in his suburban neighborhood, began injecting the oxycodone directly into his bloodstream, and eventually turned to heroin when his dealer's source went cold (an increasingly common trend). His parents were wholly oblivious to the fact that he was using again until they were faced with the physical evidence: used syringes casually discarded in his bedroom wastebasket.
It's seems contradictory that a life of ample provision could lead to such desperation, so the ignorance is somewhat understandable. Culturally entrenched and statistically unsound stereotypes are also to blame. A study released last month found that only 13 percent of white parents are very concerned about the abuse of narcotic painkillers in their families, over two times less than black or Hispanic parents. This is regardless of the fact that abuse rates are three times higher amongst white teens.
The real delusion, however, is apparent in their attempts to seek rehabilitation -- by sending their children "away for a bit" to a fancy treatment center, or military school, or into the wilderness to be healed. The hope is always that they will come back as clean as their empty bedrooms have been kept, but again, the answer is not so simple.
"It was hard to find kids who wanted to stop," Evan told me me. "Most of the time they were trying to quit just to maintain the support of their parents, and they were just using more money, and you would talk to them, and they'd say things like, 'I plan on getting high the second I get out of here .'"
That was at one the best facilities in the country, where Evan's parents spent $70,000 trying to get him sober. It was his third attempt, and it failed exactly like the previous two. Five of the kids he met there are now dead.
* * *
The true solution is a far more abstract one. It consists of making an effort to cultivate steadfast meaning rather than fickle joy, and understanding that ceaseless superficial achievement means endless unfulfillment. It's one of life's greatest paradoxes: Those raised in a state of want are taught to be grateful for what they have, while those who have everything are brought up to continue wanting. As Evan describes it, "I wanted comfort in a way that doesn't even exist."
Eventually, he attempted suicide, throwing himself sixty feet from the top landing of his parents' home, his body denting the wooden floor in the fall. He woke up on his parent's couch with nothing more than a broken rib and a cracked collarbone, and the revelation felt by those who survive the almost-end:
"That something as simple as living is worth doing."
Evan has been sober since that day a year ago. He lives with his parents, drinks a lot of tea, works a crappy job, and for some reason, he regrets very little.
"I know it sounds crazy, but I don't know how I would have learned otherwise," he said. "I wouldn't change the past seven years. I've taken my focus off the fact that I have to achieve something for now. And it makes me feel real. Now I wake up in the morning and say, 'Thank god I have this bed.'"