Xanax, Oxycodone & Little Footballs: Pill Shopping in San Angelo

Sarah grew up in a volatile household where alcoholism was a prevalent problem, and because of that, she had to “walk on eggshells” around her father. Additionally, she was a child victim of sexual abuse, an abuse perpetrated by another family member. Sadly, because of those two issues, she grew up always feeling anxious and nervous, and she never felt comfortable in large crowds. She also became a chronic worrier, and as an adult, when those issues became uncontrollable, Sarah sought help.

Sarah, who did not wish to reveal her full name because of a complaint in process, said after several misdiagnoses, she finally visited two different mental health care professionals who diagnosed her with OCD (obsessive compulsive disorder also known as the “what if” disorder). Sarah was also plagued by severe panic attacks and an anxiety disorder. She said she constantly had to check and re-check the stove, doors, and windows to make sure they were clean, and sometimes it would take her 30 minutes just to leave her home to run a simple errand. Sarah also felt she would hit someone while driving in her car. Therefore, help couldn’t come soon enough.

“I was placed on medications that are made to help patients with these types of disorders,” Sarah said. “One of the first medications did not work; so, along with an antidepressant, a medication called Xanax became part of my daily life. In a very short period of time, as in days, I began to feel better. After years of anxiety, nerves, fear, and worry, there was finally normalcy in my life.”

Finally, Sarah could function on a daily basis without worry, fear or anxiety, and for two years, she learned how to cope with her disorders. For Sarah, therapy, along with Xanax and Luvox, saved the woman’s life.

Sarah said about 16 years has passed since her disorders were diagnosed and treated, and although she has had “flare ups” over the years, they were not severe enough for her to seek additional help. She felt because of her treatment, she would never have to worry again, until recently.

“Since earlier this year, my family has been in crisis. The details are personal; however, it has affected me in a way that triggered my disorders,” explained Sarah. “They began coming back a few months ago. I tried practicing my remembered therapy. I [also] tried ignoring the problem, but to no avail. I realized I was slipping quickly back to the life of a patient with uncontrolled panic and anxiety disorders along with some symptoms of my OCD. Life for me began to stop.”

Because of these reoccurring issues, Sarah sought help from her doctor; however, her doctor tried to prescribe her a medication she reacted badly to. When she took the medication, it prompted crying fits. Sarah remembered though how Xanax helped her along with Luvox and mentioned this to her doctor, but the woman told her she wasn’t comfortable with that particular medication and prescribed her Valium instead, a medication doctors have steered away from because metabolites build up in the blood stream and can cause problems.

“I tried that medication for a month and one week, but it did not work for me at all,” Sarah stated. “I discovered my doctor had been transferred before I had a chance to inform her, and I ended up with a temporary physician's assistant.”

Once she learned this, Sarah scheduled an appointment with a new doctor. Before that appointment, Sarah saw her gynecologist for an annual physical. The doctor realized something wasn’t right and put Sarah on a low dose of Xanax after she explained what was taking place. Sarah was told to come back in 30 days and was provided with a recommendation to see a Licensed Practitioner Counselor.

Once more, Sarah immediately started feeling better, and so when the time came to see her new doctor, she went to the appointment with a list of things she needed to discuss, but when the doctor walked through the door, Sarah knew something was wrong.

“I honestly have never been met with such unprofessionalism and rudeness by a doctor in my life,” Sarah recalled. “No hello. No Smile. I introduced myself and was asked why I was there.”

Sarah said at that point, she began requesting referrals to see other doctors, and she told this new doctor about her disorders and how they had recently resurfaced after many years; she also explained how her gynecologist prescribed her a low dose of Xanax. However, before she could continue, the doctor cut her off and informed her she would not prescribe Sarah that medication.

“Her reaction was such that I actually jumped,” Sarah said. “I had no idea why she had the reaction she did. From that point, our appointment went down hill. She refused to discuss a reason with me. I tried explaining the misery I was in. I tried explaining that I had recently, under the care of the doctor I was assigned to, tried two other medications that did not work.”

Suffice it to say, after further discussion, the doctor stormed out of the room leaving Sarah upset, and she was left trying to get answers. Because of the problem with this doctor, she made an appointment with another doctor, who told her he too wouldn’t give her Xanax even though she never requested him to do so, especially after what took place with the first doctor. Instead, she was there to get the referrals she originally requested from the doctor who stormed out on her.

“I felt truly violated knowing that in all probability the first doctor I had seen either discussed me with him, or made notations in my record,” Sarah said. “I had no idea why.”

Sarah left that appointment in complete frustration, and so she went as far as to visit with the temporary physician’s assistant. She said she felt the visit to be promising until he too told her he would not prescribe Xanax to her even though she did not request it. He did, however, offer her an antidepressant. Sarah informed him she wasn’t depressed, so at that point, she asked him for a referral to a psychiatrist because she felt maybe that would be the only way to get positive treatment. Her request was granted, but when she was asked to provide the consult to the psychiatrist, Sarah learned that these medical professionals had documented in her file that she was “pill shopping.”

“I had no idea what that meant, let alone how to do so,” exclaimed Sarah. “Who would do that? I requested a change in the wording by the PA, and he refused to re-write a more detailed and truthful consultation.”

It was at that point Sarah informed the man he was blocking her from receiving the mental health care she needed to bring her disorders under control.

“I was 100% shamed by medical professionals who did not bother explaining to me their personal issues with a medication that had proven successful in helping me, personally,” Sarah said. “I even spoke in depth with a local pharmacist here in San Angelo, at a reliable pharmacy that has been in operation for many years. I told him what has been happening to me.”

Sarah said the pharmacist was confused by this treatment, and that all the medications she had taken, including the ones the doctors gave her previously, had an ability to create dependency. Yet, it appears that in San Angelo, the focus is now on prescription medications because some people have abused them.

“Because of that, now everyone is considered a pill shopping, addicted, lying piece of trash,” Sarah said. “That is exactly how I was purposely made to feel by three medical professionals.”

Unfortunately, this has happened to many people with real medical issues. They're suffering because people are abusing and selling pain pills and stimulants on the street.

The Problem with Prescription Medication

According to the Institute on Drug Abuse, 52 million people in the U.S. over the age of 12 have used prescription drugs non-medically in their lifetime. Additionally, 6.1 million have used them non-medically in the past month. Also, the U.S. makes up 5 percent of the world’s population and consumes 75 percent of the world’s prescription drugs.

In Texas, 54.2 percent obtained prescription drugs from a friend or a relative, and 3.9 percent bought them from a drug dealer or a stranger. On the streets of San Angelo, according to a source who has sold pills like Xanax and Oxycodone, and who wished to remain anonymous, people pay anywhere from $3 to $7 per pill depending on the strength.

“Footballs, which is the nickname for them, are 10 mg and the highest I believe,” the source said. “They’re shaped like footballs and go for $5 - $7 a pill. The 5 mg pills are peach color and worth $3 - $5 a pill. However, 10 mg of Percocet sell the most. Those are the money makers. Pill poppers here [in San Angelo] are bad.”

These money makers have unfortunately gotten into the hands of many San Angelo teenagers as well, and this source, along with a few students from Central High School, who also wished to remain anonymous to avoid repercussions, said many of these teenagers are going for Xanax and take them as they are. They don't doctor them or mix them with anything else. Also, many of these teenagers are getting a hold of, or buying, Adderall, a prescription for Attention Deficit Hyperactivity Disorder (ADHD).

“They take it because it helps them focus better on things,” one student said.

Another student said last week, a couple of Central students were sent to Carver because they had pills without a prescription. When San Angelo LIVE! contacted the San Angelo Independent School District, Jamie Highsmith, public information officer, said as of Oct. 30, two students out of 7,224 middle school and high school students, and no elementary school students, have been assigned to Carver as a result of discipline for prescription drugs since school started. Therefore, the district doesn’t feel this is a growing problem.

However, it is a nation-wide program, and that doesn’t mean San Angelo teens are not engaging in the buying or selling of prescription drugs. It simply means they’re not getting caught, said the anonymous sources.

In 2013, one study conducted by The Partnership at Drugfree.org showed that one-in-four teens have misused or abused a prescription drug at least once, which was up 33 percent within the past five years. One-in-eight teens reported misusing or abusing the drugs Ritalin and Adderall. Other studies during that time reported a similar increase, and many parents claimed they had no idea this was the case, which may be the same problem here in San Angelo today.

In fact, Highsmith stated, “We would ask that parents be alert to prescription drugs that are available in homes—those that can be discarded as well as those that are currently being taken—and either discard or monitor closely.”

A Trained Medical Professional’s Take on The Problem

Dr. Darrell Herrington is a family practice physician in San Angelo with over 28 years of experience, and he has had specialized training in pain management. He treats many patients with various forms of arthritis, injuries and he deals with hospice patients and provides palliative care.

Dr. Herrington said he’s not surprised to hear about the abuse of pain medications and what pills like Xanax, Oxycodone and Percocet are going for on the street. However, he is concerned about what happened to Sarah as a possible result of this abuse and how it’s affecting patients with real issues.

“That was totally inappropriate,” Dr. Herrington stated. However, because there are a number of patients who do abuse pain medications and are distributing them, many doctors are under scrutiny, and many of them aren't specially trained in pain management.

“If we knowingly prescribe to someone who is diverting substances, we’re in trouble," Dr. Herrington stated. “There are a lot of doctors who won’t prescribe [pain medications] because of that.”

However, as stated, Dr. Herrington has specialized training in pain management and feels one of the most important things he can do as a physician is alleviate suffering like pain and depression, which are two things that may lead someone to commit suicide. By taking on such a task, things need to be done right, so if people purchase medications like Xanax, Adderall, Percocet and Oxycodone on the streets, they, especially teens, are taking a major risk.

“Prescription medications are approved by the FDA because [they have] particular good usage, maybe only for a small segment of the population, or for a large segment of the population,” Dr. Herrington explained.

He added that prescription drugs then require a physician to make good decisions on how they’re used. Additionally, prescriptions, including antibiotics, blood pressure medicine, and anything that can do people a lot of good, can also do them some harm, which applies to drugs like Xanax and Adderall.

Xanax is a Benzodiazepine, or a nerve pill, which does somewhat alter someone’s mood and helps people like Sarah who suffer from anxiety disorders. There’s nothing wrong specifically with Xanax as a drug. It has been extremely effective for millions of people, and they would be ineffective without it.

“As an example of how this might work in an individual, if you were to take a Benzodiazepine in the afternoon and life was fine; you didn’t have much on your mind, and you took just a medium-sized dose of Xanax, then you probably would feel like this is a really good time to take a nap,” Dr. Herrington said. “You wouldn’t be altered in your mind in any way. You would just feel so relaxed and mellow and you’d fall asleep. If the phone rings, however, you can still get up. It’s not a huge effect on sedation.”

Dr. Herrington added that people like Sarah, with general anxiety disorders, are wound too tight, and there are medicines that are longer acting than Xanax they may take every day of their life, and people might say they’re addicted to that, but they’re not. He said they’re dependent, just like someone who is dependent on blood pressure medicine to control blood pressure.

“You’re dependent on this to control your underlying chronic anxiety disorder, which you’re not going to get well on your own; and for the people who say, ‘Well, you need to go to counseling;' well sure! Let’s go!” Dr. Herrington exclaimed. “If there are things stressful in your life that you should let go of, that’s true."

However, for the people buying Xanax on the street, including teenagers, that may be more for the thrill of it.

“So kids get into this mindset to where they want to drink; they want to get a buzz; they want to do this; they want to do that; and, this whole exploration of having fun by being in a different frame of mind ends up being a really cool thing to do," Dr. Herrington continued. “The kids get a little bit of a positive placebo effect. They are not going to have any sort of hallucinogenic, super productive or extremely humorous effect. There’s nothing extraordinary that this pill is going to provide.”

The doctor explained that certain kinds of people in certain kinds of situations are the ones who tend to think like this.

“It’s not exactly the same situation when it comes to drug use as it would be regarding alcoholism,” Dr. Herrington explained. “There does seem to be--and we’ve done a lot of research over the years--a little bit of a click that happens in the central nervous system associated with alcohol that’s almost like the kind of thing you get when you do crack cocaine, which is that this is a perfect fit for the consumer on the first time ever consumed. It’s like, ‘Where have you been all my life?’ That’s the feeling they get."

In other words, these people are more than likely going to get addicted whether they're trying alcohol, pain pills or street drugs. 

Herrington also said these people have an affinity, or an itch that needs to be scratched. They can be wound up a little too tight, too nervous, too edgy, too insecure and too overwhelmed by their daily routine.

“They may simply have a chronic anxiety disorder or it may be more complicated than that,” Dr. Herrington noted.

For those people who take Xanax inappropriately, these prescription abusers can end up being sleepy all the time, or worse.

“The other problems this may cause, and if you were to look at all the literature about the things that have gone wrong, including kids who have taken Xanax or Prozac for depression, they have not been diagnosed and no one has evaluated them,” Dr. Herrington stated. “They’re taking something that they think helps them a little bit, but let’s say their real problem is depression. They are being sexually abused, or they hate their life and they don’t want to go home if dad is there; or, they don’t want to go to school because someone is bullying them so they take a medicine like that. Well if that’s not being treated, they may, at some point, as they’re really mellowed out and tired of all the abuse they’re taking, decide to commit suicide.”

Of course, when something like that does happen, Dr. Herrington said people will blame that on Xanax, but in reality, the victim had other severe issues that weren’t being properly treated.

"They were doctoring themselves with the wrong thing," he added.

As for Adderall, if people are taking that and they’re noticing they’re able to focus better, they may have ADHD. Adderall is a stimulant and it’s meant simply to replace the normal levels of adrenaline-like substances that we all have, said Dr. Herrington. The body works by a feedback mechanism, so when a person has ADD or ADHD, the real pathology is that the adrenaline-like substances fail to function at a continuous and smooth level. They’re at a very irregular level. The doctor said it’s as though they’re released in little packets to where that baseline is not steady, and every time there’s variation in that, the patient feels distracted.

“For an ADHD person, they’re major dysfunction is they just can’t get anything done,” Dr. Herrington stated. “They can’t rest; they can’t be at peace; there’s always something they’re trying to remember to go back and do. Then they take the medicine and that puts them to the same level. The endogenous level goes down, and what you have is a smooth level created by the medicine. That normally works great in just those patients, and you would normally not categorize that as abuse or anything that is dangerous or inappropriate. It works just fine.”

However, if a person takes a handful of Adderall pills, well then they’re speeding, and that’s a problem.

“If [people] buy [Adderall] on the street for $20 and stay up late to study because it gives them a little bit of a feeling of alertness that they’re definitely not used to, they’re naive to that; so that’s why, even at a physiological dose, it seems like a big deal,” explained the doctor. “They can’t do that very often. They’re going to be sleep deprived if they get on some routine schedule.”

Dr. Herrington said though if these young people find the pill helpful, and they realize they’ve been distracted all along, they need to go talk to their parents and tell them they did the wrong thing, but the pill works. They’ve talked to other people and have looked it up, so they may have ADHD.

“It can be tremendous from making Cs and Ds to making As and Bs,” Dr. Herrington stated. “The abuse of it though would be taking several of those [pills]. Then they’re taking speed, and then it’s dangerous. They can have cardiac arrhythmias and anorexia; people who want to just go for days in a row, that’s very unhealthy.”

Dr. Herrington said medicines have a purpose, a strictly regulated purpose, and any use outside of that is a problem. However, it makes good sense to help patients who come in with legitimate problems and they don't look like people who abuse drugs, and they have issues like arthritis or a back injury and haven't gotten the pain under control. Also, they're willing to try more conservative measures.

“But, I’m telling them from day one that [they] can’t eat these like candy,” Dr. Herrington said. “This is going to be a problem.”

He said one of the things about tolerance is if someone’s pain is an eight and they’re wanting to go down to a zero or a one all the time, they are then using enough of that medicine to gain that tolerance, and it won’t be as effective. At some point, that person will become too tolerant to all these medicines, and that’s when they’re going to try something really strong to help them; they’re going to be sedated all the time.

“There are a lot of issues with treating chronic pain,” Dr. Herrington noted. “It can be frustrating.”

Overall, pain medicines, the ones people call narcotics, are all opiate based, so that’s the same thing as heroin and cocaine. These pills are opium based, but that doesn’t mean people who use them are crazy. It just means they are even more controlled substances, explained Dr. Herrington.

“They’re not just prescriptions. They’re a Schedule 5, 4, 3, 2 controlled substance,” he said. “And those [pills] like Oxycodone, Hydrocodone and Morphine, they’re going to be Schedule 2 drugs that you can only get a prescription for a month at a time; you have to pick up the prescription every month and a log has to be maintained. People can’t take more than what they’re prescribed. They can’t go to multiple doctors to get it because all these red flags go up when this happens.”

Also, these people can take them at such a level to where their dependency creates withdrawals, and if they try to quit, that’s a problem.

Dr. Herrington said, “Well if they’re thinking that this is great, the pills are great, and they’re going to be on them the rest of their life, but they just can’t score any, well then they’re going to go through some major withdrawals like a heroin addict looking for a fix; and then they’ll do anything. They’ll rob, steal, have sex and will do anything to have their fix."

Dr. Herrington added that some side effects include a lack of appetite, negative effects on their body, and high doses of medication can cause cardiac arrhythmias. These people usually die young if they’re taking a lot of pills at a time.

“They can usually smash the pill up and snort it; they can heat it and inject it; and they can get almost a heroin-like high,” Dr. Herrington described. “They can do something like that along with speed and heroin in an injection, and that’s a speed ball, something that killed Jim Belushi and lots of other people. It gives them a tremendous rush, and they’re going to want to keep doing it. As a result, they’re going to overdose.”

These type of people who are the thrill seekers who have underlying problems. To these thrill seekers, especially teenagers, Dr. Herrington provided this message.

“You have no idea what’s in that pill you’re about to take,” he said. “You just have someone telling you. And even if it’s in a bottle that has a label, you don’t know if those pills came in that bottle. In many cases, you may be paying $20 for a placebo pill that’s not going to do anything, and you’re getting taken advantage of. As a physician, there are things I know that I can make a mistake on, and I can give people a medicine that can kill them at a reasonable dose. For [you], it’s the wrong thing to do. Kids are young and healthy and we wouldn’t expect anything to happen from taking one pill, but you may find that you have some affinity for that and continue to do it, but it’s only going to do harm.“

Dr. Herrington said if someone has a medical problem and they are convinced some street drug is helping, he or she needs to talk to the professionals and get real help.

“Get your own prescription at a whole lot less than what you’re paying for on the street and have it be prescribed appropriately,” he said.