|By Rob Perez, The Honolulu Star-Advertiser|
|McClatchy-Tribune Information Services|
Then he turned to prescription pills -- mainly powerful painkillers, initially prescribed by his doctor or dentist after he broke a bone or had dental work done.
By the time Nash graduated from high school, he was a full-blown addict, taking pills and shooting heroin. Even when he spent time in a
Today, 18 years later, Nash runs Habilitat, a residential drug and alcohol rehabilitation program in
"That was the worst thing I've ever encountered in my life," Nash said of his time in OCCC. "That's the point I decided I really needed help."
After being released from jail, Nash spent four years in Habilitat's residential program.
"I haven't even thought about taking any kind of drugs since then," he said.
Physicians and other treatment providers in
But the drug deaths represent only a fraction of the problem.
Many more adults and teens have nonfatal overdoses, especially from narcotic painkillers such as hydrocodone, easily the most prescribed generic medication in
Some users start taking the drugs, commonly called opiates, for legitimate reasons, such as for chronic pain.
When the patients eventually crave greater amounts but can't get enough from doctors, they frequently pilfer pills from the medicine cabinets of family and friends or turn to street dealers.
When that supply runs dry or proves insufficient, heroin -- another form of opiate that is cheaper and more powerful -- sometimes becomes the next step on the addiction path, physicians and others say.
"We're looking at a huge epidemic coming,"
Reflecting that trend, the number of nonfatal drug overdose cases in
Of special concern is the problem among
At Hina Mauka, for instance, about 6 to 8 percent of the roughly 800 youths it treats each year are dealing with prescription drug abuse, according to Johnson.
"A few years ago, that was practically zero," he said.
Nash, as Habilitat director for the past 13 years, has seen a similar trend with the facility's roughly 100 adult residents.
When he asked at a recent residents' meeting how many came to Habilitat because of prescription pill abuse, about a third raised their hand. Ten years ago, Nash said, hardly any hands would have gone up.
Marinello developed an addiction despite being raised in what he called a good suburban family environment in
Like Nash, though, Marinello started experimenting with marijuana as a teenager, eventually turned to pills, then added heroin to the mix because of the quicker, cheaper highs. Also like Nash, he exaggerated his pain symptoms to fool doctors, raided medicine cabinets and purchased whatever he could afford from street dealers.
At one point, he was taking 20 to 30 pills daily, mostly painkillers such as Vicodin and oxycodone, spending
Marinello said his drug habit put huge strains on his relationships with family and friends, and his performance as an aircraft mechanic suffered as well.
Just like with Nash, it took a near-death experience to set Marinello straight.
"I was absolutely at my lowest point," Marinello said. "My whole life was crumbling. It was hell on earth."
Determined to turn his life around, Marinello said he came to
Nash and Marinello say pills are easy to get, legally or illegally, and word spreads on where to get them.
"There are quite a few doctors in
The high price that dealers can get for certain illicit medications also means the incentive is strong to keep the supply going.
The narcotic OxyContin, for instance, can be sold for as much as
The ease of availability is a factor in what
A hydrocodone mix is the most commonly prescribed generic drug in the islands, and, unlike prescriptions for other painkillers that have a higher classification for abuse, it can be refilled without having to see a doctor again, according to Kamita and state data.
In 2013, more than 400,000 prescriptions for a hydrocodone-acetaminophen mix were issued in
The next most common generic prescribed last year was zolpidem tartrate, commonly known by the brand-name Ambien, a sleep aid, at 143,520 prescriptions, according to the state data.
The next was a narcotic: oxycodone. About 123,000 prescriptions were issued.
Hydrocodone abuse has become such a problem nationally that the federal government is considering reclassifying it as a Schedule 2 drug, which allows no refills, from its current status as Schedule 3.
Kamita said people trying to game the system by doctor shopping, forging prescriptions or through other means represent the vast majority of those arrested in
Most experts who work in the field contend that education is the best way to combat
Various agencies have programs in place and in the works to spread the prevention message and bolster enforcement of existing regulations.
But cuts in state and federal funding in recent years to social service agencies, including nonprofits, have hampered prevention efforts, according to many in that field.
"The problem is certainly there, but the resources are not," said
Despite the steep odds, people like Nash and Marinello are willing to tell their stories in hopes that others will think twice about abusing prescription pills and other drugs.
"In the beginning, I thought it was cool and fun," Nash said. "In the end, it was tragic."
He and Marinello consider themselves fortunate, particularly after having seen many of their friends die too young from overdoses.
"I'm lucky to be alive," said Nash, who overdosed at least six times. "There is no doubt about that. Every day I see as a blessing."
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