Editor’s note: This is Part 3 of a four-part series on the role of sedatives known as benzodiazepines in the nation’s opioid crisis.
NORTHAMPTON — Often college campuses can be isolated bubbles, but here in the Five College area, the outside community is deeply intertwined with them and with those who live and study there.
So, it should be no surprise that issues facing college campuses often mirror larger community concerns in and around Hampshire County, including the rise of anxiety and use or misuse of prescription drugs to treat it.
Anxiety was the No. 1 reason students sought help from campus health services around the country, according to a 2016 annual survey of 139 campus health centers conducted by the Center for Collegiate Mental Health at Penn State.
Another annual survey of students at 137 colleges and universities nationwide by the American College Health Association found that the number of students reporting “overwhelming anxiety” increased from 50 percent in 2011 to 62 percent in 2016.
The rise in student anxiety has been accompanied by a rise in prescriptions for benzodiazepines, a class of sedatives for panic disorders and sleeplessness, according to the federal Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health.
Commonly known as benzos, drugs like Xanax, Valium and Klonopin can be effective in the short term under a doctor’s supervision.
The mental health administration’s survey showed the number of teenagers who reported using prescribed benzodiazepines increased 16 percent between 2015 and 2016.
There is also a growing trend of young people using benzos for recreational purposes. The survey showed a 12 percent increase in the number of 12-to-17-year-olds who reported using benzodiazepines without a doctor’s prescription.
The prevalence of these drugs shows up in pop culture, where Top 40 songs frequently mention prescription pills, and one in particular: Xanax.
The rapper Future’s song “Xanny Family,” which reached No. 25 on the Billboard music charts in February, mentions different drugs, including oxycodone and another synthetic opioid, before the refrain, “welcome to the xanny family.”
Lil Uzi Vert’s song “XO Tour Llife,” was unavoidable for the 34 weeks it spent as Billboard’s No. 1 song in the U.S. Over its catchy beat is an ode to Xanax.
A popular emo-hip-hop artist, Lil Peep, recently posted a photo to his Instagram with “bars” (the largest single pill dose at 2mg) of Xanax on his tongue before he was found dead the next morning of an overdose of Xanax and the synthetic opioid fentanyl, according to the medical examiner’s report.
And it’s not just rap music. An Addictions.com study of drug references in music lyrics found that prescription pills were the third most referenced drug in folk music and all “other” genres (anything that is not rock, pop, hip-hop, jazz, electronic or country).
A search of lyric databases for keywords like “Xanax,” or “Xanny” brings up results from house music, synth-pop and punk-rock. Many of those songs play in students’ earbuds not just on college campuses, but in high schools, too.
The popularity of benzodiazepines is troubling for Lynn MacDonald, program director at Northampton’s OnCall Healthy Living Program, which provides medically assisted treatment for people dependent or addicted to opioids.
MacDonald, who has four children at Northampton High School, said as a parent she is concerned about what she hears high school kids are doing.
“All the take-back stuff (information sent home to parents with students by the school) has been talking about opioids, but I think there’s a lot of parents who would like information about benzos in there,” she said.
MacDonald is worried that high school families might not know the risks of taking benzos with alcohol or the opioids prescribed for wisdom tooth removal or sports injuries.
Jess Tilley, the executive director of the New England User’s Union, reaches out to people using drugs who are unable to use brick-and-mortar services like needle exchange centers because of stigma or age (people must be 18 or older to be given syringes in Massachusetts).
Through her work, Tilley said she has seen an increase in young people using benzodiazepines like Klonopin and Xanax without prescriptions over the last few years, with benzos often readily available in a parent’s medicine cabinet.
“Even at Northampton High School there are a number of people taking Klonopins, even mixing pills with alcohol. They don’t realize they’re mixing two depressants, potentiating overdose,” she said. “They really don’t realize the enormity of the danger that can happen.”
But Karen Jarvis Vance, who has been the director of Health, Safety and Equity Programs at Northampton High School since 2006, said prescription drug use at the high school has been consistently below state and national rates, according to a twice yearly anonymous survey of junior high and high school students.
“I do think that’s because we have so many coalitions working up here to get the word out about the dangers,” she said.
“We are certainly aware of the rise in use of benzos that has gone hand in hand with the rise of prescription drugs in general.”
Over the past five years, the Youth Prevention Needs Assessment survey of eighth-, 10th- and 12th-graders conducted by the Northampton Collaborative for Education Services shows decreases in the percentages of eighth- and 10th-graders who reported using non-prescribed benzos in the last month.
In 2013, 3 percent of high school seniors reported using a benzodiazepine without a prescription in the last 30 days. In 2015, that number dropped to 1.8 percent, rising again in 2017 to 2.3 percent.
Overall, Jarvis Vance said non-prescribed benzos are a blip on the data, especially compared with alcohol, marijuana and stimulants.
But from what she’s seen as a nurse, she said there seems to be frequent prescribing of benzos to many people in the community.
“I know that Klonopin and Ativan, in particular, are two drugs that are pretty frequently prescribed for anxiety and for other issues, so it doesn’t surprise me that those would be the more popular drugs of abuse either,” she said.
“Like we saw with Percocet and morphine, any time you have … a large number of these prescriptions out there in the community, you just increase the odds that they’re going to fall into hands they’re not meant for.”
The 2017 survey found that of those students who took a prescription drug without a prescription, 62 percent got the drug from someone they know, 18 percent got the drug from their home with their parents’ permission and 16 percent got the drug from their home without permission.
Jarvis Vance said the school focuses on educating students about the risks of taking drugs that are not prescribed to them and the dangers of mixing prescription drugs or taking them with alcohol. For parents, she said, the message is “lock it down.”
She said many parents know to monitor and safeguard medications from toddlers, but need to continue doing so as their children grow up.
“It may not be your child in your home who is looking,” she said, “but it could be a visitor to your home.”
However, she added that those most at risk are people also using opioids, which she said high school students rarely do. For the community at large, though, she said that’s an important message about benzos.
“Certainly, it’s something for people to think about who are working on the opioid epidemic, adding that message in: that mixing other drugs with opioids is really going to increase your chances of accidentally overdosing,” she said.
Coming Thursday: Stemming the tide of the opioid crisis in Northampton.
M.J. Tidwell writes for the Gazette from the Boston University Statehouse Program.