Generation writes own prescriptions

Nathan Tylutki arrived late in New York, tired but eager to go out dancing. When his friend Katherine K. offered him the Ritalin she had inherited from someone who had stopped taking his prescription, he popped two pills and stayed out all night.

For the two college friends, now 25 and out in the working world, there was nothing remarkable about the transaction. A few weeks later, Katherine gave the tranquilizer Ativan to another friend who complained of feeling short of breath and panicky.

"Clear-cut anxiety disorder," Katherine decreed.

The Ativan came from a colleague who traded it to her for Vicodin that Katherine's boyfriend had been prescribed by a dentist. The boyfriend did not mind, but he asked her not to give away the Ambien she got from a doctor by exaggerating her sleeping problems. It helps him relax.

"I acquire quite a few medications and then dispense them to my friends as needed; I usually know what I'm talking about," said Katherine, a researcher at a nonprofit agency in New York. She did not want her last name used because of concerns that her behavior could get her in trouble with her employer, police or at least her parents.

For many people in their 20s and 30s, deciding on their own what drugs to take -- in particular, stimulants, antidepressants and other psychiatric medications -- is becoming the norm. Confident of their abilities and often skeptical of psychiatrists' expertise, they choose to rely on their own research and each other's experience in treating problems such as depression, fatigue, anxiety or a lack of concentration. A medical degree, in their view, is useful but not essential.

They trade unused prescription drugs, get medications without prescriptions from the Internet and, in some cases, lie to doctors to get medications they think they need.

The behavior, drug abuse prevention experts say, is notably different from the use of drugs such as marijuana or cocaine, or even the abuse of prescription painkillers. The goal for many young adults is not to get high but to feel better -- less depressed, less stressed out, more focused and well-rested. It is just that the easiest route to that end often seems to be medication for which they do not have a prescription.

Some aim to regulate every minor mood fluctuation; some want to enhance their performance at school or work; some simply want to find the best drug to treat a genuine mental illness. And patients say that many general practitioners, pressed for time and unfamiliar with the ever-growing inventory of psychiatric drugs, are happy to take their suggestions, so it pays to be informed.

Health officials say they worry that as prescription pills get passed around in small batches, information about risks and dosage are not included. Even careful self-medicators, they say, may not realize the harmful interaction that drugs can have when used together or may react unpredictably to a drug -- Tylutki and Katherine each had a bad experience with a medication taken without a prescription.

'Head meds' are familiar

To some extent, young adults embracing better living through chemistry is driven by familiarity. Unlike previous generations, they have for many years been taking drugs prescribed by doctors for depression, anxiety or attention deficit disorder.

Prescriptions to treat attention deficit disorder in adults age 20 to 30 nearly tripled from 2000 to 2004, according to Medco, a prescription management company.

Antidepressants are now prescribed to as many as half of the college students seen at student health centers, according to a recent report in The New England Journal of Medicine, and increasing numbers of students fake the symptoms of depression or attention disorder to get prescriptions.