Timothy Chernyaev wasn’t having an easy time in life. There were issues with close friends, issues at home, issues at school—issues that, frankly, he didn’t feel like deconstructing on a therapist’s oily leather couch. What was the point? To his mind, you could save a lot of money by just talking to a mirror—or, better yet, speaking into a tape recorder, then playing it back while skimming a psychiatry textbook: comparing, contrasting, reaching a diagnosis. And yet he couldn’t shake the idea that what was making his mind and body literally ache might just be … depression. So he called a friend who had a prescription for Prozac, and asked if he could “borrow” her pills. This was in April. Middle of his sophomore year at Bronx Science. He was 15 years old.
The decision, in a way, made perfect sense. Though he’d never been prescribed anything by a doctor, pharmaceuticals had become impossible to avoid, an intrinsic part of his life. Timothy had taken Ambien (his grandmother’s prescription), at first simply to unwind, then in larger doses—three pills, five, one time seven—discovering that doing so caused minor hallucinations. He’d sampled Xanax (a friend’s prescription), which he called “tombstones” because the pills resembled two gravestones stuck together. He’d dabbled with Vicodin when his mother got a prescription to treat a pulled muscle, which cracked him up: that a doctor would prescribe a synthetic opiate—wasn’t that sort of like heroin?—for such a routine ailment. And once he’d used Adderall for kicks, something seemingly every other kid he knew had done. Prozac, he understood, was different, an SSRI, which meant it subtly recalibrated your brain’s serotonin levels, and took a few weeks to take effect. Fine. This was a different sort of experiment. He just wanted to feel better.
“And I did—I felt serene almost,” Timothy told me not long ago. “I wasn’t sure if it was the placebo effect, or if it really was working. I just felt kind of numb to everything. You don’t get your lows, but you don’t get your highs either, which can be comforting.”
He’s a tall kid, Russian-born, with striking Slavic features: inquisitive, almond-shaped eyes, wide flat cheeks, full lips. Fiercely articulate, he tends to be seen by adults as too snide and cynical for his age, which he takes as a compliment. Yet as happy as he is explaining why Dostoyevsky trumps Tolstoy, he’s still very much a teenager. Just check him out most Friday nights, hanging with friends in Forest Hills, listening to Modest Mouse, drinking Flaming Doctor Peppers, a cocktail made by lighting a shot of Bacardi 151 on fire, dropping it into a beer, and chugging the whole thing as it foams up like crazy. Like a lot of kids, Timothy keeps an online diary, and after he took the Prozac, its tone became increasingly clinical. Having diagnosed himself, he became his own therapist. Sample entry:
I’m happy. Sheerly happy. Now the decision I have to make is if I’m actually happy or if my mind is stabilized by antidepressants making me happy. Either way, I may need to stop taking them soon. You know, actually deal with my issues as opposed to avoiding them shamefully.
“The other day, my momdecides to trymy Adderalland she flipsout. She calledme literallycrying, andinsisted I go off it. And I’mlike, I’m notgoing off thisduring mysenior year of high school.”
The Prozac was a secret until one recent afternoon, when he told a close friend about it. They were sitting on the hood of car, smoking menthol Marlboro Lights. She took a drag, looked at him, and said, “Well, I think it’s pathetic, but it’s your call.” That struck a nerve. He stopped taking the drug. Because, when he really thought about it—especially in retrospect—he kept coming back to the notion that he’d done what a lot of doctors in America seemed to be doing these days. Had he unwittingly diagnosed adolescence as a psychological disorder?
Lately, when adolescents and antidepressants come up in conversation, the talk gets stuck on one subject: suicide. A yearlong debate culminated two weeks ago, on September 14, when a Food and Drug Administration panel advised that more stringent “black box” warnings—similar to what you see on the sides of cigarette packs—be placed on guidelines for doctors to highlight possible links to suicide in children and teenagers. A bombshell, as they say, one that had its origins in England, where it was revealed that GlaxoSmithKline may have suppressed data suggesting a link between use of its antidepressant Paxil and suicidal thoughts in children and adolescents. (The investigation is ongoing.) This caught the eye of New York State’s crusading attorney general, Eliot Spitzer, who sued GSK—a case that was settled in August when the company agreed to post all clinical data online and pay New York a conciliatory $2.5 million fine. Meanwhile, Senator Chuck Grassley, an Iowa Republican, launched an investigation into the FDA, claiming that it too had blocked a scientist, Andrew Mosholder, from speaking out about similar findings. There was pressure. Something had to be done. The FDA contracted Columbia University to analyze 25 clinical trials involving 4,000 kids, and a conclusion was reached: Kids on antidepressants are about 1.8 times more likely to have suicidal thoughts and behavior than those not on medication.
So there it was—the mysteries of the teenage mind reduced to a hard number. Fear spread. People panicked. The Times editorialized. A $13 billion industry shuddered. And yet, for all the alarm, the findings are still pretty thin. Suicidal tendencies, of course, are a classic symptom of depression, and there were no actual suicides during any of the clinical studies. (Though one 19-year-old college student with no outward signs of depression killed herself at an Eli Lilly lab during a clinical trial for Cymbalta, the latest antidepressant to hit the market; it’s common that such trials involve healthy patients as well as depressed ones.) But what the debate misses entirely is the role prescription drugs play in the life of a teenager like Timothy Chernyaev—how the off-label prescriptions deemed “relatively promiscuous” by Dr. Michael Fant, an FDA panel member, have slyly bred a new cocktail culture of off-off-label use among kids—part self-diagnosis, part self-destruction.
Especially in New York, a city where, perhaps more than anywhere else in the world, the border between adult and child fluctuates between blurry and nonexistent: Top schools offer cutthroat environments similar to top law firms, and many children are quick to adopt their parents’ tendencies toward hyperactive perfectionism. “It’s very common that it’s the parent who first introduces the child to the drug,” says Tessa Kleeman, the coordinator of the independent school program at the Freedom Institute, a Manhattan outpatient rehab facility where, she says, there’s been an increase in problems related to prescription drugs. “The parents are often in similar environments, often relying on substances to wake up, to get through the day.”
More than 50 kids were interviewed for this article—I spoke to them online, over the phone, and many at length and repeatedly in person. Ambien, Adderall, Prozac, Ritalin, Percocet, Valium, Xanax, Klonopin, Zoloft, Wellbutrin, Vicodin, OxyContin, Concerta, Focalin—these names, and others, punctuate their sentences with the same frequency and familiarity as iPods, cell phones, instant messages, homework. Prescription drugs are sold and traded, sometimes for other prescriptions, for beer, for test answers, for cocaine. On LiveJournal, a popular Website where many teens keep online diaries, you can find Xanax, Prozac, and Ambien listed as interests alongside more prototypical teen fare like miniskirts, Carrie Bradshaw, candles, boys, girls, and Britney Spears.
It’s a tricky issue. Many doctors say that psychotropic drugs are underprescribed to kids—that, nationally, those who could seriously use them outnumber those on them. “But in a place like Manhattan, I’d say there is a bias toward overprescribing medicine to kids,” says Dr. Stanley Turecki, an Upper East Side psychiatrist specializing in adolescents, and author of The Difficult Child, a book about pediatric mental health. Turecki, who describes himself as “conservative” when it comes to writing prescriptions, points out that upper-middle-class parents are especially quick to seek chemical treatment, for themselves and their kids. “The pressure in a certain demographic is extraordinary. You see parents who talk about underperformance as if it’s a disorder, which really goes to the heart of the issue: Are we still treating disorders here? Or are we offering performance enhancement?”
Elizabeth knows all about it. A senior at an all-girls school on the Upper East Side, she’s dealt with her parents’ suggesting medication to treat her attention-deficit disorder for years. There was the Ritalin in sixth grade, which she despised, then the Concerta in eighth, which was even worse. In her sophomore year, she was put on twenty milligrams of Adderall a day, and found that her study habits (though not her eating habits) quickly improved. “So then, the other day, my mom decides to try my Adderall and she flips out,” Elizabeth told me. “She couldn’t believe how strong it was, how much it changed her mood. She called me literally crying, and insisted I go off it. And I’m like, that’s bullshit. I’m not going off this during my senior year of high school when I’m trying to get into college.” What bothered her most, she said, was the notion that suddenly her parents were looking at her like she had a drug problem because of a drug they’d put her on. “And I always take it as directed,” she said. “A lot of my friends take it recreationally, which, I’m sorry, is just sort of dumb.”
The National Institute on Drug Abuse released a study stating that “the most dramatic increase in new users of prescription drugs for nonmedical purposes” had occurred among teens. Those findings are echoed by the just-published National Survey on Drug Use and Health, one of the government’s most exhaustive looks at drug trends, which observed that pharmaceuticals have grown in popularity while use of substances like marijuana, ecstasy, and LSD have declined. “There’s almost an expectation that someone’s going to bring Ambien or Adderall or Xanax to a party these days,” says Tessa Kleeman. “One thing I’ve noticed in recent years is that when I go into classrooms to talk about drugs, students will often bring up their concerns that doctors are overprescribing medicines.”
As Timothy and I spoke, he was joined by his best friend, Nadia Smirnova, a 17-year-old senior at Bronx Science with magenta-streaked hair and an array of piercings in each ear. “I was the same way with the Wellbutrin,” she said when he finished describing his stint with Prozac, her tone casual, as if she were pointing out something glaringly obvious. “During my freshman year, I was always having these episodes, right? Like I’d break down in the hallways crying and have to skip class.” Looking back, she said this probably had to do with Ephedra, the now-illegal diet pills that she used to take every morning to wake up at 5:30 for the Queens-Bronx commute. “They make you really hyper, and then you just crash,” Nadia said. To pep herself up for tests, she felt she needed something, so she started taking Adderall. Recently that helped her get through the SATs, though with mixed results: a 720 in math, but just 580 in verbal, because she had to excuse herself many times to go to the bathroom—with Adderall comes dehydration, and a tendency to consume lots of water.
So Nadia decided to stop using Adderall, which was easy enough. Her experience with Wellbutrin, however, was more complicated. “I had a friend who was on a lot of drugs,” Nadia explained. “She was doing coke, smoking weed, doing Adderall, constantly drinking—then her doctor gave her a prescription to Wellbutrin.”
One day in Spanish class, Nadia’s friend tapped her on the shoulder and showed her the bottle of pills.
“Take some.”
“I don’t want to,” said Nadia, who had just turned 14.
“Are you scared?”
“Shut up—I’m not scared.”
“Then take some.”
“Fine,” huffed Nadia, swallowing a pill on the spot.
She started taking it every morning in class, and within weeks the episodes dissolved. Problem was, a few months later her friend’s prescription was abruptly terminated. “Her mother found out her boyfriend was dealing coke and took her off everything as punishment,” Nadia continued, wincing at the memory. “So I had to go off it just like that! It was tough. I really crashed. The episodes came back, but worse.” Nadia talked to her mother, to whom she is close, mentioning that she was depressed and that—who knows?—maybe medication would help. But her mother was adamantly opposed to antidepressants. A few weeks ago, Nadia decided to give up all drug use, but wanted her name in this article because she hoped people would understand her frustration: that even adults don’t see the difference. Doctors and dealers, illicit and essential, dumb fun and dire necessity—these distinctions mean nothing anymore. The line between recreational use and medical use has, for many kids, become a hoax, an anachronism, a lie. And though this behavior seems most prevalent among privileged New York teenagers, it is far from restricted to that group. Where there is easy access to prescription pills, there will be kids inventing their own ways of using them. Which raises the question: How much are pills redefining what it means to be a teenager?
Here’s the scene: A. is in the kitchen of her apartment on the Upper West Side, laughing with her best friend and feeling perfectly, perfectly stupid. Two fashion-conscious 17-year-olds, they are each holding a steak knife, using the serrated blade to crush two pills of Xanax on a mirror. It is early August. Summer’s in full swing: Weekdays blur into weekends, every night buzzes with potential for mischief, and this evening A. has the house to herself. Her father, who works in entertainment, has lived in another state since her parents separated when she was 11⁄2. And her mother, a teacher, is out in the city, as she often is, doing who knows what with who knows whom.
Speaking of parents: The Xanax was swiped from her friend’s father, who has Parkinson’s disease, and with it a bottomless prescription of what A. calls “the hard-core” two-milligram pills (and which her friend sometimes covertly pops to dull the stress of having a sick dad): oval-shaped tablets meant to be split into fourths, but which can cause a mute, dreamy feeling when swallowed whole. This sensation, they’d heard from a friend, is magnified exponentially when Xanax is snorted—shoots straight into your brain, and two seconds later you’re floating, tingling, reality morphed into a waking dream.
A.—who asked to be identified by her middle initial, more to avoid appearing deviant in the eyes of college-admissions officers than in her parents’—has long, layered brown hair, perfectly tweezed eyebrows, and a self-deprecating wit. A senior at one of the city’s most selective high schools, she radiates intelligence and is almost disturbingly driven: Her college applications were complete by mid-July, a cool five months ahead of schedule. Her relationship with pharmaceuticals is paradoxical, if not uncommon: On the one hand, they epitomize rebellious sophistication; on the other, an absolute necessity. She has her own prescription for Xanax for acute anxiety, though it’s too weak (.25 milligrams) and sparse (only seven pills per pharmacy visit) for recreational purposes, and she used to borrow her mother’s to quell her self-diagnosed anxiety attacks. She also takes 100 milligrams of Zoloft every day—before that it was Lexapro, but that made her faint at school—which she went on after years of therapy and depression that spiraled into a dark, impenetrable haze after breaking up with the boy she lost her virginity to. She was cutting herself and lost twenty pounds when she stopped eating. Going on antidepressants had actually been her idea—she’d seen how Wellbutrin helped her mother—and she credits Zoloft with bringing her back to her “normal self.”
And yet she also relies on such substances to escape that normal self. “Okay, so after we snorted the Xanax, we went to eat some pizza,” she told me over lunch at Cosí, describing the rest of the night. “It makes you hallucinate a little, which is cool. Anyway, we stumbled back to my house, where I passed out on my friend’s lap, only to wake up and hear ‘The coke dealer’s here!’ because apparently I’d called a coke dealer before I passed out. I got up and went to the coke dealer across the street—they meet you in a car; it’s really sketchy, but it’s fun, too.” The remainder of the evening is a blur: some lines of coke, a jaunt to a comedy club she saw listed in Time Out, laughter, some more coke, more laughter, then to a friend’s parent-free apartment on the Upper West Side. “Over there I traded some coke and some Xanax for some weed—yeah, high-class, I know. We got back to my house by one and had the coke jitters, so we snorted a milligram each of Xanax and passed out. You know, it’s good for anxiety, but it really works to counteract cocaine.”
And what about the effects of all these uppers battling downers in a brain stem she admits is fragile, one already altered by antidepressants—does she ever worry about that?
“Sometimes I do, but most times I just don’t care. I think it’s just natural to want to escape real life. I know a lot of my friends are doing this stuff and they’re fine.”
As for all the talk about antidepressants and suicide: “I don’t pay attention to reports like that,” she said. “Sometimes my friends are like, ‘Hey, you’re going to kill yourself!’ But it’s like with eggs—they’ve told us a thousand times that eggs are bad for you, then they’re good for you, one part of the egg is good, one part is bad. It’s just stupid—like saying Marilyn Manson made you kill yourself. Gimme a break.”
The New York City teenager may be a notoriously advanced and savvy species of adolescent, but it wasn’t that long ago that even 17-year-old private-school kids didn’t know what Xanax was. And to those who did, it wasn’t exactly something to brag about. As prescription drugs became a sort of cultural currency among adults (Tough meeting tomorrow? Pop an Ambien! First date? Try a Paxil!), they still carried a stigma for teenagers. Being prescribed a regimen of pills to treat something deemed a psychological disorder—from severe depression to mild anxiety to a difficulty paying attention in precalculus—was perceived as embarrassing, something best kept secret. Braces and persistent acne and tyrannical hormones were overwhelming enough without also being known as the Dude on Ritalin or the Crazy Prozac Fiend.
Drug companies, though, have plenty of incentives to market their drugs to kids. Adolescents represent a relatively untapped (but rapidly growing) market for drugmakers, something any successful business looks to exploit. And they’re generally encouraged to do so by the government. A federal law passed in 1997 allows a drug company to keep its patent an extra six months by performing clinical trials on children, which translates into enormous profits. Zoloft, for instance, grossed about $3.1 billon in sales last year, so that additional time is hugely lucrative.
Meanwhile, the shame associated with psychotropic meds continues to dissipate as doctors write more prescriptions and the diagnosed “disorders” become less severe-sounding. First there was depression, then social-anxiety disorder; now we have general-anxiety disorder, which Xanax’s Website defines as having “vague feelings that something bad is going to happen,” an apt description of what it’s like to be an adolescent. Zoloft’s Website describes social-anxiety disorder as often starting in the “mid-teen” years, and yet the drug’s television ad campaign, with its cartoon powder puffs, looks like a Sesame Street outtake. And while Pfizer denies targeting kids, teenagers themselves aren’t so sure. “That’s so geared toward children,” Timothy told me. “It’s like, ‘You’re not happy anymore? Here, take some pills and you’ll be appreciating butterflies left and right!’ ”
“What’s really changed is that now they market medical conditions,” says Marcia Angell, a member of Harvard Medical School’s Department of Social Medicine and author of The Truth About the Drug Companies, the just-published indictment of big pharmaceutical firms. “It’s simple—there will always be more healthy people than sick people, so they need to make more people think they’re sick. Teens are naturally going through an intense period of ups and downs. The marketing makes them think the downs are unacceptable, that they’re a disorder.”
What such marketing cannot take into account is that kids are cynical, reluctant to take the word of adults at face value. When this attitude mixes with prescription drugs, it turns into a desire to reinvent their intended uses in a manner that’s not necessarily ill-intentioned. Because the taboo truth is that illicit use can be legitimately helpful, which makes the dangers that much easier to overlook.
Case in point: S., who asked to be referred to by the initial of her nickname, was heading home on the subway the other day, midway through her second week of classes at an Upper East Side private school. Across from her, a guy in his twenties was fiddling with a Game Boy, which made her realize how long it had been since she’d done something stupid and childish like played Nintendo. Though she had only just turned 16, she felt old and weirdly nostalgic, which led to her starting to stress about school. It was now junior year—the one everyone tells you means everything—and she still hadn’t made it through her summer reading, The Mill on the Floss, George Eliot’s 560-page novel known for its mastery of nineteenth-century British dialects. Another year of questions, quizzes, worksheets, papers—and already her brain felt like it was overheating. “That’s when I was like, Okay, I need some Adderall,” she told me.
Similar to Ritalin, Adderall is prescribed to treat attention-deficit disorder, and it can be thought of as a parent’s best dream and worst nightmare synthesized into tiny orange and blue pills. “It makes you a little euphoric,” explains Dr. Turecki, “and it truly will help you concentrate on a paper or pull an all-nighter if you have to, which lends it to dependency issues.” It also zaps your appetite, making it especially popular among image-conscious teenage girls. S. first tried Adderall her freshman year—when she was 14—grinding up and snorting a pill “just because,” and found herself using it more last year, both for school and because it was similar to cocaine, a drug introduced to her through a friend’s older sibling. “You swallow Adderall to study, and snort it for fun,” S. explained during one of many long chats we had over the past month. “Whenever I couldn’t get a dealer I snorted Adderall instead. A lot of people use it when they’re trying to quit coke, because Adderall gives you the same rush—well, not the same, but close. The comedown isn’t as intense, either.” (As it happens, the NIDA is sponsoring studies on whether drugs like Adderall could be effective in curbing cocaine addiction.)
S. is a pixie of a girl, so thin and tiny it makes her self-conscious, namely because teachers often ask if she has an eating disorder. (“I don’t! I’m just like this—I want to be fatter!”) Her black hair is always meticulously straightened, her lips coated in gloss, her wardrobe a mix of hipster and prep. A vegetarian who makes a single exception for Gray’s Papaya, she wavers between Jaded New Yorker (bemoaning the meatpacking-district club scene and how “fake” all her private-school friends are) and Archetypical Teen (playing laser tag in Times Square; deconstructing The Family Guy). She can be charming, brash, introspective, shy, mean, sarcastic, and heartbreakingly kind within a single conversation. When I asked where she gets Xanax, which she’s taken “here and there” since she was 14, she looked at me like I was lobotomized and said, “Xanax you steal from your parents. All my friends’ parents are strange and depressed, these housewives who don’t have anything to do with their lives, the classic depressed mothers who have so many pills. I know it’s a stereotype, but it’s true. I feel sorry for them.”
Though she’s also tried codeine, Focalin, and Ambien—as well as the antidepressant Celexa accidentally when a friend thought it was Concerta, another pill S. has sampled—she likes Adderall the most. Last year, she took two 25-milligram pills (twice the standard prescribed dosage) an average of three times a week because “you study literally until your brain can’t absorb anymore.” Not that it doesn’t have unpleasant side effects: Adderall made sleep nearly impossible, which tweaked her moods—and upped the appeal of Xanax. “You’re really happy, and then you get depressed and start thinking about things you don’t want to think about,” she said. “One of my friends snorted Adderall right before an exam, and during the test he started breaking down crying.”
“We got back to my house by 1 A.M. and had the coke jitters, so we snorted a milligram each of Xanaxand passed out. You know,it’s good foranxiety but itreally works to counteractcocaine.”
She decided to make a brief stop before going home, heading to Union Square—she knew that the skater kids dealt Adderall. Walking into the park, she thought about her mother, who a few days before had delivered a familiar lecture—big year … need good grades … better than normal … if you really want Cornell … your future—which had been gnawing at S. ever since. A few minutes later, she was approaching a scrawny, pimply kid wearing baggy black pants, his hat turned sideways.
“What’s up?” S. said.
“What’s up?”
“You got any Adderall?”
It was her use of Adderall, in conjunction with cocaine, that resulted in S.’s expulsion from the all-girls private school she attended last year—despite the fact that her grades had gone from B’s to A’s. She found herself in rehab, which she accepted at first, agreeing that cocaine—and only cocaine—had become a problem. Tessa Kleeman of the Freedom Institute says that she’s seen a dramatic increase in cocaine use among private-school kids over the past year—perhaps partly owing to the fact that kids grow more accustomed to the idea of inhaling a powder first through prescription drugs. “Oh, that’s definitely true,” S. said when I asked about this.
Her rehab experience quickly soured once therapy was introduced. “My mom thought I was really fucked up, so she made me see a therapist,” S. said. “And I hate therapists. They’re sneaky, nosy, and manipulative. I’ve just never really believed in psychiatry.” This is a common outlook among people her age: A recent government-funded study led by Dr. John S. March, a professor of psychiatry at Duke, found that taking Prozac was more effective for teens than traditional therapy—findings that wouldn’t surprise S., considering that after “only my third session” her therapist suggested that she go on Prozac, Zoloft, or “some other ones that I hadn’t heard of.” She refused. It wasn’t that she didn’t think she was depressed—losing her parents’ trust tortured her, and earlier in the year a close friend she had briefly dated had committed suicide. He was a freshman in college, and used to confide in S. about how he was depressed, mainly because he wasn’t doing well in school. “Of course, I didn’t really think about it, because a lot of people are depressed, and everyone always says they don’t want to live anymore,” she said. He called her the night he died—she didn’t feel like talking to him and didn’t answer her phone—leaving her with what she knew was the irrational feeling that “I could’ve somehow prevented it.” At his funeral, she had an anxiety attack: crying, loss of breath, her knees so weak she collapsed. A friend gave her some pills—“I don’t even know what they were; Xanax, I think”—which helped her relax. Yet when, just a few weeks later, the therapist suggested she go on antidepressants, she felt as if people were trying to control her moods. She’d taken prescription drugs for years, she knew what they were all about, and didn’t need a doctor—or, for that matter, any adult—trying to convince her otherwise.
In Union Square, the skater kid pulled out a plastic bag full of pills, both blues (the four-hour tablets, often called “homework pills”) and oranges (time-release capsules), which he had because a doctor had diagnosed him with ADD.
“Score,” S. said. “Can I have 50?”
“That’s 50 bucks.”
“Don’t be a fucking idiot.” S. flashed a sassy grin that she knows has a way of getting boys to cooperate. “I’ll give you—I don’t know—how’s about 20 bucks?”
“Fine,” he said sulkily, and S. put the pills in a little coin purse and headed back home. When she got to her building her doorman gave her a suspicious look, as he often did, which got to her. After all, what did he know? Was he a 16-year-old girl? Could he relate to the pressure? Did his close friend die? Why was everyone always … prying? She had the urge to do something, to somehow hurt him, but what would be the point? So she just smiled a little awkwardly, and went upstairs to start her homework. “I’m a star studier,” she told me that last time we spoke. “I hate school so much, but you should see me. I’m unstoppable!”
There are, of course, health risks to such behavior. Too many uppers and your heart rate can go ballistic, too many downers and it can stop beating; mixing both can put your whole body at war with itself. “You’re basically playing pinball with your brain’s chemistry,” says Dr. Turecki. “You can induce a psychotic state.” But such cases are extreme, and rare, which makes the standard dictum that Drugs Are Bad all the more difficult for kids to take seriously when it comes to pharmaceuticals (especially when their parents’ medicine cabinets are fully stocked with them). Unlike drinking in excess or taking ecstasy, psychotropic drugs don’t annihilate normalcy so much as adjust it: a little Adderall for studying, Xanax to come down off the Adderall, Ambien or Klonopin to get a good night’s sleep—and Zoloft or Prozac or Wellbutrin to stave off the volatile moods that go hand in hand with being an adolescent. “That’s a primary concern of ours,” says Tessa Kleeman. “When you use a substance for something you can do naturally, you’ll ultimately lose the ability to do it naturally. In teens, pill popping can replace maturing emotionally—that person is eliminating human experience from their life.”
J. could’ve told you that. Here we are, a new school year just getting under way, which for J., a senior at a highly competitive public school, may end up meaning business. Last year, she sold (mainly) Adderall and Ritalin. Prices ranged from $3 to $10 a pill, depending on what she calls “the supply-and-demand ratio.” Her business model was both modest and flawless: She got the Adderall from a guy who works in a Rite Aid pharmacy and hooked her up in bulk for the “mad cheap” price of $20 for 100 milligrams; the Ritalin came from a friend who had numerous bottles sitting around “from when his doctor thought he had ADD but his parents weren’t sure.” People like J. have become a common presence in New York high schools: the unwitting dealer, the outgoing kid whose entrepreneurial flair gets her Constant Connection status.
“It’s not like I wanted to be a dealer or anything,” J. told me the other night. “I just got tired of spending money on these things myself. This way I’m good. I get 50 bucks in my pocket, and I can trade up easy. Like, there’s another kid, used to be such a geek, now he sells Xanax and OxyContin—so I give him what he needs to get fucked up, and he does the same for me.” We were walking along the street in Queens, near where she lives, checking out stretchy acid-washed jeans at V.I.M. J. is 17 years old, a sparkplug in female form: funny, blunt, a fast talker, every word punctuated by her tongue ring, which clicks against her teeth with the regular rhythm of a stopwatch.
She barely remembers how she first got into prescription drugs—they were just around, everywhere, not remotely taboo. In freshman year, she started going to punk shows and running with a crew who liked to do lines of Ambien and hydrocodone (generic Vicodin). Pharmaceuticals were so ingrained in her consciousness that for a biology project she decided to interview her peers about their experiences with antidepressants—not because she was particularly fascinated, but because it seemed easy.
To master the art of pharmaceuticals, to possess the knowledge of how to use her brain as a science experiment, J. and her friends often go online or study medical textbooks in the library, looking up drugs and seeing if “the side effects sound appealing.” She’s even invented her own means of ingesting the drugs, which she calls “parachuting”: grinding the pills, placing them in tissue paper, and dropping them down your throat. “That way, you get all the drug’s surface area,” she explained. “Even more than when you snort it.”
Lately, though, her outlook has started to change. Friends have gone into rehab, or gotten “crazy edgy,” and her own mood has developed a habit of swinging unpredictably from one extreme to another. Though she started dealing for the free product, J. soon cared more about making money, and then suddenly swore off dealing. She said she was “more mature about it,” and when I asked her what that meant, she said it was simple: Something wasn’t right with swallowing so many pills to do things that were ostensibly normal. “People are always trying to feel better, you know?” she said. “But they don’t know how to naturally make themselves feel better anymore, how to respect themselves, love themselves. What is that?”
Her adolescent swagger aside, I was struck by what J. was saying, how her attitude was at once flip and philosophical. It was an outlook shared by most everyone I interviewed. J. and her peers are truly the first generation to come of age in an era in which the much-touted products of major pharmaceutical companies have merged with the rebellious spirit of adolescence. And yet the majority of these teenagers expressed serious and well-thought-out reservations about such drugs. Prescriptions are too easily available, they said. Pills are more addictive than anyone realizes. Over and over I was told that if they could choose to, they would not have so many pills in their lives. But of course it’s not entirely up to them. They may mimic the behavior of their parents, but in the end, they’re still children.