The purported “War on Drugs” in the United States targets the sellers and buyers of a wide array of illegal and illicit substances including cocaine, marijuana, heroin, and methamphetamine. However, individuals and entities are now distributing and consuming prescription medications for the purpose of recreational use at an alarming rate. Recreational use and abuse of prescription medications, also known as “pill popping”, has become an increasingly common form of intoxication. As art imitates life, Hip Hop artists and other musicians have begun to describe recreational use of prescription medications in their music. Like other widely-used intoxicants, recreationally-used prescription medications have already begun to take a serious toll.
There are three major classes of prescription medication that individuals use recreationally and that often lead to abuse. The first is opiates (opioids). About 75% of cases of prescription medication abuse involve opiates, or painkillers. These painkillers include hydrocodone (i.e. Vicodin), oxycodone (i.e. Oxycontin, Percocet,), and morphine (i.e. Kadian, Avinza). Codeine is another commonly abuse opioid that is often found in prescription-strength cough-syrup http://hiphoppublichealth.org/got-drank. Prescription painkillers taken recreationally are now one of the most commonly used drugs in the world, second only to marijuana. Oftentimes, people become addicted to prescription painkillers when being treated for acute pain following a major injury or surgery or in the treatment of chronic pain (i.e. back pain). However, many people become addicted to them after being introduced to their recreational use by a friend or acquaintance. Opiates affect the body’s sensation of pain by mimicking endorphins and other chemicals produced in the body that naturally counteract the sensation of pain by binding to the opiate receptors and thus blocking pain signals. The binding of opiates to opiate receptors translates into pain relief and feelings of pleasure or euphoria. It is the activation of the reward centers in the brain by opiates that comprise their addictive capacity. Painkiller abuse can lead to constipation, fatigue, and slowed breathing, among other side effects. It can also lead to depression, anxiety, and even psychosis.
A second major class of prescription medications that are commonly used and abused recreationally are CNS (Central Nervous System) depressants. These medications include benzodiazepines like diazepam (Valium) and alprazolam (Xanax) that are prescribed for anxiety, sleep medications such as zolpidem (Ambien) and eszopiclone (Lunesta), and barbituates such as mephobarbital (Meberal) and phenobarbital (Luminal Sodium) that have similar uses as benzodiazepines and sleep medications but are more generally used for seizure disorders and surgeries. These medications increase the production of the neurotransmitter GABA (gammaaminobutyric), which in turn slows brain activity and causes a calming effect on the body. Similar to opiates, the feelings of calm and/or euphoria brought about from CNS depressants may lead to abuse and addiction. Side effects of CNS depressant abuse include headaches, dizziness, impaired judgment and coordination, memory impairment, confusion, and depression, and even seizures, among others.
A third major class of prescription medications that are commonly used and abused recreationally are stimulants, or “uppers”. These medications include dextroamphetamine (i.e. Adderall, Dexedrine) and methylphenidate (i.e. Ritalin, Concerta), which are typically prescribed to treat ADD (Attention Deficit Disorder), ADHD (Attention Deficit- Hyperactive Disorder), and narcolepsy in children and adults. In addition to being used recreationally for long nights of partying (i.e. in lieu of cocaine), these drugs are often used and abused by students and academic professionals to whom they would not otherwise be prescribed for purposes of improving academic performance. These medications mimic dopamine, which is a neurotransmitter that produces a sense of euphoria, and thus have addictive capacity. These stimulants can significantly raise blood pressure and heart rate to dangerous levels when abused. They may also cause hostility and paranoia and increase the risk of seizures and heart failure.
Prescription pills are sometimes taken in pill or capsule form. However, to speed up their effects, individuals that abuse them will often crush them up and swallow, sniff, or liquefy and inject them. By nullifying the medications’ design to be time-released in the body, the resultant high is significantly intensified, thereby increasing the risk of addiction and overdose. Individuals who abuse prescription drugs often use them in combination with alcohol and other illicit drugs, which increases the dangers involved in ingesting them non-medically. Prescription medications, like other illicit drugs, can change the way the brain functions. By unnaturally stimulating the brain’s reward system, prescription drugs make it more difficult for individuals abusing them to feel good without them, thus intensifying cravings and further promoting a cycle of abuse. Abuse and addiction of these drugs is often fatal, and deaths resulting from prescription drug abuse have doubled over the past ten years.
Numerous Hip Hop artists have described using prescription medications recreationally, and often in combination with other illicit drugs. Some artists that have written songs about pill popping include Lil Wayne and Rick Ross (i.e. Pill Poppin’ Animal) as well as Gucci Mane (Pill Poppin’ Problem). The most famous of these artists is Marshall Mathers, better known as Eminem. For example, Eminem released a song with his group D-12 called “Purple Pills”, and his song “I’m Shady” vividly describes his pill popping and other drug-related habits. Since he was thrust into the mainstream with his first major studio LP “Slim Shady”, Eminem has made multiple references to drugs such as Vicodin and Valium in his music. He often linked his recreational use of prescription medications to his mother’s abuse of them while he was a child. In the third verse of the song “Cleanin’ out My Closet”, Eminem says “Put yourself in my position, just try to envision/Witnessing your mama poppin’ prescription pills in the kitchen”. Also, in the chorus of his song “My Mom”, Eminem says “My mom loves Valium and lots of drugs/That’s why I’m on what I’m on ‘cause I’m my mom.” Eminem’s musical testimony is very much in line with the fact that the majority of teenagers that begin abusing prescription drugs first get them from the medicine cabinets of family members. Also, the propensity to drug addiction often runs in families.
Eminem became caught up in a downward spiral of addiction to prescription medications following the murder of his best friend Proof of D-12. At the height of his addiction, Eminem was sometimes popping 20 pills per day. It eventually began to take a toll on his craft, causing him to feel jealousy for other successful Hip Hop artists including Kanye West and Lil Wayne. In 2007, Eminem accidentally overdosed on methadone (which he unknowingly took in lieu of Vicodin, his painkiller of choice at the time) and came very close to death. After successfully detoxing, Eminem experienced a knee injury requiring surgery and consequently relapsed on Vicodin. At that point, he fully accepted his identify as an addict, and began the slow process to recovery. The names of Eminem’s recent albums have coincided with the various phases of his addiction (i.e. “Relapse” and “Recovery”.) “Relapse” is the first album that Eminem recorded sober in the past seven years of his music career. Eminem told Vibe Magazine: “I almost feel like a little kid again with rap. Rap was my drug. It used to get me high and then it stopped getting me high. Then I had to resort to other things to make me feel that. Now rap’s getting me high again.” He now receives visits from an addiction counselor as well as support from superstar musical artist and legend Elton John, who is also a recovering addict.
Clifford Harris Jr., better known as T.I., also recently began recovering from an addiction to prescription pain medication. T.I. first began taking Oxycontin and Vicodin that he was prescribed following intensive oral surgery he underwent after his release from prison in 2010. However, once he completely healed from the surgery and no longer felt pain, he continued to take the medications for recreational purposes. He used the pills to replace marijuana and alcohol, which we was not allowed to use due to the confines of his probation. The legality of the pills was appealing in the wake of his multiple run-ins with the law. Once he was forced to come to grips with his developing addiction, T.I. began one-on-one therapy sessions to cope. He largely credits Eminem for giving him support and thus helping him overcome his addiction. In an interview with Vibe Magazine, T.I. revealed that when he asked Eminem how he knew he was an addict, he replied: “If you put yourself in harm’s way…you’ve got to assume that there is something fundamentally wrong with your thought process.”
Indeed, addictions to prescription medications are among the most difficult addictions to treat. The fact that prescription medication abuse and addiction has taken a toll on the Hip Hop community is a mere glimpse into the magnitude of the problem, particular among youth. According to the National Institute on Drugs Abuse of the NIH, in 2011, over 7% of young people between the ages of 12 and 17 used prescription drugs recreationally. Among high-school seniors, the percentage was higher: 15.2%. The most commonly abused prescription drugs among adolescents are Vicodin and Adderall, which are second only to marijuana in this age group. Of those adolescents that become addicted to prescription drugs, only a small percentage of them receive treatment. Because of the focus of many anti-drug campaigns targeting adolescents on alcohol and illicit drugs, young people often incorrectly assume that prescription drugs are less dangerous. Therefore, young people are significantly less likely to seek and receive treatment for prescription medication addiction than adults as they do not as readily perceive its necessity. Their young developing brains are also most susceptible to the devastating side effects of prescription drugs.
The Hip Hop Public Health team, through programs such as Hip Hop Stroke and Old SCHOOL Hip Hop, highlights the benefits of prescription drugs that may be taken by adults to treat high blood pressure, high cholesterol, and diabetes in the prevention of stroke, as well as Alzheimer’s disease. However, our team fervently and methodically educates the children who participate in our programs about the dangers of the non-medical use of drugs of all types. It is imperative that effective anti-drug campaigns such as “Above The Influence” are tailored to combat prescription drug abuse among youth, and that the dangers and ease of development of prescription drug abuse and addiction is effectively communicated to adults with the help of health care and public health professionals. Hip Hop artists must also be more responsible with the ideas put forth in their music, as they may be exposing their listeners to ideas and consequent injurious behaviors, such as pill popping, to which they may not otherwise be exposed. Sometimes it’s ok to party and play, but stoppin’ the poppin’ is the rule of the day.
– By Monique Hedmann