“Lock everything up,” is the advice of Linda Auerback, substance abuse prevention coordinator for the Carroll County Prevention Office.

Written By David Greisman

Mark Liupaeter, a 19-year-old from Eldersburg, had changes in his eating habits. His nose ran. He would sleep on the sofa from the middle of the day into the next morning.

“We attributed that to being a teenager,” said Mark’s stepmother, Michelle Mazan. “You tend to be more forgiving because you’re thinking that it’s typical behavior, but it’s behavior that you have to really closely monitor.”

Mark died in May, 2010 from an accidental overdose of a mixture of cocaine and oxycontin.

His parents do not know where their son obtained the narcotics, but teens no longer need dealers in order to abuse drugs.

These days, they are just as likely to raid medicine cabinets for prescription pills, or even over-the counter drugs; and they may get them from friends or family members.

They can find synthetic marijuana, which has been sprayed with various chemicals, available for sale on the Internet or in head shops.

And they can go to local convenience stores and gas stations to find one of the latest drug trends: “bath salts,” which are not actually bath salts, but chemicals that have effects similar to amphetamine and cocaine marketed as other products. They can also be ordered online.

In the past decade, the number of people in the United States being treated whose drug of choice is a prescription drug has increased a staggering 1,800 percent, according to Susan M. Doyle, director of addiction services for the Carroll County Health Department.

“That doesn’t mean they’re getting it legally,” she said.

In Carroll County, the big change Doyle said she has seen in recent years has been an increase in the number of people using prescriptions as their drug of choice. That includes younger drug users who raid their parents’, grandparents’ and neighbors’ medicine cabinets.

“Lock everything up,” said Linda Auerback, substance abuse prevention coordinator for the Carroll County Prevention Office. “Even over-the-counter drugs. They’re abusing cold medicine. Keep it under lock and key, just like you would a loaded gun.”More people are turning to pharmaceutical drugs because they are available. And then, once someone is addicted, those medicines can act as a gateway to street drugs, Auerback said.

The difference between drug abuse and drug addiction, she said, is that abusers can stop and seek help.

“When you reach the point of addiction,” said Auerback, “you’ve built up a tolerance. You can’t stop. You’re physically and mentally craving it. As addicts describe it, it’s like the way your body craves water.”

Drug abuse isn’t necessarily more prevalent in urban settings than in suburban and rural areas. Doyle recalls what she describes as a “crisis” in the 1990s, when youth were addicted to heroin and other drugs.

“We had erroneously believed that by living in a rural area we would prevent our children from experimenting with dangerous substances,” she said. “Our close proximity to a large metropolitan area, Baltimore city, allowed for easy access to the lifestyle we were trying to prevent.”

Although prescription drugs, synthetic marijuana, and “bath salts” are easily accessible no matter what their proximity to a major city, those substances have not necessarily supplanted street drugs. Rather, they can lead to street drugs, in the same way as those using the prescription painkiller oxycodone transition to heroin, both of which are opiates.

“Once they get hooked, they find out how expensive prescription drugs like oxycodone are to buy on the street,” said Doyle.

Heroin use makes up a little less than half the caseload at the County Health Department’s addiction services, with prescription drugs following right behind that, according to Doyle. The most common drug for the department’s case load is alcohol, which she said could be related to referrals for those arrested for driving under the influence or being impaired.

Carroll County ranked fourth in the state in 2008 for high school suspensions for alcohol abuse, Auerback said. And the county ranks third in the state, behind Baltimore city and Harford County, for people being admitted to treatment for heroin use as their primary problem, according to Doyle.

Although heroin has been around for some time, the number of people in the U.S. overdosing on so-called bath salts has skyrocketed.

“Bath salts” are labeled as “not safe for human consumption” and have been marketed as insect repellant and plant fertilizer, but they are a drug that is largely snorted. It can also be swallowed, smoked or injected, according to Doyle and the American Association of Poison Control Centers.

In 2010, poison control centers in this country received 302 calls about “bath salts.” Less than five months into 2011, they had already received 2,237 calls, according to the Northern Virginia-based organization.

In June, the Maryland Department of Mental Health and Hygiene announced that it would be investigating the active ingredients in “bath salts,” which could lead to their addition to the state’s list of controlled dangerous substances. That, in turn, “would effectively ban their sale in Maryland,” said a department news release.

The county has take-back programs for prescription drugs, with police departments in Westminster, Taneytown and Sykesville, as well as the County Sheriff’s satellite office in Greenmount acting as collection sites for unused and expired medication

Moreover, the county has numerous options for those who are on drugs.

“All over the county there are Alcoholics Anonymous and Narcotics Anonymous meetings,” said Auerback. “Of course, if a parent suspects anything, he or she should immediately call a counselor at school, the county Youth Services Bureau, and the Health Department if the child is over 18. And they can always call their insurance agency. [to find out if their policy covers treatment].” Parents should not wait for the proverbial smoking gun, she said.

Michelle Mazan wants parents to be aware of the danger, to save them from the tragedy that her family has experienced.

“I don’t think a lot of times parents really connect with their kids to see the signs of drug use,” she said. “We’re children of the Ô70s. We grew up with all kinds of drugs in our environment. We thought we were pretty much cognizant with what it looked like. We totally missed it.”

“Parents need to use their own instincts,” said Auerback. “The signs and symptoms. Don’t rely on a drug test. We’ve had parents catch their children smoking pot, then the kids pass the drug test. The test is just a tool. Really, rely on what you’re seeing, what you’re finding.”