Steamboat Springs — The going price for prescription pills in Steamboat Springs is $1 per milligram of painkiller or antidepressant, local physicians say, warning that the abuse of prescription drugs is rising.

Police say the trend is noticeable but not overwhelming in Steamboat. Most visibly, the search for prescription drugs led to the March 16 arrest of a 23-year-old man suspected of burglary at Lyon's Corner Drug, a downtown pharmacy. Police said the man dropped bottles of a prescription painkiller when he was taken into custody. Doctors and police report that drug-seeking behavior, and the addiction that drives it, is becoming an increasing concern in Steamboat.

Steamboat Springs Police Department Capt. Joel Rae said determining the extent of abuse in Steamboat is tricky for several reasons.

The department keeps track of drug arrests by the classification of the substance - Schedule 3 substances include codeine, anabolic steroids, testosterone and some depressants, for example - not by whether the medication is prescribed. It's also harder to detect people who are abusing prescription drugs, Rae said.

"I think we hear a lot more than we see. I know that we have great concern for the youth in our community pertaining to prescription drugs, and it is becoming a drug of choice," he said.

Rae said that there occasionally have been reports of prescription drug abuse in Steamboat schools and that the frequency has been increasing throughout the past several years.

"We hear rumors through the high school and even the middle school at one point last year," he said. "We've had rumors of kids taking drugs and selling them to their friends."

School Resource Officer Josh Carrell, who works in Steamboat Springs High School, said he has learned about prescription drug abuse and how to spot it through training, but he does not regularly find that kind of drug abuse at the high school.

"I did have at least a few cases this year," he said, adding that it was not a continual problem.

"The more common (drugs) are obviously alcohol and marijuana," he said.

Dr. Dawn Obrecht, who specializes in addiction medicine in Steamboat, said she has seen a great deal of abuse across town.

"It's a small resort town, there are a lot of children of the '60s, flower children and their children," she said.

Obrecht said the problem stems from doctors in town who give medications too easily, including those who issue refills without seeing the patients.

"Out of a very small number of doctors, there are a few who prescribe very, very inappropriately," she said. "Every addict in town knows who they are."

Pain management specialist Dr. Brian Siegel said the doctors may not be as diligent as they should, but he does not see the rampant abuse Obrecht described.

"Yeah, there are some physicians who may give the medications easier, but who's to say they're not making adjustments?" he said.

Siegel said he doesn't think there are "bad doctors" in Steamboat who prescribe inappropriately.

"Some (doctors) will just give medication and may not be as diligent on following up on how patients are using it," he said.

Because of prescription drugs' potential for abuse, Obrecht said such medications should be prescribed on a short-term, limited basis. Prescriptions that are most commonly abused, she said, are those that contain benzodiazepine - such as Xanax, Valium and Ativan - and narcotics. Benzodiazepine is a sedating tranquilizer taken to counter disorders including anxiety and insomnia.

Siegel agreed with Obrecht that there is a problem of prescription drug abuse, but he disagreed that the problem in Steamboat is any larger than in other parts of the country.

Doctors often are put in a hard position, he said, because patients often feel entitled to pain medication as a part of their treatment, and doctors are obligated to treat their patients appropriately.

"Patients : have this sense of entitlement for their pain, whether it's a real problem or a perceived problem," he said. "If we don't treat, we can be sued for under-treatment."

On the other side of the problem, Siegel said doctors "frequently get caught up in prescribing medication where it may not be appropriate."

Siegel said doctors face a challenge in prescribing appropriately but that, that should not stop them from prescribing medications. Instead, he said, there are many ways to prescribe medication and monitor its use, including randomized urine analysis from patients to ensure that they are taking the medication instead of selling it and that they are not taking other medications not prescribed.

"We're testing five to 10 patients a week," he said. "Almost every week, I'll get (a test result) that shows something inconsistent."

A place for prescriptions

Dr. Brian Harrington, a Steamboat family physician, agreed with Siegel that the risk of abuse does not outweigh the benefits prescriptions can provide, even to addicts as they come down from highs.

People who are known addicts are at especially high risk of abusing the drugs used to help them come off of illegal drugs.

"There can be a risk of abuse, because if a person is already abusing substances we are just trading one substance for another, but I don't worry about abuse (right then)," Harrington said. "If somebody is going through alcohol withdrawal, we're medically supposed to reduce the risks, which includes giving them some of these drugs."

Harrington said withdrawal can bring delerium tremens, a severe part of withdrawal that can be treated with the benzodiazepines.

Harrington said the most important part of prescriptions is monitoring patients closely, and the important role of medication as a treatment should not be overlooked.

"Ultimately what we'd like to do is to give everybody the tools to cope healthfully with stress and mental health problems in their life and to do that without a dependence on a substance," he said. "I think that if any of us take an absolute position for or against the role of medication in treating these disorders, we're probably doing a disservice from patients out there who could benefit from either stance."

To prevent children or other people from abusing drugs, Rae said, parents should be cautious with prescription drugs that are left over after their treatment no longer is needed.

"The best advice I would give is if you have old medications at home, to flush them down the toilet or throw it away," he said.

Carrell agreed and said that his training taught him that home medicine cabinets are the most likely place students will get access to drugs.

"A lot of people tend to hang onto prescriptions that they didn't take all the way through, just to have them if something else comes up, especially pain relievers," he said. "Make sure you get rid of those."