Joseph Choflet doesn't have to look hard among his classmates at the University of Pittsburgh to spot what some health experts are calling a growing campus threat.

	Online Graphic See a chart that shows how prescriptions drugs are used and abused.

Prescription drugs are being passed among students who want to cram for exams, escape daily pressures or "just like getting messed up," he said. It's called "pharming," and those engaging in it are a small but increasing minority at colleges big and small, urban and rural.

The practice is looked upon by some undergraduates as harmless, downing a few painkillers such as Vicodin and Percocet in a dorm room on a Friday night, or girding for marathon study sessions by swallowing stimulants such as Adderall, normally prescribed for attention deficit disorders.

"It's really no big deal," said Choflet, 18, a freshman who says he does not take them himself.

"Percocet or Vicodin. That's what I see the most of," he said. "They sometimes take [Percocet] just at midday if they are flustered by a whole bunch of stuff. They'll just take it to completely mellow out and forget about everything.

"They take three or four, or they'll take a lesser dose, like two, and drink with it, which probably isn't a good idea," he said. "I've seen it both on and off campus. People look at pills as not being too bad."

Nationwide, illicit selling and sharing of prescription medications is gaining a whole new level of acceptance, government experts and drug treatment workers warn. It is worrisome, they say, given the addictive nature of some of those drugs and potentially lethal side effects when misused, especially if mixed with alcohol or other drugs.

The college-age population has been especially influenced by a phenomenon that crosses most age groups. With Americans demanding more prescription medication and doctors and others more willing to oblige, misuse of those substances is rising, too.

About 6.3 million Americans use prescription drugs non-medically, a number lagging behind only marijuana, according to government estimates. Emergency room visits related to prescription painkillers rose by 153 percent between 1995 and 2002, according to the Federal Drug Abuse Warning Network

Among young adults, 18 to 25 years old, the rise in misuse is outpacing the population as a whole, according to fall data from the National Survey on Drug Use and Health. The share in that age group saying they use prescription painkillers non-medically rose by 15 percent in 2003 from the previous year, compared with no increase for the general population.

"In just one year, it went up 15 percent for young people," said Leah Young, a spokeswoman with the U.S. Department of Health and Human Services' substance abuse and mental health services administration. "I find that disturbing."

Alcohol remains a far wider campus problem, say school health officials, and spotty data has done little to settle a debate about the prescription problem's scope. But area drug rehab centers treating college-age patients who learned how to enhance the potency of time-release painkillers such as OxyContin say the phenomenon is alarming.

"They chew it. They snort it. They are using it like a street drug," said Sharen Lape, a chemical dependency therapist at Greenbriar Treatment Center who said most heroin addicts she sees in her Brentwood office started out abusing prescription drugs.

Greenbriar says its cases involving narcotic painkillers and heroin have tripled in three years to 841. They accounted for 36 percent of admissions last year, compared with 13 percent in 2002.

'Attracted to that feeling'

Ryan Cope, 26, who never made it to college, knows well the journey from pills to heroin, a street fix that can be less expensive. At age 14, the Charleroi native, who spent part of his childhood in Oklahoma, tried a narcotic painkiller, Lorcet 10, at a friend's home after school on a lark. He remembers feeling a false sense of well-being, "a type of euphoria where you could just be sitting alone by yourself and having a good time.

"I became attracted to that feeling," he said.

Gradually, over six to eight months, he developed a full-blown addiction and eventually a $350-$400 a day heroin habit. Cope said he supported it by shoplifting, which landed him in jail several times. "I was dead inside," he said.

He got clean shortly after turning 21, and, as a Greenbriar employee, works with substance abusers and their families who seek treatment. Cope sees parallels between himself and the young faces he now sees.

"They all started out saying they were never going to get there," he said. "It starts out innocently with popping one pill. It continues innocently until they're trapped, and they have no idea how they got there."

Experts say the trend isn't surprising, given the supply of meds available nowadays.

Doctors once criticized for being reluctant to prescribe pain medication are now more likely to dispense it. And drugs such as Adderall and Ritalin are treating once-obscure but now frequently diagnosed conditions such as attention deficit hyperactivity disorder (ADHD).

Direct marketing by pharmaceutical companies has added pressure to medicate. And a gaggle of Internet sites tempt home and office computer users with deep retail discounts and convenience. "No prescription required," one advertisement for painkillers said.

On campuses, more students arrive from home with bottles of tablets legally dispensed to treat everything from back pain to bipolar disorder, and some of those pills are ending up in the wrong hands.

Even pain tablets for wisdom teeth extraction are helping fuel a campus black market where pills go as cheaply as $5. Others are doled out free from roommate to roommate, or friend to friend.

"They can always get a prescription refilled, so it's no real big deal for them," said Choflet, an engineering major from Freedom, Beaver County.

A hidden problem?

At Carnegie Mellon University, sophomore Sandip Sengupta, 20, of Boston, said classmates who take stimulants such as Adderall around finals week might not fare any better on exams. But they feel more focused and thus assume they have an edge.

"They feel they can do everything in one night, instead of studying over a period of a couple days," Sengupta said. He shuns the practice as unnatural, but added, "If you wanted to find some, you could."

Pitt freshman Jennifer Winans, 18, was surprised at dinner recently when a friend offered $15 to share her bottle of Depakote, a prescription she takes for depression and mood swings.

"I told him that it was unsafe, that I didn't want to be responsible," she said.

Still, campuses say, they are not seeing overdoses. Though a University of Michigan-led study found 7 percent of college students nationally had abused stimulants during their lives and another put the rate among males at one school, the University of Wisconsin at Eau Claire, at 17 percent, others believe the rate is far lower and problems rare.

"Most of the kids that I see in that age group are not in school," said Dr. Oscar Bukstein, an associate professor of psychiatry at Western Psychiatric Institute and Clinic.

At Pitt, the region's largest campus, pain pills are dispensed in quantities no greater than 10 to avoid misuse, said Dr. Pamela Talley, senior physician with the student health service. Attention deficit medications are prescribed only if a school psychiatrist has verified the student's diagnosis.

Clinic-goers are asked about prescription drug use, and the answers do not suggest a problem, said Marcee Radakovich, director of student health service. But it's impossible to know what's in someone's medicine cabinet, and patients aren't always truthful.

"It's sort of a hidden problem," Talley said.

A Penn State University physician put it bluntly: "Usually, students do not knock on our door and say, 'Could you help me? I've taken too many drugs that I'm not supposed to be taking,' " said Dr. Margaret Spear, director of Penn State's university health services.

"I don't think we're seeing them," she said. "That doesn't mean there isn't a problem."

But treatment workers say the trend is there, even if it isn't visible.

"With binge drinking, you see deaths. Once or twice a year, there is an accident. With OxyContin and other prescription mediations, maybe somebody's chronically underachieving or they're dope sick, but they're not out there driving drunk or getting into brawls," said Ken Montrose, an administrator and certified addictions counselor with Greenbriar.

"They drop out of school" and show up weeks later for rehab, he said.

"Their friends," he added, "don't see that."

It's partly why prescription misuse carries less stigma on campus. But what starts out as a benign act can become all consuming fast, said Dr. Neil Capretto, medical director for Gateway Rehabilitation Center, which also works with substance abusers.

"You may get a Vicodin or a Percocet for five bucks," he said. "But if you become addicted and need 15 to 20 tablets a day, then that's very expensive."

Stimulants have their own dangers if misused. They're "like a super cup of coffee" and can elevate energy levels for several days if regularly used "but at some point the body crashes," Capretto said.

"They become depressed. Some of the most suicidal people I've seen are coming off stimulants," he said.

Yet most who are experimenting are not looking that far ahead, Capretto said. "The problem with this whole age is they believe they're invincible."