Patients today see all the paraphernalia at the clinic as elaborate menus for synthetic heroin, chill pills and renamed Quaaludes. And with ads that have phrases like “ask your doctor what’s right for you,” there can be no doubt we live in a society where you decide how high you’re going to get and when.

   The fact that the shittiest actors (Judy, Liza, The King) become the biggest pill-poppers shows how easy it is for Americans to break the law and abuse drugs (something this magazine would never condone - ever). All they need is the right sob story and a health plan. Considering that clinics make their profit based on how many people they can shuffle through in one hour, Americans don’t need to go into much detail.

NO PAIN, NO GAIN (Faking Doctors)

   To get a groovy prescription, Joe Schmoe needs a groovy doctor. Outside the city centers your average American finds small clinics that are unaffiliated with hospitals and subsequently hurting for patients. Most likely the clinic has foreign-trained doctors that will go out of their way to keep patients coming back and will not have a problem prescribing narcotics.

   A no-lose way to score a prescription, however, is to visit a pharmacologist. These pill administrators will often give people a month supply of Benzos within two minutes of arriving at “their session,” with a note attached reminding them of their follow-up (mo’ patients/hr = mo’ money/hr).

   The prescription is commonly then padded out and shopped around, until a needy pharmacy cashes it in. The classic thing done with a prescription for 10 Percocets or whatever is to add on a zero and change it to 100. That’s called “perc-ing right along.” Again, the only people that are going to go along with this are a bit out of the city and in need of regular customers. Plus in some cities, prescriptions are in triplicate, forcing Americans on day trips to places where pharmacists can’t check records with the clinic/doctor before filling up a pillowcase. Of course, any Narcotics Anonymous meeting will prove this is just greasy kids’ stuff.

CRUSH GROOVE

   “If they snort something they get, like, 55% of it. Smoke it they get 65%. Shoot it they get 85% … but they have someone blow it up their ass, that’s an easy 95%. Right now, I’m working on a device to blow drugs up my own ass.”

   —Nick, a prescription drug dealer.

   When getting their prescription, most Yankees ask for it in capsule form, as taking a pill orally is the least effective way for drugs to hit their system.

   Until Nick refines his method, kids will keep working the old stand-by. First, they take a McDonald’s straw (they’re oversized and exceptionally rigid) and, spreading their ass cheeks wide, they have someone slowly drive this well-lubed puppy about a couple inches in. Then they scoop a hit into a normal sized straw and slide that baby inside.

   Most of this shit burns so these poor kids are doing coke first to numb their asses. Then who knows what kind of perverted sex acts they’re getting into.

   Here’s what 68% of Americans are doing.

AMPHETAMINES

   Speed pills are terrible for you. They don’t make them much anymore because all those diet pill users brought speed manufacturers a ton of lawsuits. Ephedrine (one of the few left) and over-the-counter stuff is so ineffective, that users keep popping them until they lose track. This can really get them into trouble. What makes pharmaceutical-grade speed pills different is that they fucking last forever – the hang time is insane. This also makes them easy to detect weeks after, in a drug test.

Ritalin (Methylphenidate)

   Before prescribing meth to four million brats became a gazillion dollar industry, ADD/ADHD was medically referred to as “mild brain damage.” Thanks to these little fuckers though, your Mom and Dad got the best speed since fat people ruined dexies for everyone. Kids with ADD are given speed to throw them into overdrive, thus burning them out. Now everyone is giving it a try.

   Taken orally, Ritalin hits in about a half hour, peaks at two hours and is gone in four but nobody has time for that so they crush it. Because it wears off quickly, many doctors are into giving out Concerta, a long-lasting/higher mg version of Ritalin with a time-release coating that vanish when crushed.

   All they need to say: “I have a problem paying attention, and specifically with focusing on learning my lines which, as an actor, is detrimental.”

Adderall (Dextroamphetamine and Amphetamine)

   Like Voltron, four amphetamines combine together in this mighty pill. It’s known as “add-er-all-up,” because Dexie and everyone in her drug family comes over to fuck your system at once. It’s intense. Being wired on Adderall, users can get, like, 3 days of work done in an hour whilst also figuring out the 4 000th digit of pi.

   The pill hits hard enough that they don’t need to snort it. After popping it, the next eight hours are in focused energy. If they get all worried about this electricity coursing through their system, most Americans chill out by remembering it’s intended for six-year-olds. They have to keep in mind, however, with amphetamines you are totally out there, which wears out the mind.

   A day passes and they start seeing something out of the corner of their eye. Two days go by and they’re full- on hallucinating. ER doctors can’t tell the difference between amphetamine users and schizophrenia.

   All they need to say: Simple. “Ritalin/Concerta isn’t working for me.” This is the next notch up.

BENZODIAZAPINES

“One that won’t make me nervous

Wondering what to do

One that makes me feel like I feel when I’m with you

When I’m alone with you, baby”

—Huey Lewis

   These are happy pill tranquilizers. They cut through anxiety to make people all groovy and relaxed. This sorta gives them that post-orgasm sense of everything being allllll-right. Additionally, nothing can phase them or make them too upset because they are totally at ease and open. Benzos are also said to be fantastic for coming down off a coke bender or any other gear-grinding activity that would normally keep them up all night.

Valium vs. Xanax (Benzodiazapine)

   Valium and Xanax are two opposite ends of the same drug, differentiated by how gradually they chill you out. With Valium, your aunt and uncle get it all right away in one big hit. The problem is, Valium doesn’t last too long and just when they’re getting into it, the buzz fades away. This is why people end up popping this again and again and that’s just plain bad. Conversely, Xanax has a really long duration and doesn’t hit them as hard as Valium. Right between the above bookends is Serax. It hits pretty hard and lasts about four hours. Physicians are less cautious to write it up than Valium or Xanax because it’s rather low profile. Granted it takes a little while to kick in but with pills there’s a placebo effect so Uncle Ian is already kind of rocking when the high arrives.

   All they need to say: “I’m going through a very difficult breakup and, in addition to canceling the wedding my novel’s getting harshly edited and it’s all building up to the point where my work is suffering. I just need to get through this phase and my mother said Senax worked really well for her.”

Klonapin (Benzodiazapine)

   This is the pharmacologist’s drug of choice and it’s pretty much the same as Valium, so if your Mum’s friend Fran can’t pull off the above routine she’ll probably end up with this. Klonopin is also great because she can get 150 of them generic for five bucks on her insurance. Most pharmacologists would rather you take a daily dose rather than as needed so Fran can expect a jackpot of low mg pills. Klonapin scores high marks with the ladies for being so easy to sink in the hole.

   All they need to say: It’s more specific to panic attacks. “Sometimes I’m on the subway and get these tremors which uncontrollably trigger these gigantic, deep breaths to the point I nearly black out. Shit, I even totally went blind from the panic, even though my eyes were wide open.” Whoa.

Ambien (Non-Benzodiazapine but it still goes here because it’s made to act like one)

   Frank Pard, a 34-year-old straight bartender says of Ambien, “Sometimes, I just want to get down on my knees and roll my tongue endlessly around the fleshy anus of the scientist that invented this winner.” It’s that popular. Ambien is a sleeping pill that acts like a Benzo, with a little extra wizardry sprinkled on top. Most drugs have a trail-off that leaves residual feelings later on. This one doesn’t. The next day the user gets up free and clear, like nothing happened.

   On top of that nice comes the spice, in that people can also trip on Ambien by fighting off the urge to sleep. Most people that take Ambien indulge in the crazy dreams but if they snort a couple of the 10 mg pills and decide to stay awake it’s a hallucinogenic experience. Flipping Ambien with caffeine is, to quote Charlton Heston, “A madhouse! A MADHOUSE!”

   All they need to say: This is prescribed for short-term use. “I’m self-employed, needing a proper, regimented sleeping cycle that is being screwed up by my roommates having guests over for the week. I’ve tried this before and it worked well.”

NARCOTICS (aka The Good Shit)

   Most doctors are extremely reluctant to give narcotics out and that’s why they usually underdiagnose pain. The first thing they will give your neighbor is Tylenol 3, which is way more Tylenol than codeine. Pain is subjective, however, so it’s really up to her.

   Narcotics are evil as shit, because basically they’re all synthetic heroin and the stronger up the list they go, the better it feels. Percocet is like the entry level into the serious narcotics and from then on, we’re talking about a warm energy inside them that feels better than an orgasm. That entire bad junkie shit follows suit. For example, it’s near impossible to stop taking Oxycontin and many people are just switching to H because it’s cheaper and easier to obtain. The girl next door can avoid the Tylenol 3 trap by saying that she’s allergic to codeine. If the doctor says “allergic?” then she says, “Yeah I start getting hoarse and have trouble breathing. My throat swells up.” That’s guaranteed Percocet. The fear of malpractice gets the old pen out more than the fear of losing his license. All the latter means is waiting a few weeks while he petitions to get it back.

Percocet (Oxycodone)

   If your average American citizen is in a shitty mood, has a hangover, doesn’t feel like going out, or feels like going to bed; they take a Percocet and everything’s on. With Percocet it’s 3-4 hours of a soft fuzzy feeling, the kind you feel through your fingertips. Pop a Perc and have a beer and that’s it, they’ve got sweetness all evening.

   All they need to say: Back pain, accident, intractable tooth pain, anything. Ideally something short-term and simple like they missed a step and fell, temporarily aggravating an old sports injury that has them in pain sitting down at the job.

Vicoden (Oxycodone)

   Junkies getting off heroin like Vike because it’s the same thing. Vicoden is a serious-deal painkiller that is the next, stronger step up from Percs. Hence to score Vike, they have to be fronting that they are in some serious pain. The king of all serious pains being: a tailbone injury. The thing with a broken tailbone is there’s nothing you can do. They won’t even bother with an x-ray because the diagnosis won’t change. When Dr. Prescribeaway flips out the pad, junkies and anyone else that wants to write good songs fake the pain really hard until the Vicodin arrives.

   All they need to say: It doesn’t matter if the tailbone is broken or not, because there is no cast for your ass. Friends carrying them in helps, as does moaning.

Oxycontin (Oxycodone)

   Percocet has 4 to 5 mg of oxycodone, whereas Oxycontin starts at 10 and goes to 160. On average, one pill of Oxycontin is equivalent to 16 Percocets. Hence, Oxy has a time-release coating that gradually releases the drug over time. Of course, as the New York Times Magazine pointed out, people have figured out crushing it kills the time release and makes the pill just like smack. Like with Ritalin.

   Doctors get away with overprescribing Oxy to dealers because it pays well and, what’s the worst that can happen? They have to petition to get their license back? If they can’t get a prescription Americans don’t worry about it. There are so many pharmacies that are getting ripped off that it’s now on the street for a buck a mg.

   All they need to say: Oxycontin is getting prescribed huge for this weird, very iffy 20th-century disease called Fibromyalgia. Basically, it’s a lot like chronic fatigue syndrome and often comes with the same ambiguous causes and symptoms. The condition means consistent pain around their pressure points that has them immobilized to the point where they can’t get out of bed. People who take Fibromyalgia seriously think it stems from diet – whatever. VICE knows this “illness” was invented by housewives and computer programmers out to cop better painkillers. The doctor has no lab test or exam to prove or refute their story so they’ll often just follow the trend.

Fentanyl (synthetic codeine)

   Perocet is oxycodone and the long-acting version is Oxycontin. People think it’s the holy grail of pharmaceuticals,and it is in a way, being the most available. But the real Holy Grail is a Fentanyl patch. Your old high school principal slaps that on and he is golden in a 2001 Star Baby way. It is 36 hours of a low-level, absolutely blissful existence that is life made painless. Nothing else can touch this.

   Corrupt radiologists and anesthesiologists all over the country are dropping like flies because they don’t realize one drop of Fentanyl is worth, like, a couple vials of anything else. That’s why they get a patch. But even cut into a third, a patch will fuck you to the point of puking. “Puking out of the biggest shit-eating grin the world has ever seen,” insists an anonymous source.

   All they need to say: “I want to volunteer to work around cancer patients.”

Other pills everyone pops...

Flexeril

   Soma was the classic muscle relaxer but we’ve moved on since those days and now the real deal is Flexeril.

   People tend to accumulate stress in their muscles and Flexeril just melts them away, like a warm bubble bath. It has a mild addictive quality to it, but anything this good is going to be mildy addictive. Tracy, a fact-checker and researcher for a New York film company told us, “On two Flexerils, I remember crawling up to the edge of my futon, looking down like half a foot and thinking, ‘I can’t make it – it’s too much of a leap.’ So I just sat there all day. It was fantastic.”

   All they need to say: “A sports injury to my back gets really bad when I’m stressed out, to the point I just lay awake in bed, unable to sleep.”

Quaaludes

   This shit turns everyone you knew at college into trashed hookers. Dude, I’m serious. Americans do so much of it they end up rolling on the floor of some kid’s loft, laughing their asses off because no one has the ability to change the channel. In order to stay semi-human they mix it with coke. This cuts through it a bit and allows them to walk around without bumping into walls. They lose all their motor skills to the point they can’t feed themselves unless they coke up. The fact that no doctor will hook-it-up doesn’t seem to be slowing things down. The pharmaceutical companies just unload this shit off to places like Russia for a profit. So it’s available on the street and looks like a big sweet tart with a perforation down the center and can cost about $25.

   Of course, there are much more popular downers out there. If your college buddies really want no coordination, Dilaudid (Hydromorphone) is a motherfucker. If they do enough Dilaudid they get the exact same effect but stronger. With Quaaludes they’re just a bit out of their mind, but without that fuzzy warm feeling, or that total-sense-of-loving feeling they get with the other stuff. Quaaludes just make them sloppy.

   Failing the above, they will also get some Secanol, the old-school barbituate from back in the ‘70s. These little red capsules look like candy and act like horse tranquilizers. Again, no motor skills but this time there’s a higher chance of passing out.

   All they need to say: If they got to a doctor and say “I have this pain, I want Dilaudid,” he’ll be like, “yeah right.” Instead they say, “I wouldn’t mind Tylenol 3 but I really have a hard time breathing when I take that.” His mind will automatically go to Percocet. Then they try the Percocet and they go back to the doctor and say “It just doesn’t cut it, is there anything else?”

Thomy Remoulade

   Thomy comes in an ointment tube and is hard to find. It’s also very addictive and probably isn’t that good for you.

   All they need to say: German delis import it, so they go there.

Viagra

   There is a full-on conspiracy to convince people that this pill doesn’t work on girls. For real, half a hit of Viagra and their clitoris is poking out like ET’s trying to phone home. Plus, like Thomy it doesn’t react with too much and is just that little extra something on top that Americans adore.

   A prescription’s not necessary. They can’t do it too much or they’ll get depressed over how weak their sex-style is normally. To save money most get the free samples every time they’re out shopping for the other shit. Doctors are the puppets of the pharmaceutical companies, so people consider it Trick or Treat.

   NOTE: Since AIDS kinda backfired, the government’s been having a hard time reigning in the homos. Hence, Viagra is engineered to be fatal when taken with amyl/butyl nitrate poppers.

   All they need to say: “My depression stems from the fact I can’t sustain a decent erection, which in turn fuels my depression which makes it hard for me to get an erection.”

   From sea to shining sea. The people of the land of the free know what’s going on. They are getting pill-trading groups together to cut down the visits and pump up the stockpile. They are laughing their heads off for no reason. They are arguing with dogs and, most importantly, they are completely fucking high.

JESSICA KINFINBOOGLER

Disclaimer: This article is intended as an exposé on the shocking complacency surrounding the ease with which an indeterminable number of people habitually abuse healthcare systems. It should not be seen as a guide to getting prescription drugs. VICE Magazine and the writer believe drug abuse hurts everyone, especially those who genuinely need it, and do not condone any of these highly illegal scams.