“It was euphoric. It was as if my soul touched the heavens.”

That was the description Otto Muller gave in his recollection of his first time trying oxycodone, a highly addictive opioid. 

In 2019, 17-year-old Muller was in a car crash while driving from his college in California to his home in Oregon. It was the Wednesday before Thanksgiving, and the sky was black. He was a few hours away from his mother’s house. 

He had been partying until the break of dawn nearly every day in the week prior. After driving for about six hours, he dozed off at the wheel. When he woke back up, he found himself in a ditch on the side of the road.

“I must have swerved. My car had flipped. I don’t remember much, but I recall my arms were twisted,” Muller said. “That ditch must have been 15 feet down.”

He sat there for an hour before he was seen. When Muller got to the hospital, he had a multitude of common car crash injuries in his upper body, including muscle tears and broken bones. The hospital had given him acetaminophen with codeine to ease the pain, commonly known as Tylenol III.

After being discharged from the hospital, he was given a small prescription for his recovery.

“I had about a week’s worth of the medication,” Muller said. 

After getting home from the hospital, Muller found that he was hooked. Psychologically and physically, Muller was addicted. He yearned for more, but he knew he would be refused. At least, that is if he obtained it through official and legal standards.

Drug addiction in youth has been on the rise in recent years. According to the National Center for Drug Abuse Statistics (NCDAS), a 61% increase in drug usage amongst eighth-grade students was recorded from 2016 to 2020. This can be further seen in the stark and drastic increase in overdose deaths among 15 to 24-year-olds.

“I knew a guy who was probably the most connected person I’ve ever met. I texted him, and when I got back to college, he hooked me up,” Muller said. 

Muller’s addiction spiraled from there. His connection had gotten him oxycodone, a powerful opioid. He then found a regular dealer and fell into a depressive state. 

Muller is not alone in his addiction. According to SAMHSA, nearly 50 million Americans suffer from addiction. But how each person deals with their addiction is different. As for how people get started, there are common patterns.

According to the Mayo Clinic, common patterns can include familial history, mental health, peer pressure, early use, and taking highly addictive drugs.

For Muller, the highly addictive drugs he was attached to were furthered by his familial history and past depressive states.

“I was falling in and out of deep depressions before, during, etcetera. I have never struggled. Perhaps the oxy and codeine brought me some semblance of relief and joy that I had never seen before,” Muller said.

For others, like Jeffery Tanguay, peer pressure was a factor.

“It was just something where all my friends and I were hanging out, and they’re all smoking or chewing tobacco. I’m like, I might as well join them,” Tanguay said.

Tanguay, who teaches Ethnic Studies and World History at Carlmont, started smoking cigarettes when he was 13.

“Back then, the smoking age was only 18. So it was a lot easier to find someone to buy up for me,” Tanguay said.

Tanguay and Muller’s teenage struggles are not uncommon within the American public. According to the CDC, 15% of under-20-year-olds have reported experimenting with illicit drugs such as cocaine, inhalants, heroin, methamphetamines, hallucinogens, and ecstasy. 14% of teens have also reported abusing prescription opioids currently or in the past.

Addiction as a teenager and young adult can fester in a multitude of ways, but the social environments one finds oneself in are one of the most significant factors. 

While peer pressure is a leading cause of addiction and substance use during the teenage years, that still translates over into one’s young adult life. According to the National Library of Medicine, those associated with groups who engaged in negative peer pressure were more likely to experience binge drinking, lifetime alcohol use, and lifetime marijuana use when compared to those with no peer pressure group. A group that influenced an individual positively was even less likely than one with no pressure to experience any of these lifelong symptoms.

According to the National Institute of Drug Abuse (NIDA), positive associations between heavy drinking during pre-gaming lead to an overall, subconscious, positive mindset when heavy drinking in other environments. 

In the same study, the average age across 148 participants who experienced or engaged in peer pressure was just over 20 years old — the prime age of college students. 

Brian Borsari, a UCSF professor and doctorate, who works on motivational rehab and studies how pregaming and college students end up with addiction, states that this can evolve into addiction.

“Generally, in college students, we see psychological dependence, or it fosters beliefs that ‘I need alcohol to be social, to be funny, to relax.’ What happens is you start believing that you have fewer and fewer opportunities where you don’t drink in social situations or in situations that are stressful,” Borsari said.

Addiction is not just limited to social environments with friends and colleagues. Families also play a significant role in addiction. Roberto Sanchez, an addiction psychiatrist at the Baylor College of Medicine, states that in his experience, he has seen many instances of this.

“Unfortunately, I’ve had patients who have told us that when they were young, the first time they ever used was with their mom or with their dad,” Sanchez said.

While studies like a 2024 study from Cleveland Clinic state that drinking rates are going down, addiction is failing to cease.

“There’s a tremendous proliferation of cannabis in different forms. Edibles, as well as vaping, and it’s so much more potent than they used to be. So the drugs themselves are changing,” Borsari said.

A new version of the fear of missing out (FOMO) now exists and can be easily spread to large cohorts of people via social media followers. Not only that, according to the Addiction Center, social media offers new exposure to substances, not previously a factor in addiction. 

This exposure is furthered by celebrities like Justin Bieber, Drake, and Cardi B, who frequently post about substances. These individuals who appear as role models or inspirations to younger populations glorify drug and substance use. With social media, exposure to substances is presented at a younger age than ever before.

Although drug and substance abuse of the past has been ever-present, the exposure that these substances now have, especially to an audience that drugs had not previously touched, is growing. 

Today, peer pressure because of addiction is worsening.

“Compared to years ago, when it was reliant on the telephone, face-to-face, or letters versus now with Snapchat, Instagram, and all of these other modalities, you have a real-time connection that can include use,” Borsari said.

At around the age of 20, Tanguay realized his smoking habit was a problem.

“It’s one of those things where you have to buy it every day. You don’t have it for a few hours. You get agitated. It affects your behavior, and it’s just a nightmare,” Tanguay said.

Tanguay turned his life around in a way that he would have never expected during his smoking.

“When I was about 15, I said I would never set foot on this campus again. My only future when I was in this place was to get the hell out,” Tanguay said. 

For individuals like Tanguay, ridding himself of addiction benefited his life. Tanguay is now over 2,000 days clean of nicotine, and he teaches Life Skills and Ethnic Studies.

Life Skills teaches students a variety of things, including how to stay safe when using drugs and how to treat addiction. In Tanguay’s class, students make drug posters and learn about the detriments of addiction. 

He describes his return to Carlmont as a prisoner who returned to run the prison as a warden. His goal is to make high school better than the experience he had.

“I thought high school sucked. So I want to try to come back and make it suck less,” Tanguay said. 

Tanguay also helps students with their sobriety. Students come up to him and ask him for help with getting clean of substances such as nicotine.

The battle with addiction is a difficult one, especially in specific drug cases. For instance, as Muller notes, an opioid addiction can be one of the most difficult to rid oneself of.

According to MedlinePlus, in 2018, an estimated 11.4 million people used narcotic pain relievers. 

Generally, with withdrawal, the symptoms one experiences while taking the drugs are the opposite while stopping the drugs. 

In Muller’s case, he does not think his addiction can be rectified.

“I think it will get me before I get it. I think one day I will just take too much, and I will be gone. I wish I could get clean. I might take something bad or too much. Because I never had the strength to kill it, it’ll kill me,” Muller said.  

Muller’s addiction is furthered by his fear of his family knowing his struggle, especially with the stigma that he fears will surround him.

“I have to spend the rest of my life around them, and I can’t let them know that this is who I am,” Muller said.

Muller wants to share his milestones of sobriety as he attempts to get clean often.

“There is no one to share my milestones of sobriety when, and if I do get sober, and no one to help me when I’m falling,” Muller said.

According to the NCDAS, opioids cause about 1 in 7 overdoses. Since the turn of the century, nearly one million people have died from drug overdoses. 

For Muller, his path to sobriety has been a rocky one, often attempting to get sober every three to four months. Soon after, he relapses. He finds his future to be set as one riddled with addiction.

Someone who struggles with substance abuse may reach a point of hitting bottom, also known as hitting rock bottom. It is the worst and lowest point of someone’s addiction that gives them the motivation to turn around and get sober.

“Hitting bottom is extremely personal for people. So it’s a real question of what it is. You know, that makes people decide enough is enough, and there are some people that never get to that point,” Borsari said.

According to the American Addictions Centers, this can look like someone losing custody of their child, getting arrested, or generally having an eye-opening experience. 

“Oftentimes, it’s wanting to reestablish relationships. Sometimes it’s a huge health scare,” Sanchez said.

There are a variety of ways to get clean of substances, including Alcoholics Anonymous, motivational interviewing, and group or individual therapies.

“It binds to them and stimulates them just enough to stop any withdrawal symptoms and hopefully reduces cravings, but it doesn’t make them feel euphoric or high,” Sanchez said.

Some of these medications include methadone and suboxone, which have been shown to reduce opioid risk, according to NIDA.

“Medication is not the sole answer. It’s just a small piece of the puzzle that can help reduce things a little bit,” Sanchez said.

Other forms, such as motivational interviewing, have proved effective as well.  “It uncovers the person’s own argument for changing their substance use,” Borsari said. “When the behavior conflicts with your own values and goals, it causes pain. It causes distress. That distress is when people are in pain, and they want to change. They want to reduce it, so that has them consider reducing the behavior of substance use.”

Other forms, such as group therapy, have proven to be effective. According to the San Antonio Recovery Center, reducing isolation, especially in those who fear the stigmas of addiction, gives the treatment benefit.

Oftentimes, using a collection of these treatment methods is very helpful.

“Everybody’s coming from a different situation, different background, different sort of factors that led to their development of addiction. So there’s not a one-size-fits-all. But I will say that one common theme is that it typically has to be multiple angles,” Sanchez said.

“I just wish people could be a little bit more empathetic towards people who struggle with substances,” Tanguay said.

This sentiment of treating addiction with empathy and kindness is not commonplace. 

According to NIDA, ignorance and a general lack of knowledge in society lead to stigmas about addiction. Many do not know that addiction is involuntary. According to NIDA, changes in the brain lead to a compulsive need and reliance on drugs. 

Further, people fail to understand how a variety of influences, such as peer pressure or genetic factors, can lead to addiction.

Addiction is further stigmatized when phrases such as “junkie” or “addict” are used. Additionally, the association with criminal behavior causes a greater amount of shame. 

As a result, people are less likely to reach out for the help they need. As in the case of Muller, he fears that his family will think differently of him.

Stigmas in the healthcare department can offer little more encouragement for getting clean.

“What we’ve seen in some of the reports for those struggling with substance use who have been interviewed is that they start to get these wounds, and the wounds are getting worse and worse. However, they don’t really want to come to the ER because the last time they did, they were stigmatized and treated as if they were just there to take up a bed,” Sanchez said. 

As a result, drastic issues can occur.

“By the time they actually come to the ER, the wound has gotten so bad that they need an amputation, and when the doctor sees them in the ER, they blame them for not coming in earlier, but at the same time, there were reasons why they didn’t,” Sanchez said.

According to NIDA, what causes someone to fall into addiction or get clean is not one set factor but rather a multitude of different reasons and components. Addiction is a disease that is stigmatized but also encouraged.

“There’s been huge advocacy in helping other specialties of medicine understand this as a disease and understanding how much our language matters, how much we treat people matters,” Sanchez said. “I’m very optimistic that the treatment of addiction is something that’s going to get better, but it’s still going to take a lot of work.”