Wednesday, September 9, 2015 // The Statement
4B
Wednesday, September 9, 2015 // The Statement
5B
ONE NIGHT,
ONE PILL, ONE TRAGEDY
—and a mother’s mission
By Lev Facher, Managing Editor
J
osh Levine’s death, examined at the simplest level, was
the doing of a pill.
Small, round, and as visually unintimidating as an
over-the-counter painkiller, Adderall tablet was first pre-
scribed to somebody not named Josh Levine, somebody who
then presumably offered it to the 22-year-old at a Saturday
night party at a Chicago apartment. Somewhere along the
line, the pill was crushed so it could be snorted. Once ingest-
ed, it went to work promoting a sense of alertness and energy
that kept Levine, no stranger to alcohol, completely unaware
he was pushing himself far, far beyond his own limits with
every sip.
Levine, a 2014 University graduate who had accepted his
first full-time job and moved to Chicago just weeks before the
incident, was found unresponsive on a sidewalk in the early-
morning hours of July 20, 2014. He suffered a fatal, alcohol-
induced cardiac episode while walking home alone. Someone
had stolen his wallet from his motionless body, and Levine
had left his phone behind at the apartment where he had been
drinking earlier. Levine’s family doesn’t know who stole the
wallet, or who called 911, or whether whoever stole the wallet
and whoever called 911 is the same person. The key fob in his
pocket that would have opened the door to the apartment he
had moved into just days before was the hospital’s only means
of identifying him.
Presence Saints Mary and Elizabeth Medical Center,
located just northwest of downtown Chicago, called Levine’s
property manager who called a family member.
Levine was declared brain-dead shortly after arriving at
the hospital. He was taken off life support hours after his par-
ents arrived at his hospital bedside, having driven through
the night from Cincinnati after receiving a concerned mid-
morning call from Levine’s brother, who also lived in Chica-
go, then an evening phone call that he was in the hospital, in
the ICU, and things weren’t looking good.
In an early morning phone call, the Cook County coroner
asked Levine’s mother, Julie Buckner, whether her son had
attention deficit hyperactivity disorder.
No, Buckner said, he didn’t. Why do you ask?
He had stimulants in his system, the coroner told Buckner.
Amphetamines. Adderall.
No, Buckner told her. He didn’t. Levine didn’t do that kind
of thing.
The coroner already knew the facts, but said she would
look into it further.
The hospital measured Levine’s blood toxicity upon his
arrival. His blood alcohol content, Buckner said, was “astro-
nomical.” When he reached the hospital, he had amphet-
amines in his system. By the time he was taken off life support
a day and a half later, the Adderall was gone, flushed out by a
network of tubes and needles and a body that, by and large,
was still functioning.
Levine’s cause of death was listed as acute alcohol poison-
ing, but the records only tell a partial story. Alcohol was only
one factor.
A pill cost Levine’s brother and three step-brothers a sib-
ling. It cost the University of Michigan a promising young
alumnus, the school’s football team a beloved former manag-
er. It cost West Bloomfield High School a popular substitute
teacher. It cost Buckner her son.
Josh’s brothers, Adam and Alec Buckner, graduated May,
2015. Here they stand together on the football practice field
the night before the Michigan-Ohio State game 2011. There
was a managers’ game and the Michigan managers crushed
Ohio State.
***
Stimulants like Ritalin and Adderall are commonly pre-
scribed to patients diagnosed with ADHD, a condition the
American Psychiatric Association has stated affects 5 percent
of American children, the population in which symptoms of
the disorder typically first manifest.
Given the frequency with which the drugs are prescribed
to children and their seemingly innocuous brand names,
it can be easy to underestimate the drugs’ seriousness and
potency.
But Ritalin has another name, too: methylphenidate. If you
came up with a nickname for the chemical compound, “meth”
might be a good place to start.
This relationship paints a far clearer picture of the effects
of these drugs, which, when taken by someone who has no
need for it, can elicit similar responses as the recreational
drug found on street corners.
The culture surrounding prescription stimulant abuse is
remarkably casual, some researchers say. Those seeking out
extra pills from friends with legitimate prescriptions are
often unaware of the intense side effects that can develop as a
result, even in healthy patients.
“Increasingly, doctors and psychiatrists are recommend-
ing that people who are prescribed stimulants take them in
private,” said Elizabeth Austic, a postdoctoral researcher at
the University who has studied the use of stimulants and opi-
oids in teenage populations.
“One thing I heard a lot in college is the ‘friend code,’ —
your friend does you a favor; you’re breaking the friend code
if you don’t (give into their requests for a prescribed stimu-
lant),” Austic said.
Giving a friend an extra dose of a controlled substance,
considering its potential effects, is no act of friendship. It’s
also a felony, a factor that typically only comes into play once
disaster has already struck. Sometimes it’s akin to what hap-
pened to Levine. Sometimes, the disaster can be a psychiatric
one.
Even in healthy patients, amphetamines can induce psy-
chosis and other severe symptoms, according to a 2012 study
published in BMC Psychiatry, a peer-reviewed psychiatric
journal. More vulnerable patients, such as those with person-
al or family history of psychiatric issues, can be susceptible to
developing symptoms even at small doses.
Symptoms for this form of psychosis can include visual
hallucinations, insomnia, anorexia, and delusional parasit-
osis, in which victims come to falsely belief that their bodies
are infested with parasites.
But the side effects of stimulant use, or the adverse effects
of combining the drugs with alcohol, are often unrealized in
users until the worst has already occurred.
Worse, Austic said, those who do suffer adverse side effects
sometimes fall off the radar. A college student who developed
symptoms of psychosis after taking stimulants might take a
semester off for health reasons or drop out of college entirely,
making it even less likely that their peers would be forced to
come to terms with issue’s prevalence.
Instead of a college freshman learning about their room-
mates’ substance abuse issue, that freshman might simply
find him or herself with a double room to themselves, Austic
said.
“Growing up, whenever I heard of someone who died from
an overdose, you don’t take it seriously, because you think,
‘My friends aren’t like that,’ ” said Ben Eilender, a lifelong
friend of Levine’s, a fellow football manager and 2014 Uni-
versity graduate. “All it takes is one bad decision. Or one bad
night.”
***
Levine, a member of Theta Chi Fraternity, was the type of
person who could be found regularly at parties and bars. He
drank a fair amount, his friends say, but not more than any-
body else in his social circle.
Levine was as much a momma’s boy as he was a frat boy.
He kept his mother in the loop about every aspect of his life.
“Way too much,” Buckner said with a laugh. “He told me
way too much.”
He worked part-time at Rick’s American Cafe, a famous
hotspot for college nightlife in Ann Arbor. Not wanting to
choose between a raucous 21st birthday celebration and a
night with his family, Levine settled for both: he brought his
parents and siblings to the bar at 611 Church Street.
Levine wasn’t known for being an out-of-control type, for
overdoing things, for being the person whose level of intoxi-
cation drew eyes from across the room.
“He’s kind of the poster child,” Buckner said. “He was a frat
boy who could drink, but he wasn’t an alcoholic. He wasn’t a
drug addict. By all accounts of him using Adderall, it was not
a regular thing for him.”
Jake Miller, another University alum who was a close
friend of Levine’s and shared a house with him in the months
following their graduation, agreed. Levine, he said, wasn’t
the type to have drawn attention to himself simply by having
overindulged.
“That’s why it’s so surprising,” Miller said. “He was never
the kid who was out of control, who you had to take care of.
He was more likely taking care of someone else.”
While several of Levine’s friends and the University stu-
dent population at large were generally aware of the dangers
of drinking — and maybe even held an abstract understand-
ing of the dangers of co-ingestion — such an outcome was
unthinkable.
“I think anybody who’s lost a friend to drinking or drugs
has had their experience change,” Miller said. “Of course you
know it’s dangerous. You’ve heard stories. But you don’t really
think that when you’re going out tonight, somebody could die.
That isn’t something that occurs to you.”
***
In the aftermath of her son’s death, Buckner started the
Josh E. Levine Foundation, a nonprofit which honors Levine’s
memory by bringing to light the rarely discussed issue of co-
ingestion.
The organization’s slogan is ominous: “It’s Fun Until…”
The goal, Buckner says, is to save lives — to bring the issue
close enough to home that those considering using stimulants
or any other drug alongside alcohol think twice.
“Please don’t co-ingest ANYTHING with alcohol,” the
foundation’s Facebook page wrote on April 14, which would
have been Levine’s 23rd birthday. “Adderall, Xanax, Perco-
cet, Red Bull, anti-depressants, etc. Have a game plan in place
when you drink to quit while you still have your wits.”
But Buckner isn’t fighting this issue alone. Wolverine Well-
ness, a subdivision of University Health Service, has also been
front and center in increasing proactive efforts to prevent stu-
dents’ abuse of stimulants and sleep aids, both when they’re
being used as sleep aids and when they’re being abused along-
side alcohol.
There’s no quick fix.
The University’s 2014 National College Health Assessment
showed that 10 percent of undergraduate students reported
having used amphetamines in the 12-month window before
taking the survey, an uptick from 9 percent in 2010, the last
year the survey was performed.
A smaller but still substantial percentage of students self-
reported having used sedatives like Xanax and Valium — 5
percent of undergraduates in a 12-month window.
Though preventative efforts are largely important in keep-
ing a handle on campus health issues, organizations like Wol-
verine Wellness find themselves searching for a “sweet spot”
that balances spreading awareness with the fear of lending an
air of social acceptability to the abuse of a particular drug,
said Wolverine Wellness director Mary Jo Desprez.
Desprez, using the hypothetical of heroin use in under-
graduates, said broadly spreading the word about abuse of a
particular drug abuse pattern can do more harm than good.
“Even if there were only five (users on campus), you still
want to do something,” Desprez said. “And you don’t want to
norm it. You don’t want to do a big campus campaign that says,
‘Don’t do heroin,’ because then all of a sudden everybody’s
like, ‘Is everybody doing heroin?’ It’s still only five people.”
Instead, Desprez said, the University needs to be “nim-
ble enough to do those targeted interventions” on smaller
populations of students who’ve developed an abusive habit,
without resorting to widespread measures that essentially
concede the commonplace nature of certain substance abuse
patterns, like AlcoholEdu.
At the same time, many say there’s a mentality issue on
campus that has yet to be addressed.
“There’s two pockets of misuse,” Desprez said. “One is per-
formance aid. We have this culture here of, ‘gonna stay up all
night, gonna write the paper, gotta focus, everybody does it.’
The other pocket of worry, which I think Josh fell into, is co-
ingestion with the idea of keeping the party going longer.
“I think the perception that (a stimulant is) a good study
aid sort of dwarves the reason it’s a prescription drug. It does
come with these huge health issues and concerns.”
A study co-authored by Sean McCabe, another University
researcher who has studied the practice of prescription drug
abuse and stimulant-alcohol co-ingestion, showed that male
undergraduates were twice as likely as females to use unpre-
scribed stimulants for nonmedical reasons. White students
were more likely to take unprescribed stimulants than any
other racial demographic.
About 13 percent of students living in fraternity or soror-
ity houses misused prescription stimulants compared with
about 4 percent of students living in off-campus apartments,
according to the study.
Another study co-authored by McCabe study showed that
6.9 percent of undergraduates self-reported having used
abusable prescription drugs alongside alcohol in the previous
12-month span.
Perhaps more disturbingly, the study reported, “nonmedi-
cal users of prescription stimulants were over six times more
likely to report frequent heavy drinking than their peers who
did not report nonmedical use of prescription stimulants.”
In other words: those who can least afford to drink heavily
are often those who do it most.
Josh brought his mother, Julie, to Rick’s American Cafe on his 21st birthday, April 14, 2013.
Josh’s brothers, Adam and Alec Buckner, graduated May, 2015. Here they stand together on the football
practice field the night before the Michigan-Ohio State game 2011. There was a managers’ game and the
Michigan managers beat Ohio State.
Josh at a graduation dinner before his Kinesiology graduation
ceremony.
PHOTO COURTESY OF JULIE BUCKNER
PHOTO COURTESY OF JULIE BUCKNER
PHOTO COURTESY OF JULIE BUCKNER
See STIMULANTS, Page 8B