Prescription drug abuse by teens on the rise

The most common dangers posed by most prescription medications include everything from dizziness to internal bleeding, from adverse reactions to overdoses.

But there's one other danger that's rarely discussed: misuse by teenagers as recreational drugs.

Yet, a growing number of teens are raiding their parents' pill bottles or buying prescription drugs illegally through Internet pharmacies and dealers.

From potent painkillers to humble cough syrups, prescription drugs can be misused to produce a "high" feeling, and can cause death, injury, or addiction just as easily as other illicit drugs.

Parents need to wake up to this growing trend, and watch out for signs that their son or daughter might be using medicines to get high, warns a University of Michigan (U-M) Health System expert who has treated teens for prescription drug abuse problems.

"Prescription drug use is becoming more of a problem among teens, and the trend has been increasing in the last three to four years," says Maher Karam-Hage, M.D., medical director of the Chelsea Arbor Treatment Center, which U-M operates in conjunction with Chelsea Community Hospital. "These drugs can be highly addictive if they're used on an ongoing basis, and the person can become physically, psychologically and behaviorally addicted to them."

Parents might not realize it, but far more teens use prescription or over-the-counter drugs to get high than use "harder" drugs like heroin, cocaine or Ecstasy.

A recent survey revealed that one in every 10 high school seniors had used the painkiller Vicodin in the last year without a doctor's orders. Roughly the same number had used the stimulant Ritalin in the last year, about 6% had used tranquilizers, and 4.5% had used the super-potent painkiller OxyContin.

Those figures, which came from the 2003 "Monitoring the Future" survey of 48,500 students across the country conducted by the U-M Institute for Social Research, hint at how big the problem really is, says Karam-Hage. Other data, from the National Survey on Drug Use and Health, indicate that the sharpest increases in new users of prescription drugs for non-medical purposes have been 12-to-25 year-olds.

Although alcohol and marijuana still account for most teen substance use, the recent increases in use of inhalants, stimulants, painkillers and tranquilizers mean more kids are putting themselves at risk — possibly thinking that medicines are "safe."

But it's never safe to use drugs that a doctor prescribed for someone else, to use prescription drugs in a different way or higher dose than a doctor prescribed, or to obtain a prescription drug without a real medical reason, Karam-Hage says. Not only can drugs interact with other drugs a person is taking, they can also cause serious side effects, become addictive, or kill.

The broad range of medications that teens and young adults are using makes the problem even tougher to spot and treat, Karam-Hage warns. "Boys seem to like more stimulants, like Ritalin and amphetamines, as well as steroids, while girls tend to use 'hypnotics' — benzodiazepines like Valium, Xanax, and Ativan," he explains. "Also commonly abused, among both boys and girls, are drugs we call opioids, which are the famous OxyContin and Vicodin."

Each of these drugs affects the brain in different ways, but teens use them to try to achieve a high feeling that can range from euphoria or intoxication to super-calm. Their chemical formulas are often related to those of "hard" drugs, which means their effects can be just as bad, says Karam-Hage, who is a clinical assistant professor in the U-M Medical School Department of Psychiatry.

Karam-Hage advised keeping drugs in places where teens can't get at them. For a short-term prescription, or a temporary cough medicine, throw it out if there's some left after symptoms are gone. If you notice your teen is taking cough medicine when he or she doesn't have a cough, ask him or her about it.

But teens can get these substances from other sources, Karam-Hage warns. "They trade them among each other, and buy them in the street," he says. "And another major variable, whose impact I don't think we account for enough yet, is the Internet."

Teens are ordering pills from websites that sell prescription drugs without a prescription, no questions asked — which means parents should monitor their child's Internet access, credit card use and mail deliveries. Authorities are stepping up efforts to shut down the online sites and illegal pharmacies that offer these drugs, but that's a difficult, maybe impossible, task.

Other things parents can look for include drops in their children's grades at school, sudden behavior changes or shifts in the kinds of friends they hang out with. "If there's a change in their relationship with their parents, or they all of a sudden become isolated or not talkative, or if they choose different friends and groups at school, these are things that can signal a problem," Karam-Hage says.

If you discover or even suspect that your teen is abusing prescription medications, talk to his or her doctor or seek other professional help. Treatment programs can help, but breaking an addiction or dependence on a prescription drug is often difficult and requires expert guidance.

Even if you don't suspect your child is using medications to get high, take time to talk about the issue. "The best way to prevent it from happening is to educate your teen and be very clear about the inappropriateness of using other people's prescriptions, and the importance of understanding how much to use of an over-the-counter medication and what for," Karam-Hage advises. "You can start creating that dialogue, and start drawing the lines, of what is appropriate and what is not." And maybe you can keep your child from joining the teens who are following a prescription for danger.

Although not mentioned by Karam-Hage, other health care professionals go one step further and advise parents to re-think their own drug "habit." Often, teens feel prescription drugs are acceptable because they see their parents taking them so often, for everything from chronic headaches to stress and from insomnia to fatigue. Teens need to be shown that there are better ways to approach health and wellness than through the use of drugs to mask symptoms or as a substitute for proper nutrition, exercise or lifestyle choices.

SOURCE:"A Prescription for Danger: Teens Using Medicines to Get High," University of Michigan Health System, July 1, 2004.

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