Teens turn to OTC, prescription meds as illicit drug use declines

American Academy of Pediatrics National Conference and Exhibition

Seven of the top 10 drugs abused by 12th graders during the last year were prescribed or purchased over the counter, according to a speaker at the AAP 2009 National Conference and Exhibition.

“Although illicit drug use by teens is declining, now there is a new threat — the family medicine cabinet,” said Hoover Adger, Jr., MD, MPH, professor of pediatrics at Johns Hopkins School of Medicine in Baltimore.

Data from national surveys indicated a 20% decline from 2001 to 2005 in the proportion of U.S. adolescents who reported illicit drug use. However, 3 million adolescents continue to initiate over-the-counter or prescription drugs each year and pain relievers are fast approaching marijuana as the gateway drug of choice, accounting for 22.5% of new substance abuse.

“Going back a decade it was rare to see adolescents in a treatment center whose drug of choice was an opoid,” Adger said. “Today that’s not rare at all.” About 5% of high school seniors report initiating Oxycontin (Purdue Pharma) use in the past year, and about 10% said they have tried Vicodin (Abbott).

Other drugs on the list include central nervous system depressants such as dextromethorphan, an active ingredient in many over-the-counter cough medicines, and stimulants such as dextroamphetamine, an ingredient in the ADHD medication Adderall (Shire).

Widespread, easy availability of these drugs and adolescent attitudes may help explain increased use, according to Adger, who said that when asked about drug use, adolescents are likely to agree that prescription drugs are easier to get and safer than illegal drugs. Many teenagers also agree that there is nothing wrong with occasionally using medications that were not prescribed to them and some believe that prescription drugs are less addictive than illegal drugs.

Pediatricians and parents should be able to recognize symptoms of OTC and prescription medication abuse as use of these substances increases. Warning signs include personality changes, mood swings, irritability, excessive energy, sleepiness or avoiding sleep, loss of appetite, forgetfulness, clumsiness, secretiveness, loss of interest in personal appearance, borrowing money or having extra cash, decline in school performance, pills missing or too early prescription refills and empty containers in trash.

Adger offered the following preventive tips:

Properly store or lock medications.
Take inventory of medications kept around the house and check regularly.
Set clear rules with teenagers about drug sharing.
Properly dispose of old and unused medications by taking them to community take-back centers or mixing them with undesirable substances, such as kitty litter or coffee grounds, before throwing away.

“As pediatricians we need to talk to teens about the dangers, educate ourselves and our patients and be available to assist our patients with referrals and treatment for substance abuse,” Adger said. – by Nicole Blazek

For more information:

#F3113. Presented at: American Academy of Pediatrics National Conference and Exhibition; Oct. 17-20, 2009; Washington.