You, the parent of an unruly teenager, may inadvertently be a big source of prescription medications he/she is using behind your back. More often than not, medicine cabinets are your teen’s “go-to” spot of choice. A whopping 61% of adolescents report that prescription medications are easier to get than illegal medications, and 41% of adolescents mistakenly believe use of medicines is less dangerous than use of illegal street medications.
One out of every two Americans is on prescription drugs. So these medications are readily available. People think they're safe because they're prescribed by a physician, and more adolescents are turning to the medicine cabinet to get their medications of choice.
Here are the five classes of prescription medications teens get most often in their own homes:
- Cough medications: Contain DXM, which acts in way that is similar to morphine. They can cause respiratory depression, brain hemorrhage, nausea, and vomiting, and prompt thousands of emergency room visits each year.
- Narcotic pain relievers: Excess use can cause respiratory depression, even coma and death. Mild use can cause constipation, depression, and problems concentrating. These are the ones most commonly used by adolescents.
- Sedatives/tranquilizers: Such as Valium, can cause impaired coordination, which can be a real danger if someone is driving. They can also cause drowsiness and depression.
- Sleep Aids: Such as Ambien, have a high potential for use (even in grown-ups), and there are reports that adolescents use it recreationally because they get a "high" by trying to fight the sleepy feeling -- and can have visual hallucinations.
- Stimulants: Such as Ritalin, can cause nervousness, insomnia, and toxic psychosis. They can be used by grown-ups and adolescents trying for what they perceive as better concentration.
The risks of adolescent prescription drug use are momentous, yet few grown-ups in a position to take action against them have realistic grip on this new frontier of adolescent crime. Not only do drug companies deceive the public to make a buck, but they influence the judgment of many physicians, paying them well to give speeches and sales pitches promoting their medications to other physicians.
From 2000 to 2005, drug maker payments to psychiatrists rose more than six-fold, to $1.6 million. During those same years, medications of anti-psychotics for kids in the Medicaid program rose more than nine-fold. It is sad, yet self-evident, that the politics of money have long infiltrated the offices of many of those who should be defending adolescents from prescription drug use. The fact is that whether people use their medications legally or not, the company still makes money on every tablet.
The culture growing between teenagers who use prescription medications is poignantly different from that around other drugs. First, know that these medications are much cheaper than most other drugs, and many adolescents get them for free, from medicine cabinets, peers, or their own prescribed medications (e.g., Ritalin). The price for a tablet of the most commonly used drug medications ranges from 3 to 6 dollars, with prices getting cheaper in bulk. OxyContin and other stronger medications can be a little more. Prices vary based on availability and on how many milligrams are in the dose. What this means is that not only can teens often afford to take them every day, but they do not have to buy them to try them since the low cost makes many happy to share.
The issue of prescription drug use is not new, so why has it been sidelined for so long, and why has the threat been growing so much faster in recent years? First consider that tablets and capsules have a connotation of safety, especially for naïve, risk-taking teenagers. The primary reasons for this connotation are because tablets and capsules are easier to take than smoking marijuana or drinking liquor and are professionally manufactured in a lab. They are easily available, comparatively cheap, and inconspicuous to carry around. Furthermore, most adolescents see them being used legally, often by their moms and dads.
An adolescent might easily say to his/her mother or father, “If you can take them, why can’t I? We do it for the same reasons.” Perhaps this is part of what many moms and dads misinterpret about adolescent drug use. Much more often than a parent might think, adolescents are abusing prescription medications not to get high, but rather to be less depressed, less stressed-out, more focused, or better rested. If moms and dads are not drawing the line, then how will their kids learn to?
Direct-to-consumer drug advertising was approved by the Food and Drug Administration in 1997. Since then, most people have come to take it for granted that their lives will be flooded with ads for prescription medications. These ads do not take a medical degree to understand, yet many of the products they advertise do. Someone who is nineteen now was nine when the floodgates opened. The result is that ever since today’s adolescents have been aware of prescription medications, their understanding of them has been largely shaped by the drug companies.
It should be no surprise that so many adolescents now believe the industry message that “tablets and capsules offer a cure for any ill.” Which ones to take, many ads suggest, is largely a matter of personal choice. Many teenagers come to view school-related stressors as a series of problems that can be solved with tablets and capsules. Being an adolescent can mean being fixated on personal problem. Unfortunately, many adolescents have not realized that using prescription medications only brings them more difficulty.
With other drugs, like marijuana and cocaine, adolescents often have to look around quite a bit to find a dealer, who also routinely sells prescription medications, often importing them in quantity from countries like Mexico that allow you to buy anything you like over the counter. Yet the primary means of trafficking prescription medications, especially for adolescents, is through social networks (e.g., peers and classmates). The effect of adolescent's sharing and trading medications at little or no increased price, is that drug dealers often can’t make as much money on these medications as they can on others for which they completely control the supply.
The multitude of ways adolescents take prescription medications and mix them with other drugs making "cocktails" demonstrates how their uses lead straight to even more destructive drug habits. All three major categories of used drugs can be easily crushed and snorted, making the sensation more instant and overwhelming, and very often leading adolescents to seek out cocaine and speed. Opiates and CNS depressants are frequently crushed and smoked, often with marijuana. The injection of Opiates and CNS depressants among adolescents, by crushing them and mixing the powder with water, is also growing. The trend is especially alarming given some of these medications similarity to heroin, especially OxyContin.
The reality of the ongoing prescription swap-meet between adolescents has long-term implications for the mental health of many children who may grow up without learning how to make themselves feel healthy without illegal medications. Another alarming trend with prescription medications is that females are more likely to use them than males. The National Survey on Drug Use and Health reported in 2002 that 4.3% of female adolescents reported abusing prescription medications in the last month in comparison to 3.6% of male adolescents. The disparity is likely due in part to the propensity of many adolescents to pop tablets and capsules to lose weight. The effect prescription medications have on one's judgment can interact with eating disorders to raise a host of fresh health threats. What many moms and dads find most painful about adolescent prescription drug use is that, because most adolescents are always willing to sell-off a few tablets and capsules, many more kids are in effect becoming drug dealers.
The growing amount of medications in more homes means, not only that they are more easily available to adolescents, but also that they may feel more commonplace and safe to adolescents. A consequence of this is that many adolescents are happy to play physician for their peers. Teens crudely mimic their physicians’ behaviors, using phrases such as, “All you have to do is try a little more or a little less, or you can always switch to something similar.” It is normal to hear adolescents express this attitude saying something like, “I don't think it is wrong -- when I have the prescription medication I know a friend needs to make them feel better, I give them a tablet or two.”
The universe of available prescription medications is too great for almost anyone to keep close track, especially with the astronomical number of new medications and generics introduced every year. Yet a practical understanding of the tablets and capsules most often popped is vital for moms and dads to fight back.
What can parents do?
Putting medications under lock and key seems obvious, yet use usually gets started because moms and dads don't. In addition to this practice, count your tablets and capsules, keeping a sticky note on the bottle where you can initial and write the number of tablets and capsules left every time you take some. This practice may sound like a lot of paperwork, but it is a clear signal to adolescents that you are constantly vigilant on the issue, and it should help provide a deterrent.
Ask your physician if your medications are often used and how, so that you know the symptoms. Most drugs will not get you high or serve adolescents' perceived self-medication needs. If this is the case with your medications, you should be open with your adolescent about it, joking "you would not get a rush from taking my heart medication -- I sure don't."
It's not just prescription medications, but over-the-counter as well that moms and dads need to focus on. Talk to your kids. Let them know that, just because they're prescribed by a physician, doesn't mean they couldn't be deadly.
Once you have taken the initial steps to become more informed, and to secure the drugs in your home, considering how to discuss the issue with your family is the next move. Begin by listening. Just starting a general conversation on prescription medications can illuminate your adolescent's tendencies before you clam them up with warnings and rules. Once you have learned your adolescent's honest opinions on the issue, set clear expectations with your adolescent, letting them know that under no circumstances should they ever take drugs without your knowledge. Let them know that if they ever feel curious about whether they would benefit from taking drugs that you would love to discuss it with them and the family physician or counselor. Your kids tune you out when you lecture them, so use teachable moments to get the message across instead (e.g., organizing the bathroom, swinging by the pharmacy).
Prescription drug use has been played down for so long that reaching out to the community for support is even more critical than with other drugs and liquor. If you are the only person in their life concerned about it, it is much easier for adolescents to discount your warnings. Making sure that your adolescent's physician is actively addressing the issue when he or she talks with your adolescent is vital. Next, meet with the adolescent's school counselor, nurse, and principal, to hear what they have to say about the issue in your adolescent's peer group. Make sure that the most current information is included in your adolescent's health class and that all moms and dads are being asked to lock-up and count their tablets and capsules.
It is highly unlikely that you can prevent your adolescent from being exposed to prescription drug use. The question is how you can help him/her to think critically and respond confidently. If your adolescent is showing a special curiosity about prescription medications, it usually means that he/she at least has peers who are abusing them. When you observe this curiosity, satisfy it with the facts. Let him/her know that taking a tablet one can’t identify or wasn’t prescribed is like playing Russian roulette.
The risks of overdosing, date rape, and taking a tablet that kills you are things that too many moms and dads as well as adolescents are not talking about. Experimenting with and becoming dependent on prescription medications is a swift path to the people, situations, and other medications that are even more dangerous for adolescents. Times are changing, and so are the cultures and methods of prescription drug use.
My Out-of-Control Teen: Help for Parents