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Prescription for Trouble?

Rx Abuse Among Teens

Overview
Commonly Abused Prescription Drugs/Signs of Use/Withdrawal
Parent Tips
Proper Disposal of Unused Medications
Sources

You’ve talked to your teens and preteens about underage drinking and illegal drug use.  But did you know that many teens are turning away from street drugs and using prescription drugs to get high?  In fact, rates of new users of prescription drugs have caught up with new users of marijuana. According to the 2006 Monitoring the Future survey, abuse of OxyContin and Vicodin over the year prior to the survey have reached a level that raises concern:  
v Past year abuse of Vicodin was 3.0 percent among 8th-graders, 7.0 percent among 10th-graders, and 9.7 percent among 12th-graders in 2006.
v Abuse of OxyContin among 8th-graders nearly doubled between 2002 and 2006, from 1.3 percent to 2.6 percent.

Teens and young adults abuse prescription drugs for a number of reasons.  They believe the myth that medications are a ‘safe high’; but misuse of these drugs can lead to dependence, addiction, long and short-term physical or psychological problems – even death. 

Teens report that it’s relatively easy and inexpensive to get prescription drugs.  Nearly half of teens that use them illicitly say they get prescription meds for free from a relative or friend.  They also take them without asking from parents, grandparents, or friends’ homes.  Unscrupulous Internet companies sell various medications without confirming purchasers’ ages or requiring a valid prescription.  Some of those companies are even selling drugs that do not meet Federal Drug Administration standards.

Common Prescription Drugs of Abuse, Signs & Symptoms -
- Opiods (painkillers)
- Depressants
- Stimulants
- Anabolic Steroids

Opioids are most often prescribed to treat pain. Morphine, for example, is often used before and after surgery to alleviate severe pain, while codeine is often prescribed for mild pain. In addition to their pain-relieving properties, some of these drugs can be used to relieve coughs and diarrhea.  Commonly used opioids include oxycodone (OxyContin), propoxyphene (Darvon), hydrocodone (Vicodin), hydromorphone (Dilaudid), meperidine (Demerol), and diphenoxylate (Lomotil).
Signs of use include constricted pupils, nausea and vomiting, and respiratory depression. 
Withdrawal symptoms include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps ("cold turkey"), and involuntary leg movements. Long-term use of opioids can lead to physical dependence and addiction. Taking a large single dose of an opioid could cause severe respiratory depression that can lead to death.

Central nervous system (CNS) depressants are used to treat anxiety and sleep disorders.   Among the CNS depressants commonly prescribed are barbiturates, such as mephobarbital (Mebaral) and pentobarbital sodium (Nembutal), used to treat anxiety, tension, and sleep disorders; Benzodiazepines, such as diazepam (Valium), chlordiazepoxide HCl (Librium), and alprazolam (Xanax), prescribed to treat anxiety, acute stress reactions, and panic attacks, and benzodiazepines, such as triazolam (Halcion) and estazolam (ProSom) prescribed for short-term treatment of sleep disorders. 
Sometimes referred to as sedatives and tranquilizers, depressants are substances that can slow normal brain function. They should not be combined with any other medication or substance that causes CNS depression, including prescription pain medicines, some OTC cold and allergy medications, and alcohol. Using CNS depressants with these other substances - particularly alcohol - can slow both the heart and respiration and may lead to death.
Signs of use include slurred speech, dizziness, and respiratory depression.
Withdrawal symptoms
- Because all CNS depressants work by slowing the brain's activity, when an individual stops taking them, the brain's activity can rebound and race out of control, potentially leading to seizures and other harmful consequences.

Stimulants are prescribed to treat the sleep disorder narcolepsy and attention-deficit hyperactivity disorder (ADHD) and depression that has not responded to other treatments.  Commonly prescribed stimulants include dextroamphetamine (Dexedrine and Adderall) and methylphenidate (Ritalin and Concerta).
Signs of use
Anxiety and delusions, flushed skin and chest pain with heart palpitations should alert you to possible stimulant abuse
Withdrawal symptoms include fatigue, depression, and disturbance of sleep patterns. Repeated use of some stimulants over a short period can lead to feelings of hostility or paranoia. Taking high doses of a stimulant may result in dangerously high body temperature and an irregular heartbeat. There is also the potential for cardiovascular failure or lethal seizures.

Anabolic Steroids are synthetic substances similar to the male sex hormone testosterone. They do have legitimate medical uses, including treatment for certain kinds of anemia and for men who don't produce enough testosterone on their own.  A different kind of steroid, called corticosteroids, is sometimes prescribed to reduce swelling, but these are not anabolic steroids and do not have the same harmful effects.  Some of the most common anabolic steroids prescribed for legitimate reasons include  anadrol, oxandrin, dianabol, winstrol, deca-durabolin, and equipoise.
When adolescents abuse steroids, their growth is halted prematurely through premature skeletal maturation and accelerated puberty changes. This means that adolescents risk remaining short for the remainder of their lives if they take anabolic steroids before the typical adolescent growth spurt. People who abuse anabolic steroids may experience physical side effects ranging from liver tumors and cancer, fluid retention, high blood pressure, increases in LDL (bad cholesterol), and decreases in HDL (good cholesterol), or kidney tumors.
In addition, there are some gender-specific side effects:
For men - shrinking of the testicles, reduced sperm count, infertility, baldness, development of breasts, increased risk for prostate cancer.
For women - growth of facial hair, male-pattern baldness, changes in or cessation of the menstrual cycle, enlargement of the clitoris, deepened voice.
Steroid abusers also risk a number of emotional/psychological side effects, including paranoid jealousy, extreme irritability, delusions, and impaired judgment stemming from feelings of invincibility.

Signs of Steroid Use
include quick weight and muscle gains (when used in a weight training program), aggressiveness and combativeness, extreme mood swings - including manic-like symptoms, jaundice, purple or red spots on the body, swelling of feet and lower legs, trembling, unexplained darkening of the skin, persistent unpleasant breath odor and severe acne breakouts and oily skin.

Withdrawal symptoms
may include mood swings, fatigue, restlessness, loss of appetite, insomnia, reduced sex drive, and steroid cravings. The most dangerous of the withdrawal symptoms is depression, because it sometimes leads to suicide attempts. If left untreated, some depressive symptoms associated with anabolic steroid withdrawal have been known to persist for a year or more after the abuser stops taking the drugs.

What Can a Parent Do?  Plenty!

First and foremost, continue talking with your teen – about drug abuse as well as all aspects of life.  Open lines of communication are your first defense against any form of substance use/abuse.  Other tips for warding off prescription drug abuse include:

ž Educate yourself and your teen about the risks.  Prescription drugs can be just as dangerous and as addictive as “street drugs,” and can be lethal. Talk to your teen about the dangers of these drugs.

ž Keep track of quantities. Take note of how many pills are in a bottle or pill packet and ask other households your teen visits to do the same, such as grandparents or other friends. Don’t forget about refills. If you find you have to refill medication for a chronic condition more often than recommended, there could be a real problem - as someone may be stealing your medication.

ž Talk to friends, relatives and school administration. Make sure your friends and relatives know about the risks, too, and encourage them to regularly monitor their own medicine cabinets. If you don’t know the parents of your teen’s circle of friends, then make an effort to get to know them, and get on the same page about rules and expectations. Follow up with your teen’s school administration to find out what they are doing to address issues of Rx (prescription) and OTC (over the counter) drug abuse on campus.

ž Follow directions carefully.  Make sure you and your teen use Rx drugs only as prescribed by a medical doctor and take only the recommended dosages as indicated for both Rx and OTC drugs. If you are directed to finish the prescription, then do so as advised. If you have any questions about how to take a prescription drug, call your family physician or pharmacist.

ž Discard old or unused medications.  Review the federal guidelines for details on how to safely dispose of prescription drugs. 

ž Monitor your teen’s time online.  Check browser histories and set a time limit for how long your teen can be online.

ž Be observant.  If you find your teen is quickly going through cough syrup, or you find empty bottles and pill packages among your child’s personal effects, talk with your teen, listen carefully, and determine if there is a problem. If there is a problem, call your family physician immediately.

ž Find other ways to relieve stress and have fun.  Many teens point to personal and family stress, as well as boredom, as reasons they abuse Rx and OTC drugs. Help your teen find other ways to relieve pressures, through positive activities that interest your teen, positive friendships, or by simply listening and offering guidance. Also, help your teen find constructive ways to pass time and set a good example yourself.

Safe Disposal Tips Federal Guidelines:

č Take unused, unneeded, or expired prescription drugs out of their original containers and throw the containers in the trash.  Remove your name and other info from them first. 

     č Mix the drugs with something like used coffee grounds or kitty litter and put them in non-descript containers, such as empty cans or sealable bags.

     č Flush prescription drugs down the toilet only if the label or accompanying patient information specifically instructs doing so; otherwise the chemicals can taint the water supply. Talk to your pharmacist if you have any questions.

     č Ask your pharmacist or doctor if there is a pharmaceutical take-back program where you may bring unused drugs for proper disposal.

Online Resources
Information for this article was drawn from
Office of National Drug Control Policy

National Institute on Drug Abuse
Parents: The Anti Drug

    2000 Prairie View Prevention Services, Inc.
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