Transcript Adolescent Abuse of Prescription Drugs

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(last updated September 2010)
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Controlled Prescription Drugs, 2004-2008
Adolescent Abuse of
Prescription Drugs
Margot L. Waitz, DO
Christiana Care Health Systems
Wilmington, DE
Historical Perspective
Overview of the Problem
• In the 2009 Partnership/MetLife
Foundation Attitude Tracking study, teens
were noted to have had an increase in the
use of alcohol, marijuana and ecstasy
from 2008.
• This followed a decade of declines in teen
drug use.
Overview of Problem
• In 2009 teens in grades 9 – 12 were
significantly more likely to have drunk
alcohol in the past month than in 2008.
• All measures of use of marijuana – ever
tried, past year use, past month use –
significantly increased between 20082009.
• The use of ecstasy also increased among
teens in grades 9 – 12.
Overview of Problem
• Teen abuse of prescription and OTC
medicines remained stable between 2008
– 2009.
Overview of Problem
• 1 in 5 teens (19%) report abusing a prescription
medication at least once in their lives
• 1 in 10 teens (10%) report having abused a
prescription pain reliever in the past year
• About 7% of teens abused OTC cough medicine
in the past year
• 2008 Partnership Attitude Tracking Study on Teen Drug Abuse
Past Year Initiates for Specific Illicit Drugs
Among Persons Aged 12 and older, 2006
First Time Users of Pain Relievers Continue
to Surpass All Other Drugs
The Partnership for a Drug Free America - 2006
3,000
2,500
Pain Relievers
Marijuana
2,000
Ecstasy
1,500
1,000
Stimulants
500
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Overview of Problem
1 in 5 teens report being offered Rx
medicine from a friend or peer to
get high
Sources: Partnership Attitude Tracking Study;
Partnership Mapping Study 2006
Lifetime Trial Among Teens
37%
20%
19%
18%
10%
10%
10%
8%
8%
RX
RX
Crack/
Meth
Medicines
stimulants
Cocaine
Inhalants
RX pain
Cough
Ecstasy
relievers
Medicine
6%
Marijuana
4%
5%
Ketamine
LSD
Source: Partnership Attitude Tracking Study (PATS) Teens 2006
4%
GHB
Heroin
Pain Reliever Abuse
• Past-year nonmedical use of Vicodin and
OxyContin increased during the last 5 years
among 10th-graders and remained unchanged
among 8th- and 12th-graders.
• Nearly 1 in 10 high school seniors reported
nonmedical use of Vicodin; 1 in 20 reported
abuse of OxyContin.
•
NIDA InfoFacts: High School and Youth Trends
Nonmedical Use of Prescription Pain Relievers in the Past
Month, by Age Group: Percentages, 2002 to 2007
Pain Reliever Abuse
•1 in 3 teens report having a
close friend who abuses Rx
pain relievers to get high
Source: Partnership Attitude Tracking Study 2006
Pain Reliever Abuse
Obtaining medication
• About 52 percent of 12th-graders said they were given
the drugs or bought them from a friend or relative.
• 30 percent reported receiving a prescription for them
• A negligible number of 12th-graders reported purchasing
the narcotics over the Internet.
•
NIDA InfoFacts: High School and Youth Trends
Source of Rx Drugs among Those Who Used in
Last Year
Grade 12, 2007-2009 (percentages)
Narcotics other than heroin
2007-2008
2009
Bought on Internet
Took from friend/relative without asking
took from friend
took from relative
Given for free by friend or relative
by a friend
by a relative
Bought from a friend or relative
from a friend
from a relative
From a prescription I had
Bought from drug dealer/stranger
Other method
weighted N=
Monitoring the Future Study, 2009
2.3
24.2
------50.5
------37.1
------40.2
18.6
8.5
361
0.0
18.6
3.6
17.9
51.5
46.1
10.1
33.6
33.6
2.9
30.3
13.0
10.0
153
Stimulant Abuse
• Between 2004 and 2009, a drop in pastyear use of methamphetamine was
reported for all grades, and lifetime use
dropped significantly among 8th-graders,
from 2.3 to 1.6 percent.
Stimulant Abuse
• SAMHSA's National Survey on Drug Use
and Health estimated that about 510,000
youth aged 12 to 17 (2%) used stimulants
(including methamphetamines)
nonmedically in the past year in 2006.
Past Year Methamphetamine Initiates among Persons
Aged 12 or Older and Mean Age at First Use of
Methamphetamine among Past Year Methamphetamine
Initiates Aged 12 to 49: 2002-2007
Stimulant Abuse
• According to the DAWN for 2004, an estimated
7,873 drug-related emergency department visits
involved methylphenidate or amphetaminedextroamphetamine
• The most frequent reason for these ADHD
stimulant medication related visits was
nonmedical use (48%), followed by adverse
reactions associated with medical use (34%),
accidental ingestion (10%), and suicide attempts
(8%).
Stimulant Abuse
• Over 71% of youth who used stimulants
nonmedically in the past year compared
with 34% of youth who did not use
stimulants nonmedically also engaged in
at least one of the six types of delinquent
behaviors in the past year that were
included in SAMHSA's National Survey of
Drug Use.
Stimulant Abuse
• These delinquent behaviors were:
– got into a serious fight
– took part in a group fight against another
group
– sold drugs
– stole anything valued more than $50
– attacked someone
– carried a handgun
Cough Medication Abuse
• The cough suppressant dextromethorphan
(DXM) is found in more than 140 over-thecounter (OTC) cough and cold
medications.
Cough Medication Abuse
• In the NSDUH, 2006 about 3.1 million
persons aged 12 to 25 (5.3%) had ever
used an over-the-counter cough and cold
medication nonmedically.
• Nearly 1 million persons aged 12 to 25
(1.7%) had used an over-the-counter
cough and cold medication to get high in
the past year.
Cough Medication Abuse
1 in 4 teens report having a
close friend who abuses
cough medicine to get high
Source: Partnership Attitude Tracking Study 2006
Cough Medication Abuse
• According to the DAWN for 2004, an
estimated 12,584 emergency department
visits (0.7% of all drug related emergency
department visits) involved
pharmaceuticals containing
dextromethorphan.
• DAWN – Drug Abuse Warning Network
Attitudes Affecting Teen Medicine
Abuse
• Medicine Abuse “Normalized”
in Teen Culture
• Misperception that abusing medicine is not
dangerous
• Misperception that abusing medicine is
safer than “street drugs”
Sources: Partnership Attitude Tracking Study;
Partnership Mapping Study 2006
Attitudes Affecting Teen Medicine
Abuse
• Three quarter of teens reported that the
number one reason for using drugs is to
cope with the pressure at school.
• 65% of students noted that using drugs to
feel better and to look cool were the other
top reasons.
Sources: Partnership Attitude Tracking Study;
Partnership Mapping Study 2007
Multiple Perceived Benefits of
Medicine Abuse Amongst Teens
• Helps me deal with my problems
• Helps me manage my life
• Enhances my performance
• To get high
Sources: Partnership Attitude Tracking Study;
Partnership Mapping Study 2006
Teens’ Perceived Ease of Access
• Medicine cabinet, at home or friend’s house
• Another person’s prescription, family
or friend
• From many sources on the Internet
Sources: Partnership Attitude Tracking Survey;
Partnership Mapping Study 2006
Prevention
Teens Perceptions
• Peer approval of getting high significantly
increased between 2008 – 2009.
• Decrease in social disapproval and risk in
using marijuana.
• Between 2005 – 2009 there has been a
decrease in the perception of risk of using
ecstasy along with an increase in the
acceptability of use.
Partnership for a Drug-Free America and Metlife Foundation
2009 Parents and Teens Attitude Tracking Study Report, 3/2/10
Teens Perceptions
• Decrease in learning from parents,
schools and media about the risks of using
alcohol and drugs between 2008 – 2009.
• Less exposure to anti-drug commercials
on TV between 2004-2009.
Partnership for a Drug-Free America and Metlife Foundation
2009 Parents and Teens Attitude Tracking Study Report, 3/2/10
Parent Education
• Only 7% of parents thought that teens
might use drugs to deal with stress
– 73% of students reported the top reason for
using drugs was to cope with school pressure.
• Parents often have a hard time accepting
that their teen may have a problem.
• Parents may ascribe the regular use of
drugs by their teens as normal teenage
experimentation
Partnership for a Drug-Free America and Metlife Foundation
2009 Parents and Teens Attitude Tracking Study Report, 3/2/10
Parent Education
• Parents of teens who use drugs more
regularly may feel that they have no
influence on their teen’s decision and do
not feel that they can enforce any rules
about substance abuse.
Partnership for a Drug-Free America and Metlife Foundation
2009 Parents and Teens Attitude Tracking Study Report, 3/2/10
Need to Increase
Parental Involvement
• Only 31% of teens “learn a lot
about the risk of drugs” from
their parents.
Source: Partnership Attitude Tracking Study 2006
Rx and OTC Medicine Abuse
Education Campaign
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Multi-media public service advertising
National consumer public relations (parents)
Web-based parent resources
Interactive teen web-site
Parent brochure, hard copy and online
Research tracking and evaluation
www.drugfree.org
Partnership for a Drug-Free America
www.drugfree.org
• Teachable Moments
• Show Kids You Care
• Tips for Talking: Approach Your Teen About
Their Possible Alcohol and Drug Use
• Know What Drugs Kids Face Today
www.drugfree.org
• Time To Act
– Step by step guidance from experts in the
field of substance abuse for parents who have
concerns about their teen.
On September 25, 2010, DEA will coordinate a collaborative effort with
state and local law enforcement
agencies to remove potentially dangerous controlled substances
from our nation’s medicine cabinets.
Collection activities will take place from 10:00 a.m. through 2:00 p.m.
at sites established throughout the country.
The National Take-Back Day provides an opportunity for the public to surrender expired,
unwanted, or unused pharmaceutical controlled substances
and other medications for destruction.
These drugs are a potential source of supply for illegal use and
an unacceptable risk to public health and safety.
This one-day effort is intended to bring national focus to the issue
of increasing pharmaceutical controlled substance abuse.
The program is anonymous.
Prescription and over the counter solid
dosage medications, i.e. tablets and
capsules accepted.
Intra-venous solutions, injectables, and
needles will not be accepted.
Illicit substances such as marijuana or
methamphetamine are not a part of this
initiative.
National Drug Intelligence Center
National Prescription Drug Threat
Assessment 2009
April 2009
Teens and Prescription
Drugs
Office of the National Drug Control Policy
Executive Office of the President
January 2008
Executive Summary
• Teens are turning away from street drugs
and using prescription drugs to get high.
New users of prescription drugs have
caught up with new users of marijuana.
• Next to marijuana, the most common
illegal drugs teens are using to get high
are prescription medications.
Executive Summary
• Teens are abusing prescription drugs
because they believe the myth that these
drugs provide a medically safe high.
• The majority of teens get prescription
drugs easily and for free, often from
friends and relatives.
Executive Summary
• Girls are more likely than boys to
intentionally abuse prescription drugs to
get high.
• Pain relievers such as Oxycontin and
Vicodin are the most commonly abused
prescription drugs by teens.
• Adolescents are more likely than young
adults to become dependent on
prescription medication.