COMMENTARY

Teen Prescription and Over-the-Counter Drug Abuse

Kate Driscoll-Malliarakis, MSM, CNP, MAC

Disclosures

December 09, 2009

In This Article

Stopping Prescription Drug Abuse

The Role of Parents

The challenge for parents is to become aware of the problem, remain vigilant, and to educate themselves about the various means through which their children may be putting themselves at risk with prescription and OTC drugs. Parents may simply not be aware of the consequences of this type of abuse. Despite the increase in parent-teen discussions about the risks for drugs, many parents may not be discussing the risks of abusing prescription and OTC medicines with their children. Only 24% of teens have reported that their parents had talked with them about the dangers of abusing prescription drugs or the use of medications outside of a clinician's supervision, and just 18% of teens have indicated that their parents had discussed the risks of abusing OTC cough medicine.[6] Prescription and OTC drug misuse often begins innocently with teens "borrowing" medications from each other. Recent research found that approximately 20% of adolescents have shared prescription medications.[10]

The Partnership for a Drug-Free America recommends a 3-step approach: (1) educate; (2) communicate; and (3) safeguard. Parents are encouraged to:

  • Educate themselves about which medications can be misused or abused, and learn about the very real dangers and risks of this behavior;

  • Communicate these risks to their kids, dispelling the notion that medicines can be safely abused; and

  • Safeguard medications by limiting access to those that can be abused, keeping track of quantities, and safely disposing of medications that are no longer needed. Parents should also enlist the support of fellow parents to ensure that they do the same.

Role of Health Practitioners

Communication, honesty, and vigilance are the keys to success for healthcare professionals who treat teens. Practitioners should talk with adolescents directly to ascertain whether they are misusing or abusing prescriptions or other drugs. Questions that can be asked include:

  • What cold preparations do you use? How often?

  • What do you take when you have pain? How often?

  • Do you borrow medications from your friends or family? If so, what have you taken? How much?

  • Do you or your friends use OTC drugs to get high?

  • Do you or your friends take prescription medications to get high?

It is important to address the health and safety risks that such practices present. For example, "borrowing" prescriptions, such as antibiotics, exacerbates antibiotic resistance. "Sharing" acne medication is dangerous because these drugs contain teratogens.[10] Research has demonstrated that education for teens must be reinforced over several encounters.[11] This reinforcement includes illustrations, repetition, and having the patient paraphrase messages from the healthcare practitioner. For example, practitioners can explain the pathology of a young person's illness, along with how the medication will help it. Asking the adolescent patient to repeat back instructions for taking medications is important because this locks in the message.[11] This type of dialogue also allows the adolescent to participate in the treatment process.

Parents must be counseled to handle their own prescription medications carefully, by counting the number of pills and placing them in secure locations. Assisting parents to talk with their teens about alcohol and other drug abuse, including prescription and OTC drug misuse, is of critical importance. Parents need to familiarize themselves with the side effects of all prescription and OTC preparations that they bring into their homes. For example, parents should learn and teach their children about the dosages and side effects of the drugs that they take, such as which drugs can cause drowsiness and the possibility of stomach bleeding from taking aspirin. Parents can talk with their teenagers about the potential drug interactions that occur when drugs are shared or taken without checking with parents first.

Can prescription and OTC drug abuse be eliminated? Probably not; however, education, awareness, and clear communication with teens can go a long way to control the problem.

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