Risk-taking tendencies, major depression, and other substance use problems
are some of the major risk factors linked to teens' misuse of prescription
drugs, a study in the July Journal of the American Academy of Child and
According to data collected in the 2005 National Survey on Drug Use and
Health (NSDUH), one in 12 adolescents aged 12 to 17 (8.2 percent) reported
having misused at least one prescription medication in the previous year. This
prevalence trailed only the use of alcohol, tobacco, and marijuana.
Misuse was defined as "any intentional use of a medication with
intoxicating properties outside of a physician's prescription for a bona fide
medical condition, excluding accidental misuse."
Opioids such as hydrocodone and oxycodone are by far the class of
medications most frequently misused by adolescents, followed by stimulants
(for example, amphetamines and methylphenidate), tranquilizers (including
benzodiazepines and muscle relaxants), and sedatives (for example,
In this study, Ty Schepis, Ph.D., and Suchitra Krishnan-Sarin, Ph.D., from
the Department of Psychiatry at Yale University School of Medicine found that
prescription drug misuse among adolescents was significantly linked to poor
academic performance, a major depressive episode in the past year, risk-taking
tendencies, a history of mental health treatment in the past year, and the
concurrent use of other substances, including cigarettes, alcohol, marijuana,
cocaine, or inhalants.
Thirty-six percent of these adolescents who misused medications had
symptoms that met one or more DSM-IV criteria for substance use
disorder. "It was somewhat unexpected to see that over a third of the
adolescents misusing prescription drugs have begun to develop symptoms of
dependence," Schepis commented to Psychiatric News.
The high rate of adolescents with co-existing substance use problems is
consistent with findings from other studies, the authors pointed out. They
urged clinicians to screen young patients routinely for possible prescription
misuse and educate parents about the high risk of such misuse.
"There is anecdotal evidence to suggest that prescription drugs are
perceived to be safer or less problematic than illicit substances,"
Schepis said. In addition, because prescription drugs are legal, teenagers may
have easier access to painkillers, stimulants, and tranquilizers than to
illegal substances, especially if parents are not monitoring their medicine
"We can combat the supply of illicit drugs, but it's a lot harder to
control the supply of prescription medications because they have legitimate
medical indications," he said.
Clinicians should be more proactive in educating parents and adolescents
about the dangers of misusing prescription medications, Schepis suggested,
especially considering the high prevalence of substance use disorder symptoms
among these teenagers.
Another notable finding was that adolescent girls had a slightly higher
prevalence of misusing opioids, stimulants, and tranquilizers than did their
male peers. This trend is consistent with some adult surveys that found a
higher rate of misusing prescription medications by women than by men.
The NSDUH is an annual in-home survey sponsored by the Substance Abuse and
Mental Health Services Administration that tracks trends in substance use
throughout the United States. The sample used in this study comprised 18,678
adolescents, and the results were extrapolated to population estimates. This
study was supported in part by a grant from the National Institutes of
"Clinicians must educate adolescents about the difference between
proper and improper use," said Schepis. "Adolescents may not fully
understand the potential harm in misusing prescription drugs like overdose and
An abstract of "Characterizing Adolescent Prescription
Misusers: A Population-Based Study" is posted at<www.jaacap.com/pt/re/jaacap/abstract.00004583-200807000-00006.htm>.▪