The misuse of prescription medications by adolescents is surpassed only by illicit use of alcohol, tobacco, and marijuana. A study to be published in the August 2009 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) shows that how an adolescent obtains these prescription drugs may signal the likelihood that an adolescent will be concurrently abusing another substance and the severity of substance abuse and prescription misuse.

Drs. Ty Schepis and Suchitra Krishnan-Sarin at the Yale University School of Medicine used data from the 2005 and 2006 National Survey on Drug Use and Health (NSDUH), to show that across all classes of medications (opioids, stimulants, tranquilizers, and sedatives) nearly 50 percent were obtained from friends or families for free. With the exception of opioids, the second most common source was by purchasing the drug from friends or relatives (13.1% - 29.7%) or from a drug dealer (4.6% - 12.0%). For opioids, the second most common source was from a physician. The misuse of opioids, stimulants, tranquilizers, and sedatives poses significant risk for physical and/or psychological dependence as well as overdose.

In the article titled, "Sources of Prescriptions for Misuse by Adolescents: Differences in Sex, Ethnicity, and Severity of Misuse in a Population-Based Study," the authors used regression analyses, to offer "…preliminary evidence that the group with greatest odds of concurrent other substance use may be those who purchased their medication for misuse from friends, family or drug dealers. In comparisons with adolescents who misused medication obtained from a physician, adolescents who buy medication are more likely to have endorsed binge alcohol use (opioids and tranquilizers), daily cigarette use (opioids and stimulants), past month marijuana use (all three classes examined), and past year cocaine use (opioids and stimulants)."

Addressing the concern of identifying at risk youths, Schepis said, "In addition to assessing whether or not child and adolescent patients are misusing addictive prescription medications, it also appears important for clinicians to assess how these medications are obtained. Such information may help determine which patients are most likely to have substance use problems or depressive symptoms."

Follow up data from the 2007 National Survey on Drug Use and Health (NSDUH), shows that among persons aged 12 or older in 2007 who used pain relievers nonmedically in the past 12 months, 56.5 percent got the pain relievers they most recently used from a friend or relative for free. Another 8.9 percent bought them from a friend or relative, and 5.2 percent reported stealing them from a friend or relative. Nearly one fifth (18.1 percent) indicated that they got the drugs from one doctor. Around 1 in 20 users (4.1 percent) got pain relievers from a drug dealer or other stranger, and 0.5 percent said they bought them on the Internet.

The National Survey on Drug Use and Health (NSDUH) is conducted by Substance Abuse and Mental Health Services Administration (SAMHSA) under the Department of Health and Human Services and provides national and state-level data on the use of illicit and non-medical prescription drugs in the United States on an annual basis.

The study findings by Drs. Schepis and Krishnan-Sarin were supported in part by National Institutes of Health grant T32-DA007238. The National Survey on Drug Use and Health is sponsored by the Substance Abuse and Mental Health Services Administration.

The study is published in the Journal of the American Academy of Child and Adolescent Psychiatry and online.

References

Schepis TS, Krishnan-Sarin S. Sources of Prescriptions for Misuse by Adolescents: Differences in Sex, Ethnicity, and Severity of Misuse in a Population-Based Study. Journal of the American Academy of Child and Adolescent Psychiatry. 2009; 48: 828-836.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies (2008).
Results from the 2007 National Survey on Drug Use and Health: National Findings (NSDUH Series H-34, DHHS Publication No. SMA 08-4343). Rockville, MD.

Source
The Journal of the American Academy of Child and Adolescent Psychiatry