A number of national studies and published reports indicate that the intentional abuse of prescription drugs, such as pain relievers, tranquilizers, stimulants and sedatives, to get high is a growing concern -- particularly among teens -- in the United States. In fact, among young people ages 12-17, prescription drugs have become the second most abused illegal drug, behind marijuana. Though overall teen drug use is down nationwide and the percentage of teens abusing prescription drugs is still relatively low compared to marijuana use, there are troubling signs that teens view abusing prescription drugs as safer than illegal drugs and parents are unaware of the problem. This report examines this emerging threat by seeking to identify trends in the intentional abuse of prescription drugs among teens.

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.

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 or relatives.

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.

Prevalence and Incidence

Next to marijuana, the most common illegal drugs teens are using to get high are prescription medi- cations. Teens are turning away from street drugs and using prescription drugs to get high. Indeed, new users of prescription drugs have caught up with new users of marijuana.

For the first time, there are just as many new abusers (12 and older) of prescription drugs as there are for marijuana. (SAMHSA, 2006)

Among 12-17-year-olds, the gap between new marijuana users and new prescription drug users is shrinking. Between 2003 and 2005, the gap closed by 5.9 percent. In 2005, the estimated number of 12-17-year- olds who started using prescription drugs in the 12 months prior to the sur vey was 850,000, compared with 1,139,000 marijuana initiates. In 2003 the estimates were 913,000 for pre- scription drugs, compared to 1,219,000 mari- juana initiates. (NSDUH, 2004 and 2006)

Three percent, or 840,000 teens ages 12-17, reported current abuse of prescription drugs in 2005, making this illegal drug category the second most abused next to marijuana (7%). (NSDUH, 2006)

In 2005, 2.1 million teens abused prescription drugs. (NSDUH, 2006)

Teens ages 12-17 have the second-highest annual rates of prescription drug abuse after young adults (18-25). (SAMHSA, 2006)

Prescription drugs are the most commonly abused drug among 12-13-year-olds. (NSDUH, 2006)

Teens (12-17) and young adults (18-25) were more likely than older adults to start abusing prescription drugs in the past year. (SAMHSA, 2006)

One-third of all new abusers of prescription drugs in 2005 were 12-17-year-olds. (NSDUH, 2006)

Myth vs. Reality

Teens are abusing prescription drugs because they believe the myth that these drugs provide a medically safe high.

Nearly one in five teens (19% or 4.5 million) report abusing prescription medications that were not prescribed to them. (PATS, 2006)

Teens admit to abusing prescription medicine for reasons other than getting high, including to relieve pain or anxiety, to sleep better, to experiment, to help with concentration or to increase alertness. (Boyd, McCabe, Cranford and young, 2006)

When teens abuse prescription drugs, they often characterize their use of the drugs as responsible, controlled, or safe, with the perception that the drugs are safer than street drugs. (Friedman, 2006)

More than one-third of teens say they feel some pressure to abuse prescription drugs, and nine percent say using prescription drugs to get high is an important part of fitting in with their friends. (Seventeen, 2006)

Four out of 10 teens agree that prescription medicines are much safer to use than illegal drugs, even if they are not prescribed by a doctor. (PATS, 2006)

One-third of teens (31% or 7.3 million) believe there's nothing wrong with using prescrip- tion medicines without a prescription once in a while. (PATS, 2006)

Nearly three out of 10 teens (29% or 6.8 million) believe prescription pain relievers -- even if not prescribed by a doctor -- are not addictive. (PATS, 2006)

Accessibility and Availibility

The majority of teens get prescription drugs easily and for free, often from friends and relatives.

Nearly half (47%) of teens who use prescription drugs say they get them for free from a relative or friend. Ten percent say they buy pain relievers from a friend or relative, and another 10 percent say they took the drugs without asking. (NSDUH, 2006)

More than three in five (62% or 14.6 million) teens say prescription pain relievers are easy to get from parents' medicine cabinets; half of teens (50% or 11.9 million) say they are easy to get through other people's prescriptions; and more than half (52% or 12.3 million) say prescription pain relievers are available everywhere. (PATS, 2006)

The majority of teens (56% or 13.4 million) agree that prescription drugs are easier to get than illegal drugs. (PATS, 2006)

More teens have been offered prescription drugs than other illicit drugs, excluding mari- juana. Fourteen percent of 12-17-year-olds have been offered prescription drugs at some point in their lives, compared to 10 percent of teens who have been offered cocaine, ecstasy (9%), methamphetamine (6%) and LSD (5%). (CASA, 2006)

14-year-olds are four times more likely than 13-year-olds to be offered prescription drugs. (CASA, 2006)

Thirty-nine percent of 14-20-year-olds say it is easy to get prescription drugs online or by phone. Of that total, more girls than boys said it was easy (48% vs. 31%). (TRU, 2006)

Gender Differences

Girls are more likely than boys to intentionally abuse prescription drugs to get high.

Among 12-17-year-olds, girls are more likely than boys to have abused prescription drugs (9.9% of girls vs. 8.2% of boys), pain relievers (8.1% vs. 7.0 %), tranquilizers (2.6% vs. 1.9%), and stimulants (2.6% vs. 1.9%) in the past year. (SAMHSA, 2006)

Among 12-17-year-olds, girls had higher rates of dependence or abuse involving prescription drugs (1.8% for girls and 1.1% for boys), pain relievers (1.4% vs. 0.8%), tranquilizers (0.4% vs. 0.3%) and stimulants (0.5% vs. 0.3%) in the past year. (SAMHSA, 2006)

Types of Prescription Drugs Abused by Teens

Pain relievers such as OxyContin and Vicodin are the most commonly abused prescription drugs by teens.

Pain relievers are currently the most abused type of prescription drugs by 12-17-year-olds, followed by stimulants, tranquilizers and sedatives. (NSDUH, 2006)

Past-year use of Vicodin is high among 8th, 10th and 12th graders, with nearly one in 10 high school seniors using it in the past year. (MTF, 2006)

On average, almost four percent (3.5%) of 8th- 12th graders reported using OxyContin, and six percent reported using Vicodin in the past year. (MTF, 2006)

In 2006, past-year abuse of OxyContin among 8th graders exactly doubled, increasing 100 percent over the last four years (from 1.3% in 2002 to 2.6% in 2006). In 10th graders, past-year abuse of OxyContin increased by 26 percent (from 3.0% in 2002, to 3.8% in 2006). (MTF, 2006)

Five of the top six drugs abused by 12th grad- ers in the past year were prescription drugs or cough and cold medicines. (MTF, 2006)

Four percent of 8th graders, five percent of 10th graders, and seven percent of 12th graders reported taking medicines with dextrometho- rphan (DXM) during the past year to get high. (MTF, 2006)

Almost two out of five teens reported having friends who abused prescription pain reliev- ers and nearly three out of 10 reported having friends who abused prescription stimulants in the past year. (PATS, 2006)

Dependence and Treatment

Adolescents are more likely than young adults to become dependent on prescription medication.

In 2004, more than 29 percent of teens in treatment were dependent on tranquilizers, sedatives, amphetamines and other stimulants. (TeDS, 2004)

More 12-17-year-olds than young adults (18- 25) (15.9% vs. 12.7%) became dependent on or abused prescription drugs in the past year. (SAMHSA, 2006)

Abusing prescription drugs for the first time before age 16 leads to a greater risk of dependence later in life. (SAMHSA, 2006)

In the past year, nearly half (48%) of all emer- gency department (eD) visits resulting from dextromethorphan abuse were patients 12-20 years old. (DAWN, 2006)

Appendix: Definitions

Prescription drugs that are most commonly abused include three classes: opioids, central nervous system (CNS) depressants and stimulants.

  • Opioids are prescribed to alleviate pain. examples include oxycodone (OxyContin), propoxyphene (Darvon), hydrocodone (Vicodin), hydromorphone (Dilaudid) and meperidine (Demerol).
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  • CNS depressants slow normal brain function and are used to treat anxiety and sleep disorders. In higher doses, some CNS depressants can become general anesthetics. Tranquilizers and sedatives are examples of CNS depressants and include barbiturates (Amytal, Nembutal, Seconal, Phenobarbital), benzodiazepines (Valium, Xanax) and flunitrazepam (Rohypnol).
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  • Stimulants increase alertness, attention and energy, which are accompanied by increases in blood pressure, heart rate and respiration. Stimulants are prescribed to treat narcolepsy, attention-deficit hyperactivity disorder (ADHD) and depression that has not responded to other treatments. examples of prescription stimulants include amphetamines (Biphetamine, Dexedrine), cocaine (Cocaine Hydrochloride), methamphetamine (Desoxyn) and methylphenidate (Ritalin).

Dextromethorphan (DXM) is a cough suppressant found in many over-the-counter cough and cold remedies.

Nonmedical use, misuse and abuse of prescription drugs are all defined here as use of prescription medications without medical supervision for the intentional purpose of getting high, or for some reason other than what the medication was intended.

Current use refers to use of prescription drugs during the month prior to the survey interview.