Approaches to preventing prescription drug abuse discussed

An interview with Carol J. Boyd, PhD, MSN, FAAN, is Research Professor at the University of Michigan Substance Abuse Research Center

Join Together:

You have done quite a bit of research on drug use among 12 to 17 year olds. Why do you believe it is important to focus on that age group when it comes to Rx abuse?

CB:

Substance use disproportionately starts between the ages of 12 to 25. When we look at National Survey on Drug Use and Health (NSDUH) data, about 75 percent of the new users of prescription pain killers are under the age of 25 and about 38 percent are under the age of 18. Adolescents are prescribed controlled medications but are not taught about the risk associated with their use - including the risks associated with diversion. Thus, the highest risk groups for nonmedical use of controlled medications are young adults, followed by adolescents.

Join Together:

Why has Rx drug use has become such a major part of teens' repertoire?

CB:

It is not entirely clear why prescription medication misuse and abuse has increased, while other forms of drug use have decreased. However, several issues appear to be interacting to create this problem. These include: increased availability due to increases in prescribing controlled medications to adolescents; perceptions that prescription drugs generally are safer than street drugs; changing attitudes toward the use of medications because of direct-to-consumer marketing (DTC) and the Internet, where adolescents can quickly learn about medications and how to use them to self-treat and get high.

Join Together:

Can you tell us a little bit about diversion of prescription drugs among adolescents - who is most likely to divert medications and what their likely motive is for diversion?

CB:

National and regional data show that most nonmedical users get their pills from peers and/or parents and siblings. Our data show that although most adolescents use their medications correctly, some adolescents divert their own medications to friends and family members and if they divert, they are also more likely to use marijuana and other drugs.

Approximately 10 percent of adolescents have diverted pain medications and 15 percent stimulant medications. Like other researchers, we found that girls, when compared to boys, reported higher lifetime rates for giving or loaning medications (27.5 percent vs. 17.4 percent) and they were significantly more likely to divert to their girlfriends (64.0 percent vs. 21.2 percent). In contrast, boys were more likely to divert their controlled medications to their male friends (45.5 percent vs. 25.6 percent. Approximately 10 percent divert their pills to their parents. Overall, 13 percent of adolescents in our most current studies divert their controlled medicines and approximately 16 percent of adolescents with legal prescriptions are asked to divert, it is usually stimulants that are requested.

Join Together:

The research that you presented at the recent Surgeon General's meeting touched on the role of parental monitoring in preventing drug use. How important do you think parental monitoring is and is it equally effective when it comes to Rx abuse as it is with other drugs?

CB:

I believe that parental monitoring is the "key" to reducing the nonmedical use of prescription medications in ages 12 to 17 years. Our data show that general parental supervision is associated with lower rates of marijuana, alcohol and tobacco use; however this is not true for the nonmedical use of prescription medication.

Join Together:

What kind of different tactics do you think we need to employ to prevent abuse of Rx drugs?

CB:

Marketers know that before you send a message, one must know who is intended to receive the message - this goes for drug prevention messages as well. Prevention content must be age, gender and culturally appropriate. In general, adolescent girls are less likely to be risk takers and more likely to endorse high levels of social connection when compared to boys.

For this reason, I suggest that prevention experts take advantage of girls' desire to help friends and craft gender specific messages that highlight the harm that comes from sharing medications - even when the goal is to help a friend.