Although teens are turning away from street drugs, now
there's a new threat and it's from the family medicine cabinet: The abuse of
prescription (Rx) and over-the-counter (OTC) drugs.
Parents and caregivers are the first line of defense in
addressing this troubling trend.
The problem with teens abusing prescription drugs is more
common than many parents think. More teens are abusing prescription drugs than
any illicit drug except marijuana. In 2006, more than 2.1 million teens ages 12
to 17 reported abusing prescription drugs.1
And among 12- and 13-year-olds, prescription drugs are the drugs of choice.2
What's the problem?
Teens are abusing some prescription and over-the-counter
drugs to get high. This includes painkillers,
such as those drugs prescribed after surgery; depressants, such as sleeping pills or anti-anxiety
drugs; and stimulants,
such as those drugs prescribed for attention deficit hyperactivity disorder
(ADHD). Teens are also abusing over-the-counter drugs, such as cough and cold
Every day 2,500 youth age 12 to 17 abuse
a pain reliever for the very first time. More teens abuse prescription drugs
than any illicit drug except marijuana. In 2006, more than 2.1 million teens
ages 12 to 17 reported abusing prescription drugs.1
Among 12- and 13-year-olds, prescription drugs are the drug of choice.2
Because these drugs are so readily available, and many
teens believe they are a safe way to get high, teens who
wouldn't otherwise touch illicit drugs might abuse prescription drugs. And not
many parents are talking to them about it, even though teens report that
parental disapproval is a powerful way to keep them away from drugs.3
What are the dangers?
There are serious health risks related to abuse of
prescription drugs. A single large dose of prescription or over-the-counter
painkillers or depressants can cause breathing difficulty that can lead to
death. Stimulant abuse can lead to hostility or paranoia, or the potential for
heart system failure or fatal seizures. Even in small doses, depressants and
painkillers have subtle effects on motor skills, judgment, and ability to
The abuse of OTC cough and cold remedies can cause blurred
vision, nausea, vomiting, dizziness, coma, and even death. Many teens report
mixing prescription drugs, OTC drugs, and alcohol. Using these drugs in
combination can cause respiratory failure and death.
Prescription and OTC drug abuse is addictive. Between 1995
and 2005, treatment admissions for prescription painkillers increased more than
Teens are abusing a variety of prescription drugs to get
What are painkillers or opioids?
Opioids are drugs that contain opium or are derived
from and imitate opium. They are prescribed for pain relief and are only
available by prescription. Most opioid or painkilling
drugs are non-refillable and, when used properly under a medical doctor's
supervision, are safe and effective.1
Opioid drugs act by effectively changing the way a
person experiences pain.2
Morphine derivatives (or "narcotics") come from opioids and are used to therapeutically treat pain,
suppress coughing, alleviate diarrhea, and induce anesthesia. When using these
narcotics, abusers experience a general sense of well-being by reduced tension,
anxiety, and aggression.3
Examples of Painkillers
Some of the most well-known painkillers are listed below
with the names you might find on a prescription label. Note that although
painkillers have different potencies and are taken in different ways, when they
are abused, all pose a risk for addiction and other serious effects.
Codeine: like morphine, this is found in opium, is weaker in action than morphine, and is used especially as a painkiller.
Fentanyl (and fentanyl analogs): a man-made opioid painkiller similar to morphine that is administered as a skin patch or orally.
the powerful, active ingredient of opium is used as a painkiller and
from the opium poppy, formerly used in medicine to soothe pain but is now
often replaced by derivative alkaloids (as morphine or codeine) or man-made
Hydrocodone: often combined with acetaminophen for use as a painkiller. Vicodin is an example.
Oxycodone: a narcotic painkiller, for example OxyContin, Percocet, and Percodan.4
Painkillers like OxyContin and Vicodin are the prescription drugs most commonly abused by
teens. In fact, within the past year nearly one in 10 high school seniors has
abused Vicodin and more than five percent of seniors
have abused OxyContin.5
Painkillers are also the most abused type of prescription
drugs by 16- to 17-year-olds, followed by stimulants, tranquilizers, and
Almost two out of five teens report having friends that abuse prescription painkillers
and nearly three out of 10 report having friends that abuse prescription
How Do Teens Take Painkillers?
There are several ways painkillers can be taken. Most
teens report swallowing pills, but they can also be crushed and snorted for an
Signs and Symptoms
Painkillers can cause drowsiness, inability to concentrate, apathy, lack of
energy, constriction of the pupils, flushing of the face and neck,
constipation, nausea, vomiting, and most significantly, respiratory depression.9
If a teen abuses painkillers for a period of time, he
can become addicted to the drug and experience withdrawal symptoms when he stops
taking the drug. Associated with addiction is tolerance, which means more and
more of the drug or a combination of drugs is needed to produce the same high
or euphoric feeling, possibly leading to overdose.10
Potential Drug Interactions
Always consult your teens' physician before giving them
any medicines if they are already taking a prescribed painkiller or other
medication, as it may be dangerous to use them together. Painkillers should not
be used with alcohol, antihistamines, barbiturates, or benzodiazepines. Since
these substances slow breathing, their combined effects could lead to
life-threatening respiratory depression.11
What Is a Painkiller Overdose?
Physical signs of painkiller overdose include pinpoint
pupils, cold and clammy skin, confusion, convulsions, severe drowsiness, and
slow or troubled breathing.12
What Is Painkiller Withdrawal?
Due to the physical dependence produced by chronic use of opioid painkillers, teens who are
prescribed opioid medications need to be monitored
not just when they are appropriately taking the medicine, but also when they
stop using the drug to reduce or avoid withdrawal symptoms. Symptoms of
withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea,
vomiting, cold flashes, and involuntary leg movements.13
Street or Slang Terms for Painkillers
Oxies, OC, oxycotton, 80s, percs, vikes, and vikings are commonly used terms to refer to painkillers.
Depressants, or downers, are often prescribed by doctors
to treat a variety of health conditions including anxiety and panic attacks,
tension, acute stress reactions, and sleep disorders. When given in high doses,
depressants may act as anesthesia.1
Often referred to as sedatives and tranquilizers,
depressants are substances that can slow normal brain function.2
Most depressants reduce brain function through a neurotransmitter called gammaaminobutyric acid (GABA) which is a chemical that
enables communication between brain cells.
While different depressants work in unique ways, they
produce a drowsy or calming effect that can help those suffering from anxiety
or sleep disorders.3
Because they can produce a state of intoxication, they have a high potential
Examples of Depressants
Barbiturates are a type of depressant often prescribed to
Benzodiazepines are a type of depressant prescribed to relieve anxiety.6
Depressants such as sedatives and tranquilizers have been
growing in popularity among teens. In 2007, six percent of high school seniors
reported abusing depressants including Valium and Xanax,
compared to four percent in 1995.7
Signs and Symptoms
Depressants have the potential for abuse and should be
used only as prescribed.
Be on the lookout for these side effects:
side effects include dilated pupils and slurred speech; relaxed muscles;
intoxication; loss of motor coordination; fatigue, respiratory depression;
sensory alteration; and lowered blood pressure.8
Teens taking barbiturates may exhibit side effects such as slurred speech,
dizziness, sedation, drowsiness, and fever.9
side effects include poor concentration or feelings of confusion; impaired
judgment; and lowered inhibitions.10
Teens on barbiturates may experience depression, fatigue, confusion, and
If you have observed any of the symptoms or side effects
listed above, contact a medical professional immediately.
Withdrawal symptoms include anxiety, insomnia, muscle
tremors, and loss of appetite. Going "cold-turkey" off of some
depressants can have life-threatening complications, cause convulsions,
delirium, and in rare instances, death.12
Because all depressants work by slowing the brain's
activity, when someone stops taking them, the brain's activity can rebound and
race out of control, possibly leading to seizures and other serious
Symptoms including shallow breathing, clammy skin, dilated
pupils, weak and rapid pulse, coma, or death.
Interactions with Depressants
Depressant abuse is often combined with the use of other
drugs like alcohol, other prescription drugs, over-the-counter drugs, and
street drugs like marijuana.
Combining these substances can be highly dangerous:
Using depressants with alcohol can slow both the heart and breathing and may
lead to death.14
When combined with alcohol, the effects and risks of depressants are seriously
Some interactions with other drugs can be risky. Depressants should be used in
combination with other medications only under a physician's close supervision.15
Depressants should not be combined with any other medication or substance that
causes central nervous system depression, including some over-the-counter cold
and allergy medications.16
Doing so may slow the heart and breathing, a serious health risk.
Street or Slang Terms for Depressants
Benzos, xanies, xani-bars, xani-bombs, and roofies are commonly used terms to refer to depressants.
Stimulants are sometimes prescribed by doctors to treat
conditions such as asthma, respiratory problems, obesity, attention
deficit/hyperactivity disorder (ADHD), and sleep disorders like narcolepsy.
This class of drug is often abused for its ability to
produce euphoric effects or to counteract sluggish feelings induced by
tranquilizers or alcohol.1
In the hands of teens, stimulants are taken to stay awake, increase alertness
and concentration, boost energy, and get high. Sometimes teens go beyond swallowing
these pills. If they are prescribed drugs for ADHD, they can save up their
pills during the week and share them with friends at weekend parties. They then
crush and snort them, or mix with alcohol. Teens also report saving and selling
their own ADD drugs around exam time.
Examples of Stimulants
and dextroamphetamine are stimulant drugs whose
effects are similar to cocaine.2
is a highly addictive stimulant drug that is part of a larger family of
is a central nervous system stimulant. It has effects similar to, but
stronger than, caffeine and less potent than amphetamines.4
Do you suspect your teen is abusing stimulants? If so,
there are a number of symptoms and side effects to look for:
side effects include dilated pupils; decreased appetite; loss of
coordination; collapse; increased heart and respiratory rates; elevated
dizziness; tremors; headache; flushed skin; chest pain with palpitations;
excessive sweating; vomiting; and abdominal cramps.6
side effects include feelings of restlessness, anxiety, and delusions;7
hostility and aggression; and panic, suicidal, or homicidal tendencies.
Paranoia, often accompanied by auditory and visual hallucinations, may
If you have observed any of the symptoms or side effects
listed above, be mindful of the possibility of withdrawal or overdoses, as
Withdrawal symptoms associated with discontinuing
stimulant use may include depression, disturbance of sleep patterns, fatigue,
Overdose or death is preceded by high fever, convulsions,
and heart failure. Since death in these cases is partially due to strain on the
heart, physical exercise increases the risks of stimulant use.10
Interactions with Stimulants
Stimulant abuse often goes along with the use of other
substances like alcohol, other prescription drugs, over-the-counter drugs, and
the use of illegal substances like marijuana.
Did you know:
Teens who use alcohol and stimulants together are likely to drink more before
feeling the effects of alcohol because of the stimulant effects. The result?
When the stimulant effect(s) wear off, the alcohol kicks in.11
Stimulants should only be used in combination with other medications under a
physician's careful supervision.12
There are dangers associated with mixing stimulants and over the counter drugs
that contain decongestants. Blood pressure can become dangerously high or lead
to irregular heart rhythms.13
Street or Slang Terms for Stimulants
Ritz, rippers, dexies, and bennies are commonly used terms to refer to stimulants.