PREVENTING PRESCRIPTION DRUG ABUSE AMONG ADOLESCENTS

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Abstract

The goal of this capstone paper is to present current and up to date research on prescrip$on drug abuse

and addiction as it relates to the specific population of adolescents. Prescrip$on drug abuse presents a

major concern to professionals at varying degrees, but the purpose of this paper it to give School

Counselors an overview of how to detect possible drug abuse, intervene appropriately, consult fellow co–

workers, administrators, and community personnel, empower others to make a change, and prevent at

risk students who exhibit signs of eventual addiction. A thorough evalua$on of the history, sta$s$cs,

dangers, and presen$ng problems of prescrip$on drugs is also discussed. This paper also takes into

considera$on ways of assessing prescrip$on drug abuse and addiction. These assessments can be found

in Appendix A and B. Finally, this paper serves as a way to help School Counselors be aware of this

increasing problem and forming a preven$on team by creating a collabora$ve approach with others

involved; other preven$on aspects are explored.

Drug abuse represents an overwhelmingly dangerous trend among adolescents with prescrip$on drugs

being a major culprit at this age level (Manchikan$, Fellow, Allinani, & Pampa$, 2010; Weigel, Donovan,

Krug, & Dixon, 2007; SAMHSA, 2010). The problem with most of these trends is the ever-increasing

accessibility to prescrip$on drugs, and their use for reasons other than the prescribed treatment.

Research clearly states that parents, educators, and other health professionals need to be cognizant of

the fact that “when prescrip$on drug abuse occurs before age 16, there is an increased risk for addiction

and abuse of psychotherapeu$c drugs later in life” (Jones, Fullwood, & Hawthorn, 2012, p.13). Jones et

al. (2012) also state prescrip$on drug abuse as a major social problem and concern for counselors.

According to the American Psychiatric association (2013), it is the most prevalent mind disorder,

encompassing some 40 percent of the diagnoses in the DSM-V. Inaba and Cohen (2011) call it the

number one con$nuing health problem, as well as the number one prison problem in the United States.

SAMHSA (2008) found that adolescents are at the greatest risk for prescrip$on drug abuse than at any

other $me in their lives. The number of teens and young adults (ages 12 to 25) who were new abusers of

prescrip$on painkillers grew from 400,000 in the mid-’80s to 2 million in 2000 (SAMHSA, 2008). Drugs

can aFect the central nervous system and it is this system that helps us gather and process informa$on

from the outside world. It is also responsible for our emotional and physical responses to our

environment. Scien$sts have made great advances in understanding brain function and as a result, a

number of drugs have been developed to treat such condition as depression and anxiety (Hunter, 2013).

Hunter also mention that while these prescrip$on drugs can improve the pa$ent’s quality of life, the

misuse of these drugs can have just the opposite eFect. Repeated misuse of prescrip$on drugs can

actually alter the normal chemical balance in the brain. This can result in a physical dependence on the

drug. This is a very important issue and one that experts and researchers say needs to be addressed and

dealt with in order help assure that our youth popula$on stays drug free, and more importantly,

addiction free.

It is important to understand and dis$nguish these terms, as most people tend to use them

synonymously (DSM-5, 2013). ASAM (2011) de%nes addiction as “a primary, chronic disease of brain

reward, mo$va$on, memory and related circuitry.” NIDA (2011, Drug Facts) de%nes addiction as a

chronic, oHen relapsing brain disease that causes compulsive drug seeking and use despite harmful

consequences to the addicted individual and those around him or her. When a drug is taken in a way for

which it is not intended, it is classified as drug abuse; this is a general de%ni$on found from numerous

websites, such as NIDA and other sources.

The national Ins$tute on Drug Abuse (NIDA, 2011) de%nes prescrip$on drug abuse as the inten$onal use

of a medica$on without a prescrip$on; in a way other than as prescribed; or for the experience or

feeling it causes. It is not a new problem, but one that deserves renewed aIen$on. Prescrip$on drug

abuse is a lot diFerent than being able to obtain an over-the-counter (OTC) drug as well. OTC’s can be

obtained without a prescrip$on; laws regulate prescrip$on drugs. “A person who needs one of these

drugs requires an oJcial note, or prescrip$on, from a licensed doctor in order to obtain and use it. Over

the last few decades, Americans have turned to thousands of new prescrip$on drugs to help them deal

with physical and mental health problems” (Fitzhugh, 2006, p. 5). Hamilton (2009) also found it

important to say prescrip$ons for nonmedical uses of specific drugs are wriIen by a rela$vely small

number of physicians who put themselves at risk of losing their medical license for providing drugs for

substance abuse. For beIer or for worse, these medica$ons have become an accepted part of our

society; it is creating a dilemma for many other physicians in the profession of prescribing medicine. How

can we make such medica$ons readily available for being used therapeu$cally while limi$ng access for

non-therapeu$c misuse or abuse? According to Clark and Bizzell (2005), “such a dilemma poses

challenges very diFerent from those raised by illicit drugs, because control of prescrip$on drugs must be

achieved without impeding patient’ access to needed medical care” (p. 262).

According to NIDA (2011) the most commonly abused prescrip$on drugs can be classified in one of three

groups: opioid painkillers, depressants, and s$mulants. Kirsh, Passik and Savage (2008) explain that

opioids are normally prescribed to help a person suFering from pain, whether it is chronic pain, or

temporary pain from a past or present medical procedure or illness. Another author explains that

painkillers, or opioids, represent a large population of abuse by adolescents for nonmedical use.

Rozenbroek and Rothstein (2011) state that opioids are a type of prescrip$on drug which are prescribed

for pain relief and can produce euphoria or a sense of well-being when used nonmedically. Commonly

abused painkillers include OxyCon$n, Vicodin, Morphine and Demerol. What makes these so popular is

the intense feeling of pleasure or rush people get from their eFects. Their pleasurable eFects oHen

derive from their ability to s$mulate the brain’s pleasure circuits, which are similar to the feelings of

sexual pleasure or pleasure from ea$ng a sa$sfying meal (Begley, 2001). Adding to the problem is that

prescrip$on opioids can become drugs of abuse when they are used illicitly as street drugs (Friedman,

2006). A survey by Friedman revealed approximately 5.5% of high school seniors report using opioids like

OxyCon$n and Vicodin for use other than prescribed (2006).

A second category of prescrip$on drugs is used to treat sleep disorders, anxiety, and panic aIacks. These

are commonly referred to as central nervous system depressants, or “downers.” Two of the most popular

ones are Valium and Xanax. Both of these prescrip$on medica$ons can be highly addic$ve if abused. For

Central Nervous System (CNS) depressant abusers, the situa$on is likely more complicated based on the

fact that abusers are also hooked on alcohol or other drugs as well. “On any given day, 100 million

American are taking some s$mulant, an$depressant, tranquilizer, or painkiller; smoking; inhaling from

aerosol cans or glue boIles; or self-medica$ng with alcohol or illegal substances like marijuana, cocaine,

heroin, methamphetamines, hallucinogens, Ecstasy, and other designer drugs” (Califano Jr., 2007, p. 1).

Clearly an ongoing problem for most abusers, misuse of depressants when mixed with alcohol can be

extremely dangerous, especially when overdosed (APA, 2013).

A third category of commonly abused prescrip$on drugs is called central nervous system s$mulants, or

“uppers.” Their eFect on the body is not too diFerent from that of cocaine or methamphetamines. Some

common types of s$mulants being abused are Concerta, Dexedrine, Adderall and Ritalin. Of the drugs in

this group, Ritalin is perhaps the most widely abused and most likely to be illegally distributed. “Studies

have reported that 16-20% of school-aged teenagers prescribed Ritalin for ADHD have been approached

to sell, give away, or trade their medica$on” (Askenasy, Taber, Yang, & Dafny, 2007, p. 774). Ritalin is a

very controversial drug on the market right now due to its availability; nega$ve availability that is. When