Prescription medication diversion, misuse common among adolescents
MedWire News: Study findings show that nearly one-quarter of adolescents misuse their prescribed controlled medications, often diverting their prescription and embarking on illicit drug use.
Sean McCabe (University of Michigan, Ann Arbor, USA) and co-authors say the study findings "indicate the need for clinicians to closely monitor prescribed controlled medications among adolescents, as well as the importance of detecting unusual patterns of use, especially for sleeping medication."
They add: "Clinicians and parents should educate adolescents to use prescribed medications correctly because their misuse could result in non-adherence or lack of therapeutic effect."
For the study, the team developed a web-based survey that was self-administered by 2744 secondary school students (aged on average 14.8 years) over a 5-month period during 2009-2010. The survey assessed medical use of controlled medications, and medical misuse and diversion (eg, selling their medication).
In total, 18% of surveyed adolescents reported past-year medical use of at least one prescribed controlled medication (pain, stimulant, sleeping, or anxiety drug), which was significantly higher among female compared with male adolescents (20.8% vs 15.1%, respectively).
Past-year medical use prevalence was highest for pain medication, at 14.2%, followed by 3.5% for stimulant medication, 2.2% for anti-anxiety medication, and 1.6% for sleeping medication.
Among past-year medical users, 22.0% reported misuse of their controlled medications. Misuse varied by medication class, ranging from 20.1% for pain medication to 43.9% for sleeping medication.
Adolescents who frequently used controlled medication (10 or more occasions in their lifetime) had a higher prevalence of misuse than those who used less frequently. Indeed, 36.4% of those who took frequent pain medication reported taking too much compared with 19.8% of those who took pain medication on 3-9 occasions and 14.4% of those who used it on one to two occasions.
Similar associations were observed for frequent users of sleeping and anti-anxiety medication, but not stimulants.
Misuse was also higher among users of multiple medication classes compared with those using only one medication classes, at 43.5% among 62 users of multiple medication, 18.0% among 316 users of pain medication only, and 14.0% among 57 users of stimulant medication only.
Regression analysis showed that the likelihood of a positive screening result for drug use among medical misusers was 7.8-fold higher compared with medical users who used their medication appropriately after controlling for gender, race/ethnicity, school district, and grade level.
Furthermore, substance use and abuse outcomes were not significantly different between past-year medical users and nonusers regardless of medication class.
Medical misusers also had a significantly higher prevalence of diversion of controlled medications than medical users who took their medication appropriately, with the odds of any form of diversion being 4.3-fold higher.
Writing in the Archives of Pediatric & Adolescent Medicine, the team concludes: "Clinicians should consider prescribing controlled medications with less potential for substance abuse and diversion. Careful therapeutic monitoring, centralized prescription databases, and increased patient education could facilitate reductions in medical misuse, nonmedical use, and diversion of controlled medications among adolescents."
By Ingrid Grasmo