MONDAY May 7, 2012 — Among U.S. adolescents, misuse of prescription painkillers peaks at age 16, earlier than thought, a new large survey analysis reveals.
“What our findings suggest is that if we wait until the last year of high school or college to take some kind of action that could prevent the misuse of opioid painkillers, it’ll be a case of too little, too late,” cautioned study co-author James Anthony, a professor of epidemiology and biostatistics in the department of epidemiology and biostatistics at Michigan State University in East Lansing.
Many experts consider “extramedical” painkiller abuse — taking pain drugs such as OxyContin (oxycodone) and Vicodin (hydrocodone) to get high rather than to relieve extreme pain — the country’s most serious drug challenge. Some kids had already misused these drugs by age 13 or 14, or eighth grade, the researchers found.
Anthony and his colleagues discuss their work, co-funded by the university and the U.S. National Institute on Drug Abuse, in the May 7 online edition of the Archives of Pediatrics & Adolescent Medicine.
Concerned by rising rates of painkiller prescriptions and related overdoses, the team analyzed information gathered between 2004 and 2008 by the National Survey on Drug Use and Health. The information was self-reported by nearly 120,000 males and females between 12 and 21 years old.
The authors found that while roughly one in 60 kids between 12 and 21 initiates prescription pain reliever abuse at some point in that age range, the risk for doing so peaks at about 2.5 percent by age 16.
Approximately one in 30 to 40 young people initiated such abuse at 16, a rate higher than that reported by the 12- to 14-year-old set or 19- to 21-year-olds, the researchers said.
All of the respondents reported that up until the year they participated in the poll they had not previously used pain relievers not prescribed for them.
The team cautioned that the findings are based solely on participants’ recollections of abuse, rather than on medical testing. As well, the overall pool of people surveyed could have been skewed by an unwillingness on the part of potential abusers to get involved in such a poll.
The authors warned that their findings highlight a weakness in public health strategies that take sole aim at college-age drug abusers, given that the roots of the problem seem firmly planted among younger students.
Dr. Marc Galanter, director of the division of alcoholism and substance abuse within the psychiatry department at New York University Langone Medical Center in New York City, agreed that the current analysis “correctly points to the need for prevention and early intervention.”
“Prescription pain relievers are becoming our nation’s gravest drug-abuse problem,” Galanter said. “And a pattern that often emerges is that younger adolescents may use these pills intermittently or occasionally, and then later fall into heavier use and addiction. So the earlier this issue can be addressed in that sequence, the greater will be the opportunity for a constructive outcome.”
Anthony added, however, that “even school-based programs targeting younger kids about the dangers of opioids are not going to be the whole answer.”
Public health efforts in schools need to be integrated with “efforts on the front lines of clinical practice where these medicines are being prescribed,” he said.
In some cases, doctors and dentists could prescribe instead over-the-counter ibuprofen (Advil, Motrin), or consider dispensing smaller quantities, instead of a 30- or 40-day supply, he said.
What can parents do?
Besides thinking about locking up their medicines, he said parents should maintain open lines of communication with their children and pay attention to what’s going on in their lives.
“What are they doing that’s engaging them, rewarding them, and are those activities socially adaptive?” Anthony said. “Because when you begin to see these activities — swimming, playing baseball, watching movies, video-gaming, whatever — start to narrow and mood problems set in, that’s the time to pay a little more attention and stay engaged.”
For more on prescription drug abuse, visit the U.S. National Institute on Drug Abuse.