Prescription drugs: their use and abuse.

• Position: HEADS UP: REAL NEWS ABOUT DRUGS AND YOUR BODY

Prescription drugs have helped millions of people with any number of medical problems. Many people wouldn't even be alive without these medicines. But you've probably noticed that prescription drugs come with warnings such as: Caution: Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed.... Do not drive or operate machinery.... Take with food.... Avoid prolonged sunlight.

"The reason these drugs require a prescription is that they are powerful medications," says Wilson Compton, MD, director of the Division of Epidemiology, Services and Prevention Research, at the National Institute on Drug Abuse (NIDA).

Used at certain dosage levels in certain forms at certain times, prescription drugs are safe and effective. But when they are used for nonmedical purposes, that is called abuse, and abuse of prescription drugs is not safe. Abuse of a prescription drug--to get high, lose weight, or build up muscle--can have very serious health consequences and can even be deadly.

HEADS UP: HEALTH RISKS FOR TEENS

Unfortunately, prescription drug abuse is on the rise. While it is important to note that most teens do not abuse prescription drugs, the current level of abuse of certain prescription drugs concerns NIDA scientists. In 2004, nearly 15 million Americans ages 12 and up--that's 6.1 percent of the population--took a prescription drug for nonmedical purposes, according to a study by the federal government's Substance Abuse and Mental Health Services Administration.

The prescription drugs most often abused by teens are painkillers, antianxiety medications (benzodiazepines), stimulants, and steroids--powerful drugs that carry real health risks.

How many teens are abusing these drugs? Enough to cause a lot of concern.

According to a 2004 NIDA study, 9.3 percent of high school seniors said they had abused the painkiller Vicodin in the past year. "That's a huge and frightening number," says Dr. Compton. Also disturbing news is that 7.3 percent of 12th-graders had abused benzodiazepines at least once in the last year, 5.1 percent had abused Ritalin, and 5 percent said they had abused the powerful pain reliever OxyContin. Adding to concern, teens in some communities are engaging in dangerous trading sessions, where they gather whatever medications they can find--old prescriptions of their own, pills from their families' medicine cabinets--and swap them. The bar graph above illustrates abuse among teens of five different prescription drugs.

HEADS UP: GET THE FACTS

NIDA scientists are searching for reasons why teens abuse prescription drugs. One reason may simply be availability. The number of prescriptions being written has gone way up in recent years, especially for pain relievers and stimulants.

Another reason is that abusers may mistakenly believe that prescription drugs, because they come from a pharmacy and not a drug dealer, are safer to take, even at high doses or without a prescription. And still another might be that abusing prescription drugs follows a pattern of behavior among people who abuse other drugs.

HEADS UP: KILLER PAINKILLERS

Just how harmful are the most abused prescription drugs? Extremely harmful.

One of the most dangerous is OxyContin, a pill that is designed to deliver pain relief over a 12-hour period. After the patient swallows the pill, medicine is released into the body little by little. But some abusers bypass the time-release system by crushing or chewing the pills. That way, they get all of the drug in their system at one time, and the body responds very differently. It's like taking several doses of medicine all at once.

The risk of overdose then becomes huge. And an overdose of OxyContin can kill you.

To make matters worse, young people may abuse OxyContin at parties where alcohol is also on hand. This is a deadly situation because both OxyContin and alcohol can depress respiration (in other words, slow down a person's breathing or stop it altogether). When the two substances are taken together, the risk of serious harm or death becomes much greater than with either taken alone.

Sadly, last year this combination claimed the life of a 20-year-old student at the University of California, San Diego. Daniel died in his dorm room after he took OxyContin to get high, then drank alcohol at a party. Daniel had a 3.2 grade-point average. He wanted to be a lawyer. Prescription drug abuse killed that dream.

What about Vicodin, Ritalin, and Adderall? Can they kill you? Yes, definitely--but not nearly as easily as OxyContin can. Can they land you in the hospital? Yes. But the biggest known risk--and it is a real and serious risk--is addiction.

HEADS UP: LIFE OF ADDICTION?

When a person becomes addicted to a drug, his or her brain is changed. Normally, the brain's pleasure center releases the neurotransmitter dopamine in response to positive experiences like a walk on the beach, a chat with friends, or victory in a big game. When a person becomes addicted to a drug, all those things lose their impact and diminish in importance. M1 that matters is finding and taking the drug that changed their brain to begin with.

"That's a terrible life sentence," says Dr. Compton. "It means your life gets narrower instead of bigger."

HEADS UP: USE AS DIRECTED

A recent NIDA-sponsored survey found that one in four teens with legitimate prescriptions said other kids had asked them for pills.

Students need to know that abusing prescription drugs is no different from abusing illegal drugs. If you wind up addicted to a painkiller or hospitalized because you've stopped breathing, it makes no difference whether the drugs that got you there were picked up from a legitimate pharmacy or bought from a drug dealer.

Now that you...