Introduction
You might have heard of the nation’s opioid crisis or wondered about whether a medication prescribed to your child/teen is safe. You may be concerned about the potential of your child/teen drinking or using marijuana and feel overwhelmed with worrying about prescription medication. The recent increase in accidental fentanyl poisonings from using illicit drugs that have fentanyl added to them is alarming. This document defines what misusing prescription pain medication is, explores the potential risks associated with misuse, and reviews how to reduce the likelihood that your child/teen will misuse prescription pain medication. As a parent or someone in a parenting role, your awareness is vital, and there are practical things you can do to make a difference.
What Is Prescription Pain Medication?
Prescription pain medications are also called opioids and include oxycodone, morphine, fentanyl, and others. Brand names include Vicodin, OxyContin, and Percocet; common names include Oxy and Percs. People who have misused prescription pain medication report doing so to relieve pain, to feel good or “get high,” or to relieve tension. Prescription pain medicine is highly addictive, which can make it extremely difficult for people to stop using.1,2
“Misuse” of Prescription Pain Medication
Most people have taken medication prescribed by a doctor or other healthcare provider, and we often perceive those medications as safe and helpful. Because prescription pain medication is addictive, concern arises with “misuse” of these medications. Misuse of prescription pain medication occurs when someone:
- Uses a prescription pain medication not prescribed for themself, such as using medication prescribed for a family member or friend
- Uses a prescription pain medication in a way other than directed by the doctor or prescriber, such as taking a larger dose or using it for longer than directed
- Uses a prescription pain medication for the feeling the drug causes or to “get high”1
Risks Associated With Misuse
The use of prescription pain medication is common, including by children/teens, and is often thought of as safe and helpful. Some children/teens underestimate the dangers associated with misusing prescription pain medication and may also believe that misusing prescription medication is safer than using other drugs.3 But, misuse of prescription pain medication is associated with serious adverse health outcomes1,4 including:
- Use of alcohol and other drugs
- Increased risk of developing a substance use disorder
- Overdose
- Poisoning and death resulting from fentanyl-laced illicit drugs
Misuse of prescription pain medication can lead to tolerance, where greater amounts of the medication are needed to obtain the same effect. For example, with prescription opioids, tolerance can mean that stronger medications and larger doses are needed to achieve pain relief. Misuse can also lead to dependence, where a person experiences withdrawal symptoms if they stop taking the medication, and medical support can be needed to discontinue the use of the medication safely.1,5
Misusing prescription pain medication can also lead to the use of other drugs, especially if the prescription is no longer available or no longer has an effect due to tolerance. The use of illicit drugs such as heroin comes with additional risks, including increased risk of overdose. Further, an illicit drug may have fentanyl added to it. Fentanyl is a synthetic opioid that is very potent and extremely dangerous.6 It is nearly impossible to tell if an illicit drug is laced with fentanyl, but even a very small amount of fentanyl can lead to overdose or death.6 Misuse of prescription pain medication in combination with other drugs or substances — whether other prescription medication, alcohol, or illicit drugs — also increases the risk for severe health consequences. Combining certain medications, such as opioids, with benzodiazepines greatly increases the risk of overdose.1,5
Misuse of prescription pain medication can cause overdose and death, especially when used in combination with other drugs.1,5
Misuse of prescription pain medication can cause tolerance and dependence, leading to increased use over time as well as addiction.1,5
Fentanyl is a synthetic opioid that is much more potent than heroin and morphine and is being mixed with other drugs like heroin, cocaine, and methamphetamine.6 Fentanyl-laced drugs are dangerous and associated with a high risk of overdose and death.6
For more information about fentanyl and its risks, go to https://www.dea.gov/onepill.
How to Prevent Misuse
Many children/teens are prescribed pain medication by their doctor or healthcare provider for legitimate reasons, and prescription pain medication can often be used safely for the treatment of health conditions. However, given the risks associated with misuse, it is essential for parents and those in a parenting role to be proactive in preventing prescription pain medication misuse.
Talk with your child’s/teen’s doctor or healthcare provider when they prescribe any medication, especially if it is an opioid pain medication. Include your child/teen in this conversation. Ask about the risks associated with the medication and if alternatives are available. Prescription opioids should be limited to the smallest dose and shortest duration required. For example, if your child/teen is prescribed an opioid following wisdom teeth extraction or a sports injury, discuss with the doctor how long it is safe for the child/teen to take the medication and signs that it may no longer be needed. You might also consider filling a partial prescription initially and obtaining more pills only if needed.
Children/Teens obtain prescription pain medication for misuse both from their prescriptions and also from prescriptions for others. It is uncommon for children/teens to obtain prescription pain medication from a dealer or online sources; more often, they obtain it, with or without permission, from family members or friends.7 Medication that is in the home should be stored securely and not freely available for children/teens or others who are at risk of misuse. Medication should also be carefully monitored. If the prescription pain medication is for your child/teen, consider how many doses or days’ worth of medication they have access to at any given time and monitor their use to ensure they do not run out early.
Do not keep unused medication, especially prescription pain medication. It is common for people to continue to store leftover prescription pain medication and other medications in case they might need them in the future. However, this means that the medication is continually available for misuse. Store current medication in a secure lockbox to limit access. Dispose of prescription medication safely by taking it to a drug take-back event in your community or medication disposal site, using a medication disposal bag before placing them in the trash, or asking your local pharmacist for options.8
To Address Misuse
If you are concerned that your child/teen is misusing prescription pain medication, reach out for help. The earlier, the better to reduce the likelihood of developing tolerance or dependence. Help is available, and treatment works. To find help in your community:
- Your child’s/teen’s pediatrician or doctor can provide health-based educational information for your child/teen. They may be able to provide an assessment and brief counseling for your child/teen. Doctors can also give information and referrals for additional counseling or treatment.
- Contact the counselor(s) at your child’s/teen’s school for recommendations and support. They can help your child/teen during their school day and are often familiar with helpful local resources.
- Call the National Helpline at 800-662-HELP(4357) for information on treatment and referrals.
- Find treatment resources using SAMHSA’s locator tool available at https://findtreatment.samhsa.gov/.
While you are seeking support and your child/teen is working on stopping their misuse, there may be a period that their misuse continues. During that time, you can consider harm-reduction strategies. You can do these things to reduce the likelihood that your child/teen will experience preventable harm from their misuse behaviors.
If your teen is misusing prescription pain medication or using other drugs, they should not drive. You could provide alternative transportation options and ensure they do not have access to a vehicle.
Misusing prescription pain medication (or opioids) or using heroin places individuals at risk of overdose death. If you know or suspect your child/teen is misusing opioids or using heroin, you should be aware of this risk. Illicit drugs are also sometimes laced with fentanyl, a type of opioid that is dangerous and is associated with a high risk of overdose. Harm reduction strategies to prevent overdose death include regular check-ins or supervision of the individual and having naloxone available. Naloxone (one brand name is Narcan) is a medication that reverses overdose and is available as an injectable or nasal spray. It is available at many pharmacies; no prescription is needed, and it is often free.
Misuse of Other Prescription Medication
In addition to prescription pain medication, two other types of prescription medications are most often misused — stimulants and depressants.1
Prescription stimulants are a class of medications commonly prescribed to treat attention-deficit or attention-deficit/hyperactivity disorder (ADHD). Brand names include Adderall and Ritalin. Reported reasons for misuse of stimulants include curiosity or experimentation, to “get high,” and to improve academic performance due to a perception that the stimulant will help with studying and alertness.1,9,10
Prescription medications that are depressants or tranquilizers belong to a class of medications called central nervous system depressants and are commonly prescribed to treat anxiety, muscle spasms, and sleep disorders such as insomnia. Benzodiazepines are in this class and have brand names of Xanax, Valium, Ativan, and Klonopin. The brand names of Soma and Flexeril are muscle relaxants, and Ambien, Lunesta, and Sonata are examples of sedatives.1,9,10
Like prescription pain medication misuse, misuse of stimulants and depressants is dangerous and associated with adverse health consequences. The strategies described above to prevent and address misuse of prescription pain medications can also be used for misuse of other kinds of prescription medication.
More Information:
More information about teen drug use and prescription medication misuse is available at teens.drugabuse.gov/parents.
More information about fentanyl and its risks is available at https://www.dea.gov/onepill.
