Prescription drug abuse by teens increasing
Primary care physicians are being encouraged to help
stem the tide by offering patients office-based drug treatment.
By
Susan J. Landers, AMNews staff.
Feb. 10, 2003. Additional information
Washington -- Kyle Moores, a
19-year-old recovering drug addict, got his first "oxys" from a classmate.
She gave him free samples from a prescribed supply of Oxycontin that her
father readily shared with her. After a couple of months she started
charging for the pain relievers. By then, Moores was hooked.
After 1½ years of addiction, Moores enrolled in a substance abuse
program and managed to break his habit. But his experience leading up to
rehab places him among the growing ranks of teens and young adults who
admit to recreational use of prescription opioids, antidepressants and
stimulants.
In 2001, nearly 3 million 12- to 17-year-olds and 7 million 18- to
25-year-olds reported abusing prescription medications, according to the
National Household Survey on Drug Abuse.
"The human, social and economic costs associated with the abuse of
prescription medication are truly profound," said Westley Clark, MD, MPH,
director of the Center for Substance Abuse Treatment at the Substance
Abuse and Mental Health Services Administration. "Young adults, even teens
... do not seem to realize that this misuse can lead to serious problems
with addiction."
Last month, the Food and Drug Administration and SAMHSA kicked off an
effort designed to raise awareness about the increasing rates of abuse.
In 2001, 3 million teenagers reported abusing prescription
medications.
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The annual number of new prescriptions for pain relievers has increased
since the mid-1980s from about 400,000 to 2 million in 2000 -- making
these medications more accessible, according to SAMHSA data. Meanwhile,
many young people may not understand the danger posed by the improper use
of prescription pain relievers, said John Jenkins, MD, director of FDA's
Office of New Drugs.
While the proper use of pain medications is fully supported by the FDA,
said Dr. Jenkins, prescription pain relievers, particularly opiates, have
well-recognized and potentially serious side effects, including the risk
of respiratory depression, that a physician must carefully monitor.
Data from SAMHSA's Drug Abuse Warning Network show that visits to
emergency departments increased significantly from 1994 to 2001 for
narcotic prescription pain relievers. Visits naming oxycodone increased
352%; methadone, 230%; morphine, 210%; and hydrocodone, 131%. The data
also show that many people were using more than one drug.
New treatment option
Dr. Clark is seeking the help of primary care physicians in the effort
to curb this increased abuse. "Primary care clinicians, through their
regular, long-term contact with patients, are in an ideal position to
screen for misuse of prescription medications and, more broadly,
indications of substance abuse," he said.
Dr. Clark expressed disappointment with the low interest in a new
treatment option intended to allow primary care physicians to treat their
addicted patients in their offices as they would treat any patient with a
chronic disease.
"Nothing better reflects the important role of primary care physicians
in facilitating substance abuse care than the emergence of office-based
opioid treatment," he said.
Annual prescriptions for pain relievers increased from 400,000 in
mid-1980s to 2 million in 2000.
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The new treatment option was made possible by a law signed in 2000 and
the approval by the FDA in October 2002 of two formulations of
buprenorphine to treat patients addicted to opiates.
Physicians who take an eight-week instructional course about
buprenorphine, file a waiver with SAMHSA and receive certification would
be able to treat opiate addiction in their offices and prescribe a 30-day
supply of the medication for patients to take at home.
A head count on the SAMHSA Web site shows that, so far, only about 600
physicians have received certification and many of those had apparently
already been treating addictions. SAMHSA is hoping that more generalists
will sign up as word of the drugs' availability spreads.
There have also been some problems with the program. The new
medications, manufactured by Reckitt Benckiser Pharmaceuticals as Subutex
and Suboxone, were difficult to come by until recently and larger
treatment facilities are bumping up against a provision that limits to 30
the number of patients they can treat with buprenorphine.
The medications are apparently now reaching pharmacies, but it remains
up to Congress to clarify or eliminate the 30-patient cap.
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ADDITIONAL INFORMATION:
Bad news numbers
New data from the 2001 National Household Survey on Drug Abuse
revealed that:
- Of the estimated 11.1 million people who reported using
prescription drugs nonmedically in 2000, nearly half, or 5.4 million,
were age 12 to 25.
- Pain relievers were the most common category of prescription drugs
used by teens and young adults.
- 6% of 12- to 17-year-olds and 10% of 18- to 25-year-olds used
prescription pain relievers.
- 2% of 12- to 17-year-olds and 3% of 18- to 25-year-olds used
stimulants.
- 2% of 12- to 17-year-olds and 4% of 18- to 25-year-olds used
tranquilizers nonmedically.
Source: The Substance Abuse and Mental Health Services Administration
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Weblink
Subutex and Suboxone tablets
resource page, Center for Drug Evaluation and Research
(http://www.fda.gov/cder/drug/infopage/subutex_suboxone/)
Campaign against prescription
drug abuse, HHS Substance Abuse and Mental Health Services
Administration (http://www.rx.samhsa.gov/)
SAMHSA
statistics on substance abuse (http://www.drugabusestatistics.samhsa.gov/)
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Copyright 2003 American Medical Association. All
rights reserved.
