Study: 10 percent of teens in the ER abuse prescription drugs

Approximately one in 10 young teenagers receiving emergency medical treatment admitted to abusing prescription painkillers and sedatives like Oxycontin and Valium within the last year, according to new research from the University of Michigan released this week. The findings come just two months after a study in the journal The Lancet declared painkiller addictions the worst drug epidemic in U.S. history.

In a survey of more than 2,100 teenagers between the ages of 14 and 20 years old who visited the emergency room at the University of Michigan Medical Center, 10.4 percent admitted to having abused prescription painkillers or sedatives within the last year — and most didn't have any prescriptions for the drugs on their medical records, the researchers said.

Among the 8.7 percent of teens who reported abusing a prescription opioid like Oxycontin, methadone or hydrocodone, only about 15 percent had a prescription for the painkillers; among the 5.4 percent of teenagers who admitted to abusing a sedative like Ativan, Xanax or Valium just 12 percent had a prescription.

Previous, school-based studies from the University of Michigan (PDF) had found that 7.9 percent of young teens had abused opioids and 4.5 percent had abused sedatives in a given year.

“It’s an increasing concern that youth are experimenting with (these drugs), which weren’t available in previous generations,” said Dr. Rebecca Cunningham, director of the University of Michigan Injury Center and an author of the study, which was published in the journal Pediatrics. “The information isn’t getting through to providers that this is an issue that needs to be addressed and monitored, especially in our teen population.”

The Centers for Disease Control has also called prescription drug abuse an epidemic. Emergency room visits for prescription painkiller overdoses have doubled during the past five years to reach nearly half a million, and the non-medical use of prescription painkillers costs more than $72.5 billion each year in direct health care costs, according to the CDC.

But the University of Michigan study is the first look at the non-medical use of prescription painkillers and sedatives among emergency room patients, its authors say, an important population to examine given that one in seven of the patients in the study left the hospital with a new prescription.

What’s more, people who go to the emergency room for medical treatment are different from the general population. They may be there because they don’t have access to primary care, said Cunningham, and “they could be a group that’s higher-risk in general.”

When statistically accounting for demographic difference like age, gender, race and family income, the researchers found a link between non-medical prescription drug abuse among teens and other substance abuse, drinking and driving or riding with a driver who is drinking.

And the abuse of sedatives among teens visiting the ER was also linked with experiencing dating violence, which was not the case among teens abusing prescription painkillers.

The study wasn’t designed to investigate the reason behind those links, but Cunningham said it could be that teens who are taking sedatives are either using them to treat mental health or relationship problems, or taking them recreationally in combination with alcohol, “but we don’t exactly know yet.”

The study notes that painkiller and sedative prescriptions have doubled from 1994 to 2007, meaning that they’re more widely available in homes where teens may abuse them.

Cunningham said the influx of these prescriptions has occurred, because doctors were concerned that they were undertreating chronic pain, she said. At the same time, the array of painkillers available on the market increased, so it became easier to obtain them from doctors.

In addition, she said, the prevailing belief among doctors was that it was unlikely for patients being treated for pain to get addicted to painkillers. While that belief is now changing, Cunningham said, “I think many physicians are still not pausing before they write prescriptions of 30 or 60 pills of Vicodin or Oxycontin. They’re not considering the possibility that patients may become addicted.”

Either way, she said it’s important for doctors to be aware of which kinds of prescriptions their patients may be receiving elsewhere, “especially in emergency departments,” and that while many states have prescription drug surveillance programs to crack down on abuse, “that information transfer is not yet seamless.”

In terms of teens and adolescents, though, Cunningham said, “parents and other adults need to be aware that they have prescriptions lying around on their shelves, and make sure they’re properly monitored the way they would monitor any alcohol or drug in their homes.”