One in eight older teens has used opioid painkillers when they weren't prescribed – and many of them start misusing the medications earlier than was previously assumed, according to new research.
The findings are based on two nationally-representative surveys that asked teenagers about their recent or lifetime use of prescription opioids, including oxycontin and codeine.
"The non-medical use of controlled medications in (teens) has surpassed almost all illicit drugs except for marijuana," said paediatrician Dr Robert Fortuna, from the University of Rochester Medical Centre in New York. "It's just an alarming trend."
Dr Fortuna, who wasn't involved in the new research, said more doctors are prescribing kids opioid painkillers for conditions like back or knee pain – and some of those drugs may end up getting used recreationally.
Kids still use meds as intended
But that doesn't mean any prescribing of oxycontin or a related drug is a bad idea in young people who really need them, researchers agreed.
"The majority of these kids are still using these medications as intended," said Dr Sean Esteban McCabe, from the University of Michigan in Ann Arbor, who led one of the new studies.
Dr McCabe and his colleagues analysed teenagers' drug-related responses on a general survey of behaviours and attitudes that was given to about 7,400 high school seniors in 2007 through 2009.
Of those teens – from 135 different public and private schools – about 13% said they had ever used prescription painkillers for non-medical reasons, such as to get high or to relieve pain without a doctor's oversight.
Opioid use to self treat pain
Teens who said they'd used the painkillers for non-medical purposes were more likely to smoke pot or cigarettes or to binge drink, compared with those who'd only taken the pills under a doctor's supervision or not at all.
Most of the kids who used the drugs recreationally had previously been prescribed them for a medical condition. Teens may be using their own leftover medication for pain or recreational purposes, or may get painkillers from family members or friends who were prescribed the drugs, researchers said.
"There does seem to be a casual attitude held by some regarding sharing medications that have abuse potential," Dr McCabe said. "Some kids are using opioid medications to self-treat pain, and really they would benefit from a professional assessment for their pain management."
Keep kids away from painkillers
Other survey data on 12- to 21-year olds revealed that most teens who took up the habit started using painkillers at age 16 or 17 – not at the end of high school or afterwards, as some research had suggested.
At age 16, one in 30 or 40 teens took their first non-medical painkillers, Dr James Anthony of Michigan State University in East Lansing and his colleagues reported in the Archives of Pediatrics & Adolescent Medicine alongside Dr McCabe's findings.
Among both younger kids and older teens that had never used painkillers recreationally, much fewer started experimenting with them each year in comparison, based on the survey of about 120 000 youth.
The findings suggest that programmes aimed at keeping kids away from painkillers should start early in high school, and not just aim at older teens or high school grads, Anthony said.
Dispose meds to avoid misuse
"Perhaps we've been thinking about this as an older adolescent phenomenon, or a problem that's more common among college students or high school seniors," he said.
But with that assumption, he added, "we're missing an opportunity for prevention of the problem of extra-medical drug use in these earlier teen years."
The 13% of high school seniors nationally who had used painkillers for non-medical purposes is lower than has been shown among some specific communities, such as Detroit, according to McCabe and his colleagues. So schools and communities may need to do their own analysis on whether prescription drug use is a problem for their youth before deciding how to move forward, the researchers concluded.
In the meantime, they said doctors can warn their younger patients about the abuse potential of painkillers, and parents can make sure the drugs are properly stored and disposed of to avoid misuse.
(Genevra Pittman, Reuters Health, May 2012)
The different groups of painkillers