For nearly 25 years I have worked with teenagers in therapy groups and asked them to identify any mood altering substances that they or their friends have tried. Year after year, the top two answers were always the same: marijuana and alcohol.

Recently, I asked teenagers in my groups the same question. What drugs or mood-altering substances have they or their friends tried? Here’s the what they said: Ritalin, Adderall, Vyvanse, Concerta, Xanax, Klonopin, Valium, Ecstasy/Molly, and Cocaine.

Over three quarters of the substances they identified were prescription medications. Group after group, I was flabbergasted to hear the same drugs listed over and over again. Keep in mind, these teenagers and their friends who you don’t look like drug users; most maintain good grades, are liked by their teachers, and have positive relationships with their parents.

The Epidemic of Teen Prescription Drug Abuse

According to The Foundation for a Drug-free World, 90% of prescription drug addicts reported that they started using prescription drugs in middle school or high school. This is supported by a National Institute on Drug Abuse report which notes 25% of prescription drugs abusers started using prescription drugs before they were 13 years old. 

This isn’t a minor problem among youth in the U.S. -- it’s a national epidemic. According to the New York Times, there are an average of 125 overdoses per day, with rural areas recording higher overdose death rates than large cities. 

Parents in the Dark

Prescription drug abuse can be difficult for parents to spot. Unlike, marijuana or alcohol, there is no odor or smell. As teenagers are prone to mood swings or unstable behaviors, it’s common for parents to chalk up their unpredictable behaviors to symptoms of adolescence. Teens abusing prescription drugs may, at times, even seem more energetic and focused.

For example, one parent reported to me that her son started finishing his homework in record time. She was pleased that he was finally applying himself. When I recommended that she add a drug test during his annual physical, she balked. After a brief discussion, she reluctantly agreed. The test came back positive for amphetamines. He confessed to buying Adderall, an  ADD medication, with his lunch money; five dollars a pill. He also admitted to drinking alcohol at parties while on Adderall, which increases health dangers.

The Health Hazards of Prescription Medication Abuse

Prescription medications can be very attractive to teenagers who struggle with bouts of psychological and emotional distress resulting from hormone imbalances, irregularities in brain development, social pressures or family conflicts. Prescription drugs offer an instant escape from discomfort and insecurity. After using prescription drugs, many teens report a burst of confidence or a sense of euphoria that they had never known before.

Adolescents who are particularly impulsive, lack foresight, or wrestle with low self-esteem are most vulnerable. To complicate matters, many well-educated teens assume that prescription drugs are safer than “street” drugs. Nothing could be further from the truth. The Center for Lawful Access and Abuse Deterrence reports that medical emergencies resulting from prescription drug abuse have increased over 132%; in fact, overdoses from prescription meds have now surpassed meth, cocaine, and heroin -- combined.

Deadly Combinations

Teens are also more likely to experiment and combine prescription drugs with other substances, leading to potentially lethal outcomes.  For example:  

  • Benzodiazepines, such as Xanax or Klonopin, which are used to lower anxiety, are extremely addictive. However, life-threatening seizures may result if benzodiazepines are taken regularly and stopped suddenly. Mixing "Benzos" with alcohol also increases the potential for overdosing, leading to hazardous respiratory problems and possible coma.
  • Amphetamines, such as Adderall, Ritalin or Vyvanse, are stimulants commonly used to treat ADD in teenagers. When overdosed or combined with other stimulants, they can cause an erratic heartbeat, heart attack or stroke.
  • Opiates, painkillers such as OxyContin, when combined with alcohol can be particularly deadly. Since alcohol and opiates are downers, they affect the central nervous system by slowing down breathing and heart rate. When overdosed they can stop your heart.

Combinations of over-the-counter drugs and legal recreational substances also prove deadly. The Office of Health and Counseling at Geneseo College created a detailed chart identifying the dangers of combining drugs. (For a PDF of the chart, CLICK HERE)

Seven Signs That Your Kid May Be Abusing Prescription Drugs

If you think that your kid is experimenting with prescription drugs, look out for these seven warning signs:  

1. Severe Mood Swings

Drug-induced mood swings are more sudden, aggressive and severe than typical adolescent mood swings. Rage attacks, destroying property, violent behavior, and abusive language can be side effects from coming down from the high of prescription drugs.

2. Family History of Substance Abuse

Family patterns of substance abuse span generations. If your family has a history of substance abuse, your child is at higher risk for addiction.

3. Extreme Change in Sleep Habits:

Teens have erratic sleep habit. However, drug-induced sleep can make your teenager appear comatose. If your kid is unresponsive, impossible to wake-up, or appears pale and cold, it’s time to be concerned. Pay particular attention to your teenager’s breathing while unconscious. Shallow breathing or gurgling sounds are common signs of an overdose.

4. Physical Indications

Weight loss, memory loss, slurred or pressured speech, long senseless monologues, manic episodes, extreme anxiety or panic attacks can be side effects of prescription drug abuse.

5. Sudden Changes in Friend Groups

Friendships based on mutual drug use are intense, producing instant (and artificial) feelings of closeness and intimacy. As drug dependency increases, friends that don’t do drugs are deserted. If your gut tells you that your kid's new friends are a bad influence, you’re probably right. 

6. Self-Harm

As drug dependency increases, frustration tolerance decreases, and the ability self-sooth comes to a screeching halt. If you kid is suddenly punching walls, cutting, intensely scratching, head banging or hair pulling, it may be the effects of withdrawal.

7. Loss of Pleasure in Activities

Drug use often cause passions start to vanish. Activities that once brought pleasure are forsaken. Nothing can compete with the false happiness that prescription drugs produce.

Start a Dialogue about Prescription Drugs

That prescription drugs today are more powerful, more addictive and more dangerous than any drugs teenagers in the past have experimented with. And they are cheaper and easier to obtain.

The Center for Disease Control and Prevention notes that the United States is in the midst of a “Drug overdose epidemic.” More people have died from prescription drug overdoses than at any year on record.

If you’re concerned that your teenager is exposed to prescription drug abuse, take action immediately.  Start a dialogue, educate your kid about prescription drug use, encourage your local school to address the issue with teachers and students. And if your kid exhibits more than three or four of the seven warning sights, consider having your doctor perform a drug test. It may sound extreme, but In my experience, the kids that protest the most, often test positive.

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