One of the first clues that prescription drug abuse was permeating America's youth came from the 2003 household survey statistics from the Substance Abuse and Mental Health Services Administration. These statistics showed a significant rise in the nonmedical use of pharmaceuticals by juveniles aged 12 through 17 years.
A December 2005 Associated Press report indicated that 9.5% of high school seniors had recreationally used hydrocodone, the most abused prescription drug in this country. This abuse of a prescription drug is happening at the same time that illicit drug usage among teens is seeing a modest decline.
Over most of my past 38 years in law enforcement, prescription drug abuse among the nation's young people has not been a significant problem. One of the reasons has always been their inability to participate in "doctor shopping"without the consent and assistance of a parent or guardian. Therefore, because they could not get prescriptions on their own, forging and altering prescriptions was not an option either.
What has changed significantly in the prescription drug abuse arena is that there are even more lucrative ways of obtaining illegal pharmaceuticals than the conventional diversion methods. These drug-diversion pathways include illegal Internet sales and street sales through international smuggling and pharmacy robbery and burglaries. In some states, teenagers can work inside pharmacies, where their access to these drugs is tremendous.
The other source is the teen's own medicine cabinet, or that of a chronic pain patient relative, who deservedly has significant amounts of prescription painkillers and is not likely to miss a few pills that will be used by the teen to get high. The overall prescribing of prescription opiates and benzodiazepines has increased significantly in the past several years, making these drugs more available to diversion due to sheer numbers.
A December 2005 New York Times article written by Howard Markel, MD, a professor of pediatrics at the University of Michigan, indicates that some of the improper use and diversion of prescription drugs is due to irresponsible prescribing by physicians. He cites an incident with one of his teenage patients who underwent a routine tonsillectomy and was prescribed 80 controlled-release oxycodone tablets for her pain.
Dr. Markel says that, in addition to prescribing such a high-powered pain reliever to this patient, the doctor never noticed that her medical chart detailed an extensive history of substance abuse. The patient's mother finally took away the last 20 pills after realizing that her daughter had consumed 75% of the tablets in a short time.
Regardless of the source, it seems to be obvious that it is time for the government, drug abuse coalitions, and other interested organizations to spend much more of their resources on tackling this problem among the country's youth. Direct education of this age group should begin in the latter elementary school years and should continue all through high school.
Of course, the parents and teachers of these children also need to be educated on the potential problem of prescription drug abuse among their kids. Parents, like the general population, have long thought that pharmaceutical abuse is not a real drug problem. It is time to wake up and realize that one's children and grandchildren are being subjected to this additional temptation, and whatever steps are needed should be taken to try to keep it in check.
John Burke, commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 38-year veteran of law enforcement. Cmdr Burke also is the current president of the National Association of Drug Diversion Investigators. For information, he can be reached by e-mail at firstname.lastname@example.org, via the Web site www.rxdiversion.com, or by phone at 513-336-0070.
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