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  1. Moving Pictures
    1 in 9 teens receiving medications that can potentially be abused, such as painkillers, sedatives, stimulants

    NEW YORK — The chance that a teenager or young adult will receive a prescription for a controlled medication has nearly doubled in the last 15 years in the U.S., according to a new report.

    In 2007, one out of every nine teens and one out of six young adults in their 20s received prescriptions for medication that have the potential for abuse, such as painkillers, sedatives and stimulants like Ritalin.

    "This study indicates that there are many more abusable prescriptions in people's medicine cabinets, in homes where there are children," said Dr. Cindy Thomas at Brandeis University in Waltham, Massachusetts, who reviewed the findings for Reuters

    Just because teenagers and young adults receive these prescriptions, however, doesn't mean they will abuse them, or pass them onto others, cautioned study author Dr. Robert Fortuna of the University of Rochester in New York.

    Whether the increase means young people are getting too many of these prescriptions, and doctors should cut back, is also not clear from this study, he told Reuters Health.

    What the study does do, he noted, is reinforce the importance of communicating the risks of controlled medications to young people — and the importance of monitoring their use.

    "Physicians need to have open discussions with patients about the risks and benefits of using controlled medications, including the potential for misuse and diversion," Fortuna said in an e-mail. "Patients should also be monitored closely to ensure that their symptoms are adequately being treated and to ensure that prescriptions are being used as prescribed."

    In addition, parents should stay vigilant if their teenagers ever need one of these prescriptions, he said — maintaining "open communication" with their children and remaining aware of the potential for misuse.

    Common reasons young people received prescriptions for opioid drugs such as OxyContin and Vicodin — the most frequently abused medications, Fortuna noted — was back or other musculoskeletal pain, injury, insomnia and other types of pain.

    Psychiatric problems elicited prescriptions for Ritalin and other stimulants for Attention Deficit Hyperactivity Disorder (ADHD), as well as sedatives.

    The study focused on prescriptions for controlled medications, defined as drugs that have the potential for abuse, and whose use is therefore regulated by the government.

    The findings are concerning, the authors note, because teenagers and young adults are more likely than any other group to abuse prescription medicines. Indeed, nearly one in eight teenagers and one in three adults in their 20s say they have used prescription drugs recreationally at some point in their lifetimes. Surveys show that up to 36 percent of college students pass on their controlled medications to others.

    To investigate prescription trends, Fortuna and his team reviewed data collected from 4,304 doctors and 3,856 clinics and emergency departments.

    In 1994, only six percent of teens received a prescription for a controlled medication. By 2007, more than 11 percent were getting them — adding up to 2.3 million doctors' visits in which a drug of this category was prescribed, the authors report in the journal Pediatrics

    The same trend held among young adults, who saw the rate of prescriptions increase from eight to 16 percent of doctors' visits within the same time period. In 2007, a total of 7.8 million visits led to a prescription for a controlled medication for a young adult.

    There are a number of reasons why these prescriptions have likely increased, Fortuna noted. In recent years, there has been more advocacy for the importance of treating pain, regulations have changed, and physicians have likely become more comfortable with opioids, he said. In the case of sedatives, there are newer drugs, which have been marketed heavily.

    Thomas said the increases "are clearly alarming" and raise questions about whether each prescription is warranted. "One has to question the increased diagnosing and treatment of psychiatric conditions and lower threshold for prescribing both pain medications and psychiatric medications in this population," she said in an e-mail.

    An important step, she suggested, may include reaching out to doctors about the dangers of these medications in young people. "In the past, initiatives to educate physicians regarding overuse of antibiotics, for example, were effective."

    Along with risks, these drugs come with a cost — most low-dose, generic opioids run at less than $150 a month. The cost for sedatives ranges from $5 to more than $100 for 15 pills. The cost of ADHD drugs varies widely, from around $10 per month to more than $1,000.




  1. SamanthaRabbit
    Prescriptions for Stimulants, Painkillers Soaring Among Youth

    Prescriptions for Stimulants, Painkillers Soaring Among Youth

    Trend mirrors similar increase in misuse of these powerful medications, study authors note

    (HealthDay News) -- The number of prescriptions for controlled medications such as opioids and stimulants has nearly doubled in adolescents and young adults since 1994.

    The trend, reported in the December issue of Pediatrics, mirrors a similar increase in misuse of these drugs, with adolescents and young adults' illicit use of prescription drugs now outstripping all other illicit drug use except marijuana.

    The researchers couldn't attribute the increased misuse directly to more prescriptions, but did urge both physicians and patients to be vigilant when considering the use of drugs such as Oxycontin or Ritalin.

    "Our study did not look at the relationship between prescribing and misuse, but the increased prescribing increases the potential availability [of these drugs]," said study author Dr. Robert Fortuna, an assistant professor of internal medicine and pediatrics at the University of Rochester Medical Center. "Physicians and patients need to be aware of the increased rates of prescribing, be aware of misuse and have discussions about the risks and benefits."

    "In total, a controlled medication was prescribed at approximately one out of 6 [health-care visits] for young adults and one in nine for adolescents," he added. "The numbers are large."

    Increased prescribing rates for controlled medications is not a new phenomenon, and many believe that some of it has to do with recent initiatives to make sure pain isn't undertreated.

    "We believe we've been underusing pain medicine and sedative-hypnotic medications because we have been so concerned about the potential for abuse," said Dr. Jess P. Shatkin, director of education and training at the NYU Child Study Center in New York City.

    "Increases are possibly due to changing regulations at both the federal and state levels," Fortuna agreed. "There has been an increased advocacy to treat patients for pain, and there's some evidence that physicians are becoming increasingly comfortable prescribing these medications."

    Opioids are a prime example, with sales of oxycodone surging 732 percent and those of methadone by more than 1,000 percent between 1997 and 2006.

    The authors looked at two national databases to determine how often opioids, sedative-hypnotics and stimulants were prescribed to adolescents and young adults.

    In 2007 alone, a scrip for one of these medications was written at 2.3 million visits by adolescents and 7.8 million visits by young adults.

    In 1994, such medications were prescribed at only 6.4 percent of such visits for adolescents, but rose to 11.2 percent in 2007. For young adults, the rate increased from 8.3 percent to 16.1 percent.

    Doctors wrote these prescriptions in regular doctors' offices and in emergency departments, for injuries and for more pedestrian complaints such as back pain.

    A drawback of the study, Fortuna conceded, was that it "did not look at diverted or misused medications."

    He and the other researchers called for more investigation into prescribing trends and prescription misuse, noting the potential for trauma, high-risk behaviors and unintentional overdose among those abusing controlled substances.

    Other experts agreed that caution was necessary.

    "There's a potential connection between the more prescriptions you have going on and the more potential risk that patients will use it themselves for a purpose it wasn't it intended for or divert it to a friend or someone else," said Shatkin. "It's not infrequent that that happens."

    "We certainly have a concern about increased misuse and increased diversion," said Fortuna. "The increase in prescribing of controlled medications such as opioids, stimulants and sedatives in and of itself is not necessarily bad as long as they're being used appropriately."

    TUESDAY, Nov. 30
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