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Abuse, dependence common in teen painkiller users

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Reuters Health

Tuesday, September 9, 2008

NEW YORK (Reuters Health) - Seven percent of U.S. adolescents have used prescription pain relievers that were not prescribed to them, according to data from 2005-2006.

And more than one third of these young people were dependent on the drugs, were abusing them, or both, Dr. Li-Tzy Wu of Duke University School of Medicine in Durham, North Carolina and colleagues found.

Abuse of drugs like Vicodin, OxyContin and Percodan is becoming increasingly common among adolescents, the researchers point out, with one study finding that 13 percent of high school seniors had used prescription painkillers that weren't prescribed to them in their lifetimes, compared to 6 percent in the early 1990s.

To better understand the prevalence and patterns of prescription pain reliever use among U.S. teens, Wu and colleagues evaluated 2,675 adolescents 12 to17 years old, who had participated in the 2005-2006 National Surveys of Drug Use and Health, 7 percent of whom reported the use of an unprescribed prescription pain killer in the past year. Adolescents who used the drugs had done so on 38 days in the previous 12 months, on average, and had used two different categories of the medications.

Abuse was defined as showing one or more symptom of abuse, such as getting in trouble with the law or having problems at school due to prescription pain reliever use, but no signs of dependence. Individuals were classified as being dependent if they met at least three criteria for dependence, such as needing to use more of the drug to get the same effect or experiencing withdrawal symptoms, while those who met one or two criteria for dependence but showed no signs of abuse were classified as having "subthreshold dependence."

Among prescription pain reliever users, 6.7 percent were classified as abusers; 19.6 percent showed subthreshold dependence, and 9.1 percent were dependent on the drugs, the researchers reported in Journal of the American Academy of Child and Adolescent Psychiatry. Dependent individuals had used drugs 86.7 days in the past year, on average, and used 3.9 categories of drug, compared with 55.6 days and 2.7 categories for the abusers, and 39.6 days and 2.1 categories for those with subthreshold dependence.

Individuals with subthreshold dependence are often not diagnosed with drug dependence, the researchers note, but in their study this level of use also was related to alcohol use, major depression, and emergency medical treatment.

The researchers conclude: "Dependence on prescription pain relievers can occur without abuse, and subthreshold dependence deserves to be investigated further for consideration in major diagnostic classification symptoms."

SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry, September 2008.

Reuters Health

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