Teen drug abuse moves to the medicine cabinet

There's some very good news in the battle against illicit drugs: Use by America's teens has dropped more than 23 percent during the last five years.

But their abuse of medicines, both over-the-counter and prescription, is rising.

These opposing trends – detailed in a survey of teens released Thursday – reflect the complexity of the US drug scene. They also present a new set of challenges. The most important: How to apply the prevention tools that have apparently succeeded in combating illegal drug use to fight the abuse of legal medicines.

Experts credit campaigns focusing on parental involvement and the dangers of abuse for the significant declines in not only drugs like marijuana, but alcohol and cigarettes as well.

The newly released Monitoring the Future study, which experts consider to be one of the most definitive in the US, is done by the University of Michigan and funded by the National Institute on Drug Abuse. It found that teen use of marijuana – their most common drug – declined from 35 percent in 2001 to 29 percent in 2006.

"The broad nature of these declines across multiple drugs and alcohol and cigarettes ... is a kind of youth movement for the good," says John Walters, director of National Drug Control Policy at the press conference in Washington. "This shows us that we can as a society push back and make a difference. When we do that effectively together it has enormous beneficial consequences not only for our children now, but for the rest of their lives."

Studies consistently show that if people don't start using drugs during their teen years, it is very unlike that they will develop drug problems later in life. That means there will be "less addiction, less suffering, less crime, lower health costs, and higher achievement for this upcoming generation of Americans," Mr. Walters says.

At the same time Walters trumpeted success, he warned that the increase in the abuse of medicines has to be addressed now, if the positive trends are to continue.

Nearly 1 in 10 high school seniors used the narcotic painkiller Vicodin without a prescription and nearly 1 in 20 used the painkiller Oxycontin, according to the Monitoring the Future study.

The findings were backed by recent studies done by the Partnership for a Drug-Free America in New York. Those studies found 1 in 5 teens, ages 12 to 17, report intentionally abusing a prescription drug. As many as 1 in 10 intentionally abused over-the-counter drugs, like cough medicines that contain dextromethorphan.

Focus groups done by the Partnership found that kids think these drugs are either safe, or at least safer, because they're legal. This change of drug type and source, from the neighborhood drug dealer to the family medicine cabinet, is just one of the dilemmas.

"We don't know if they're abusing medicines instead of abusing so-called street drugs," says Tom Hedrick, a founding member of Partnership, "although current research does indicate that heavy abusers of medicines are also abusing illicit drugs."

Another challenge for prevention experts is finessing a message that these legal drugs are safe when used properly, but can be life threatening when abused. That challenge is compounded by both easy access to legal drugs on the Internet and the nation's advertising culture, according to David Rosenbloom, director of Join Together, a nonprofit research and prevention organization based in Boston.

The growth of direct-to-consumer advertising of pharmaceuticals over the past decade has in many ways normalized the use of medicines, making it more difficult to finesse a campaign against abuse, he says.

"The traditional prevention messages become somewhat confused because there are clearly some circumstances under which these medications are wonderful," says Dr. Rosenbloom. "So it's got to be a much more nuanced message and as a practical mater, prevention curricula are still focused on alcohol and illicit drugs."

Three years ago, Linda Surks discovered firsthand the importance of changing the nation's antidrug focus. For more than 15 years she's worked at the National Council of Alcoholism and Drug Dependence on prevention programs in Middlesex County, N.J. As she counseled other parents, she also regularly talked to her son about the dangers of illicit drug abuse. When he was 19, in college studying to become a pharmacist, he died of an overdose of a combination of the antidepressant Xanex and the painkillers Oxycontin and Vicodin.

"I talked about drug abuse a lot more than most parents do," says Ms. Surks. "It wasn't until I was called to the emergency room that I found out he was abusing prescription drugs – and it was quite a shock... because I had no clue he was using at all, and this is from someone who's in prevention and knows what to look for."

Walters says that in order to prevent such tragedies there's something that everyone can do to help deal with the hike in prescription drug abuse.

"Go to your medicine cabinet, take unused prescription [medication] and throw them away," says Walters.