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You might have heard of the nation’s opioid crisis or wondered about whether a medication prescribed to your child is safe. You may be concerned about the potential of your child drinking or using marijuana and feel overwhelmed with worrying about prescription medications. This document defines what misusing prescription pain medication is, explores the potential risks associated with misuse, and reviews how to reduce the likelihood that your child will misuse prescription pain medication. As a parent or someone in a parenting role, your awareness is key and there are practical things you can do that will make a difference.
Early and frequent conversations with your child about the risks of substance use are an important part of preventing substance use. In those conversations, talk about prescription pain medication as well alcohol, marijuana, and drugs such as heroin and methamphetamine.
What Is Prescription Pain Medication?
Prescription pain medications are also called opioids and include oxycodone, morphine, fentanyl, and others. Brand names include Vicodin, OxyContin, and Percocet and common street names are Oxy and Percs. People who have misused prescription pain medication report doing so in order to relieve pain, to feel good or “get high,” or to relieve tension. Prescription pain medicine is highly addictive, which can make it extremely difficult for people to stop using.1,2
Most Montana high school students (87.2%) have never misused prescription pain medication.3
“Misuse” of Prescription Pain Medication
Most people have taken medication prescribed by a doctor or other healthcare provider, and we often perceive those medications as safe and helpful. Because prescription pain medication is addictive, concern arises with “misuse” of these medications. Misuse of prescription pain medication occurs when someone:
- Uses a prescription pain medication not prescribed for themself, such as using medication prescribed for a family member or friend
- Uses a prescription pain medication in a way other than directed by the doctor or prescriber, such as taking a larger dose or using it for longer than directed
- Uses a prescription pain medication for the feeling the drug causes or to “get high”1
Risks Associated With Misuse
Use of prescription pain medication is common, including by teens, and is often thought of as safe and useful. Some teens underestimate the dangers associated with misusing prescription pain medication and may also believe that misusing prescription medication is safer than using other drugs.4 But, misuse of prescription pain medication is associated with serious negative health outcomes1,5 including:
- Use of alcohol and other drugs, including marijuana and heroin
- Increased risk for addiction and substance use disorder
- Suicidal ideation
With prescription pain medication, misuse can lead to tolerance, where greater amounts of the medication are needed to obtain the same effect. For example, with prescription opioids, tolerance can mean that stronger medications and/or larger doses are needed in order to achieve pain relief. Misuse can also lead to dependence, where a person experiences withdrawal symptoms if they stop taking the medication, and medical support can be needed in order to safely discontinue use of the medication.1,6
Misusing prescription pain medication can also lead to the use of other drugs, especially if the prescription is no longer available or no longer having an effect due to tolerance. For example, people who misuse prescription pain medication or opioids may switch to heroin because it is often easier to obtain and cheaper than prescription pain medication. The use of illicit drugs such as heroin come with additional risks including increased risk of overdose. Misuse of prescription pain medication in combination with other drugs or substances — whether other prescription medication, alcohol, or illicit drugs — also increases the risk for severe health consequences. Taking certain medications in combination, such as opioids with benzodiazepines, greatly increases the risk for overdose.1,6
How to Prevent Misuse
Many teens are prescribed pain medication for legitimate reasons by their doctor or healthcare provider, and prescription pain medication can often be used safely for treatment of health conditions. But given the risks associated with misuse, it is important for parents and those in a parenting role to be proactive in preventing prescription pain medication misuse.
Talk with your teen’s doctor or healthcare provider when they prescribe any medication, especially if it is an opioid pain medication. Include your teen in this conversation. Ask about the risks associated with the medication and if alternatives are available. Prescription opioids should be limited to the smallest dose and shortest duration required. For example, if your teen is prescribed an opioid following wisdom teeth extraction or a sports injury, discuss with the doctor how long it is safe for the teen to take the medication and signs that it may no longer be needed. You might also consider filling a partial prescription or a smaller quantity of pills initially and obtaining more pills only if they are needed.
Talk to your doctor about your family’s medications and strategies for limiting prescriptions for medications that may be misused.
Teens obtain prescription pain medication for misuse both from their own prescriptions but also from prescriptions for others. It is uncommon for teens to obtain prescription pain medication from a dealer or online sources; more often they obtain it, with or without permission, from family members or friends.7 Medication that is in the home should be stored securely and not freely available for teenagers or others who are at risk of misuse. Medication should also be carefully monitored. If the prescription pain medication is for your teen, consider how many doses or days’ worth of medication they have access to at any given time and monitor their use to ensure they do not run out early.
Do not keep unused medication, especially prescription pain medication. It is common for people to continue to store leftover prescription pain medication and other medications in case they might need them in the future. However, this means that the medication is continually available for misuse. Dispose of prescription medication safely by taking it to a drug take-back event in your community or medication disposal site, using a medication disposal bag before placing them in the trash, or asking your local pharmacist for options.8
Talk with the other adults in your teen’s life about safe storage and disposal of prescription pain medication. Because teens may obtain medication from their friends or without permission from the homes where they spend time, it is important to work together to keep children and youth safe. Find information about how to dispose of unused prescription medication at https://teens.drugabuse.gov/parents/safely-dispose-your-prescription-medicines
To Address Misuse
If you are concerned that your child is misusing prescription pain medication, reach out for help. The earlier the better to reduce the likelihood of developing tolerance or dependence. Help is available and treatment works. To find help in your community:
- Your child’s/teen’s pediatrician or doctor can provide health-based educational information for your child/teen. They may be able to provide an assessment and brief counseling for your child/teen. Often doctors can also give information and referrals for additional counseling or treatment.
- Reach out to the counselor(s) at your child’s/teen’s school for recommendations and support. They can offer help to your child/teen during their school day and are often familiar with local resources that are useful.
- Call the National Helpline at 800-662-HELP (4357) for information on treatment and referrals.
- Find treatment resources using SAMHSA’s locator tool available at https://findtreatment.samhsa.gov/
While you are seeking support and your child/teen is working on stopping their misuse, there may be a period of time that their misuse continues. During that time, you can consider harm reduction strategies. These are things you can do to reduce the likelihood that your child/teen will experience preventable harms from their misuse behaviors.
If your teen is misusing prescription pain medication or using other drugs, they should not drive. You could provide alternative transportation options and ensure they do not have access to a vehicle.
If your child/teen is currently misusing prescription pain medication or using other drugs, there are some key things you can do right away to help keep them safe. Make sure they don’t drive and have naloxone available in case of overdose. Reach out to your healthcare providers or school counselor for support in getting your child/teen help to stop.
For tips on talking to your child about their prescription pain medication misuse or other drug use, see Is My Child Using Drugs? What Do I Do?
Misusing prescription pain medication (or opioids) or using heroin places individuals at risk of overdose death. If you know or suspect your child/teen is misusing opioids or using heroin, you should be aware of this risk. Illicit drugs are also sometimes laced with fentanyl, a type of opioid that is dangerous and is associated with high risk of overdose. Harm reduction strategies to prevent overdose death include regular check-ins or supervision of the individual and having naloxone available. Naloxone is a medication that reverses overdose and is available as an injectable or nasal spray. It is available at many pharmacies in Montana; no prescription is needed, and it is often free. More information on overdose signs and naloxone is available at www.naloxone.mt.gov.
Misuse of Other Prescription Medication
In addition to prescription pain medication, two other types prescription medications are most often misused — stimulants and depressants.1
Prescription stimulants are a class of medications commonly prescribed to treat attention-deficit or attention-deficit/hyperactivity disorder (ADHD). Brand names include Adderall and Ritalin. Reported reasons for misuse of stimulants include curiosity or to experiment, to “get high,” and to improve academic or school performance because of a perception that the stimulant will help with studying and alertness.1,9,10
Prescription medications that are depressants or tranquilizers belong to a class of medications called central nervous system depressants and are commonly prescribed to treat anxiety, muscle spasms, and sleep disorders such as insomnia. Benzodiazepines are in this class and have brand names of Xanax, Valium, Ativan, and Klonopin. Brand names of Soma and Flexeril are muscle relaxants, and Ambien, Lunesta, and Sonata are examples of sedatives.1,9,10
Like prescription pain medication misuse, misuse of stimulants and depressants is dangerous and associated with negative health consequences. The strategies described above to prevent and address misuse of prescription pain medications can also be used for misuse of other kinds of prescription medication.
More information about teen drug use and prescription medication misuse is available at teens.drugabuse.gov/parents.
Connect with other Montana parents about underage drinking and youth drug use, including prescription medication misuse, at LetsFaceItMt.com.
Download and print the at-a-glance resource highlighting key information about prescription pain medication.