Facts and Prevention: Prescription and Opioid Drug Abuse

Quick facts about prescription and opioid drug abuse:

  • Nearly 1 in 4 teens has used a prescription medicine for non-medical reasons.
  • 1 in 8 teens has reported getting high on cough medicine.
  • 1 in 6 teens has abused a pain reliever such as OxyContin or Vicodin.
  • 1 in 8 teens has abused the stimulants Ritalin or Adderall for non-medical purposes.


What is an opioid?

According to the National Institute on Drug Abuse, opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally through prescription, such as oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, methadone, and many others.

How do opioids work?

Opioids bind to receptors in the brain and spinal cord and disrupt pain signals. They also activate the reward areas of the brain by releasing the hormone dopamine. This creates a feeling of euphoria or a “high.”

How can I spot the signs of drug use?

There are many warning signs to watch for.

  • Changes in behavior, which may include not doing well in school, missing school or extracurricular activities, changing the group of people they hang out with, isolating themselves from family, avoiding eye contact, acting secretive, etc.
  • Psychological changes, which may include mood changes that come on suddenly and frequently, lethargy, drowsiness, memory problems, poor concentration, slurred speech, paranoia, manipulative or deceitful behavior, etc.
  • Health problems, which may include changes in appetite or sleeping patterns, weight loss or weight gain, nausea, vomiting, sweating, runny nose, shaking, excessive thirst, etc.
  • Personal appearance, which may include poor hygiene, bloodshot eyes, constant itching, track marks, sores, burns on lips or fingers, etc.
  • Other signs to look for: finding drug paraphernalia, cash going missing, medications going missing from medicine cabinets, other property going missing, finding drug residue, etc.

What are the symptoms of an overdose?

Symptoms of an overdose may include acting confused, frequent vomiting, pinpoint pupils, extreme sleepiness, losing conscious and nodding off frequently, slow or irregular breathing, respiratory arrest, cold clammy skin, and blue skin around the lips or under fingernails.

How can an overdose be reversed?

An overdose can be reversed with naloxone if given right away. This is available as either an injection or nasal spray. Further treatment of an overdose may include intubation to open the airway, activated charcoal or stomach pumping, and treating cardiac arrest if that occurs.

Other Types of Prescription Drugs

With the focus on the the opioid epidemic, fewer parents are talking to their teens about other prescription drugs. However, these are just as dangerous, especially because they are readily available. 66% of teens who report abuse of prescription medicine are getting it from the medicine cabinets of friends, family, and acquaintances. There are different types of prescription medicines, so it is helpful to educate yourself about them before talking to your teen.

Pain medicines

  • Names:
    • Vicodin (hydrocodone)
    • OxyContin (oxycodone)
    • Percocet (oxycodone and acetaminophen)
    • Darvon (propoxyphene)
    • Codeine
    • Opana
  • Medical Uses:
    • These medications are prescribed to treat moderate to severe pain, including after surgery or dental procedures.
    • Keep in mind that the main prescriber of pain medications for youth ages 10-19 are dentists. If your child is prescribed pain medication after surgery, injury, or a dental procedure, make sure to monitor that the medication is being used as directed.

Teens use pain medicine to feel pleasure or feel sensations of well-being. These types of prescriptions are dangerous because they are highly addictive. Over time, an individual will develop tolerance to doses and in turn, will need more each time to experience the desired feelings. If someone were to overdose on pain medication, it could slow their breathing down, possibly so much as to stop breathing altogether. If it is taken in combination with other drugs, the risk for life-threatening respiratory depression is increased.


  • Names:
    • Ritalin
    • Concerta (methylphenidate)
    • Adderall (mixed amphetamine salts)
    • Focalin (dexmethylphenidate)
    • Dexedrine (dextroamphetamine)
  • Medical Uses:
    • These medications are prescribed to treat ADHD, narcolepsy, and short-term treatment of obesity.

Teens will abuse stimulants to feel alert and have a lot of energy. Students in particular are prone to abuse stimulants to pull an all-nighter while preparing for an exam or finishing a report. Like pain medications, stimulants are also highly addictive. High doses can lead to feelings of hostility, fear, and paranoia. If combined with other drugs, such as over-the-counter decongestants, it can elevate blood pressure to a dangerously high level and cause irregular heart rhythms. Side effects also include insomnia, digestive problems, and erratic weight chance.

Sedatives, Sedative-hypnotics, and Tranquilizers

  • Names:
    • Benzodiazepines
      • Valium (diazepam)
      • Xanax (alprazolam)
      • Ativan (lorazepam)
      • Klonopin (clonazepam)
      • Restoril (temazepam)
    • Non-Benzodiazepine Sedatives
      • Ambien (zolpidem)
      • Lunesta (eszopiclone)
    • Barbiturates
      • Mebaral (mephobarbital)
      • Nembutal (pentobarbital)
  • Medical uses:
    • These are prescribed to treat anxiety, panic attacks, stress, and insomnia (short term).
    • They can also treat some types of seizure disorders and muscle spasms.

Teens will use these medications to feel calm, sleepy, and less tense. Again, these are also highly addictive and dangerous if combined with other over-the-counter medications and/or alcohol.

Over-the-counter medications

A commonly abused over-the-counter medication is dextromethorphan, or DXM. This can be found in antihistamines, decongestants, and simple pain relievers. Some of the brand names DXM can be found in are certain types of Coricidin, Alka-Seltzer Plus, TheraFlu, Robitussin, Tylenol, and many more.

These medications are used to treat coughs and colds when used as directed. However, teens use DXM products to experience many feelings, such as euphoria to enhanced awareness to hallucinations. DXM products are dangerous in overdose because they cause rapid heartbeat, high blood pressure, blurred vision, drowsiness, confusion, etc. If used with other medications, alcohol, or street drugs, the side effects can be much worse.

ABC News just reported that when Imodium, a diarrhea medicine, is taken at 100 times the recommended amount, it can be deadly. The reason this medicine is being taken in such large amounts is that it can cross the gut lining, giving users an opioid-like “high.” It is also being used to treat withdrawal symptoms and has been dubbed the “poor man’s methadone.” Keep an eye out for other over-the-counter medications that teens could be using to get “high.”

Kratom is another over-the-counter legal drug to watch for. Kratom is used to increase energy, alertness, and produces similar effects to opiates. Currently in the US, it is categorized as a dietary supplement. It does have some serious side effects, such as nausea, vomiting, weight loss, insomnia, depression, hallucinations, and more. It can also be addictive. Kratom has been in the news a lot recently as it grows in popularity and is easily available. The DEA is working to ban Kratom, but until then, it can still be found in many convenience stores and even online.

Now that you have some basic information on prescription and opioid drugs, how can you play an active role in preventing your teen from abusing them?

Research shows that teens who learn about the risks from their parents are at least 20 percent less likely to use drugs as kids who have not had that conversation with their parents. So it is definitely a conversation worth having. Most parents leave out other prescription drugs altogether, but explain to your teen how they can be just as deadly. Just because they can be prescribed does not make them safe. Also, lay down some rules and consequences.

When you talk to your teen about drugs, ask them what they have learned in school and from their friends. Be a part of their anti-drug education, and let them know if they want to ask questions, they can come to you. They may feel embarrassed to ask questions in front of everyone in class, so let them know you are open to answering any questions.

One step you can take is to make sure you are properly disposing of any old pills. Watch for National Drug Take Back Day to find a place where you can dispose of old medications in your community. You can search the DEA’s website to find an authorized collector in your community. You can also lock up any prescriptions you take on a regular basis.

If your teen is prescribed medication for an injury or after surgery, make sure to administer the medication as directed. Talk to the doctor if there are any concerns.

Stay involved in your teens life. This includes monitoring their mental health. There is a strong link between mental and physical health issues, including stress, and the use of drugs and alcohol.

Help your teen come up with a plan if they are approached about buying or trying prescription drugs from someone selling them illegally. How can they say no? Let them know they can even use you as an excuse, such as “I would be in so much trouble from my parents if I did that.”

While conversation is a great tool, showing your teen the impact of drugs may also be a powerful tool. Look for opportunities for them to volunteer at homeless shelters, hospitals, or victim services centers in your community.

Again, it is very important to note that it isn’t just prescription painkillers you should worry about. Antidepressants, sleep aids, stimulants, anxiety pills, and dietary supplements can all be abused and misused.

Below is the Dear Future Me letter for today’s topic of National Prevention Week.