Although controlled medications — drugs that are regulated by the federal government — have the strongest potential for abuse by adolescents and young adults, prescriptions for these age groups have almost doubled within the past 14 years, according to a recent study published in Pediatrics.
The findings reveal that a controlled drug is prescribed for young adults (20-29 year olds) in approximately one out of every six visits and for adolescents (15-19 years) in one in nine visits.
The study classified clinical visits based on the drug prescribed, reason for visit, place of visit and demographic and geographic factors. Drugs were categorized as narcotics (or opioids), sedatives or stimulants.
“Physicians must balance the need to treat patients’ symptoms while remaining aware of the possibility that prescription medications can be misused or shared with others. At times, it can be a delicate balance between treating a problem and inadvertently causing one,” said Robert J. Fortuna, M.D., M.P.H., principal investigator of the study and assistant professor of Pediatrics and Internal Medicine at the University of Rochester Medical Center.
For the study, researchers observed prescription patterns for teens and young adults, using data from the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS).
Specifically, controlled drug prescription rates for young adults almost doubled from 8.3 to 16.1 percent and rose from 6.4 to 11.2 percent in adolescents between 1994 and 2007. This increase was similar among both males and females and in a variety of settings: emergency departments, ambulatory offices, and for injury related and non-injury related visits.
These medications were often given for common conditions, including back pain or headaches. Although the purpose of the study did not including analyzing prescription appropriateness, researchers noted how important it is for doctors to continue to monitor patients to ensure that the treatment is effective and that the medication is being used appropriately.
Researchers believe the rise in narcotic prescriptions among young adults may be due to changing state and federal regulations that emphasize advocacy for pain management. For example, narcotic prescriptions rose after 2001, when the Joint Commission on Accreditation of Healthcare Organizations began an initiative to label pain as a fifth vital sign, along with blood pressure, pulse, temperature, and respiration.
The study also reveals that sedative drugs were increasingly offered to adolescents and young adults. Researchers associate this growth to a greater awareness of insomnia and anxiety, newly developed pharmaceuticals and marketing aimed directly to consumers.
Stimulant prescriptions have also risen. Although abuse of stimulant medications like Ritalin dropped between 2002 and 2008, recent research shows that calls to poison centers have increased by individuals who have intentionally misused stimulants. This may be explained by the notion that stimulant abusers, although smaller in numbers, have increased this behavior.
The researchers recognized that prescribing more controlled medications does not necessarily promote abuse or the sharing of medications with others; however, they suggested more vigilance on the part of physicians when prescribing medications to young adults and adolescents.
“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.
