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Battling Teen Prescription Drug Abuse

By Luis F. Morales Knight, Ph.D.​

When you think of teenage drug abuse, you probably think of marijuana, methamphetamine, heroin or cocaine, and a scruffy-looking dealer standing in some dark alley. But there is an alarming rise in another kind of drug abuse — one where the medicine cabinet is the dealer.

Drug Abuse as a Response to Pressure

In Orange County, California, where I practice clinical child and adolescent psychology, we are seeing teens abuse prescription drugs as a way to deal with the pressures of adolescence. Benzodiazepines, particularly Xanax (often called "zannies" or "bars"), are the drugs of choice for many. 

This type of drug is typically prescribed to counter the effects of anxiety in adults. It works in a way similar to the way alcohol works. In larger doses it will provide a sense of numbness and a feeling of "I don't care," but without risking detection by breathalyzers or even by the cheaper home drug tests. It's no wonder we see such drugs being misused by teens.

Of course, because these medications aren't being administered by prescription and under the direction of a ​physician, there is serious danger of addiction, overdose or even death.

Why is This Problem Becoming More Prevalent?

Many of the kids I see are what I refer to as "overscheduled." In addition to their many academic obligations, they engage in numerous sports, clubs and other extracurricular activities. Although these things are designed to enrich children's lives, they can sometimes do the opposite if they compete with and edge out important social activities, such as spending time and connecting with family. When that happens, teens can wind up distanced and alienated from their parents and siblings.

That's just one part of the problem. Another component is the pressure these children feel from parents, peers and society in general.

Many teens feel like they must excel in all of their activities so they can get into good colleges and eventually get good jobs as adults. Parents want their children to succeed, too, so they sometimes push their teens to work harder and achieve more. Although Mom and Dad may believe they're doing this in a loving way and that it's all in their teen's best interest, the child feels the pressure regardless of the intent behind it.

Teenagers are still children, and they need to be given the time and space to be children — have fun, relax and blow off steam. Without this downtime, stress can build up to a point they feel is unbearable. That's when drugs such as Xanax can become an attractive alternative.

Drug Abuse as a Way to Compete

On the other end of the spectrum, psychostimulants (such as Adderall, Ritalin, Focalin and Provigil), which are intended to treat the symptoms of ADHD and narcolepsy, can be easily abused for the same reasons. Rather than treating the anxiety of overscheduled teens, however, they enable teens to concentrate harder, work longer and, in their minds at least, achieve more. These drugs are also extremely dangerous and can lead to addiction, overdose and death. This is especially true of specific formulations (famously Adderall and Ritalin) which can be ground up and snorted. Newer formulations, such as Concerta and Vyvanse, cannot be abused in this manner.

Recognizing the Warning Signs

As a parent, it's up to you to recognize the warning signs of prescription drug abuse in your teen.

  • The most obvious sign is a marked change in behavior. This can manifest in a sudden change in mood, such as outbursts of irritability or periods of withdrawal and silence. (Please note that behaviors such as these may be signs of issues other than drug abuse.)
  • You may also see things like your child appearing "out of it" or unable to carry on a normal conversation. You may notice slurred speech or the appearance of being drunk.
  • One classic sign of drug abuse, both prescription and nonprescription, is a sudden change in the group of friends your teen hangs out with, the places they go and the things they do.
  • Regardless of the issue, when major things change in your child's life, and those changes are not positive, it may be a good time to ask a professional for help. At the very least, it's time to have a conversation with your child.

Addressing the Problem in Your Own Home

The final thing you can do to address prescription drug abuse is to take a look inside your own medicine cabinet. Take an inventory of any prescription drugs you or your spouse may have. Make sure they're all there, down to the pill. Dispose of any drugs that are no longer needed and do so in a way that they cannot be found and ingested. (Experts suggest mixing them with coffee grounds, kitty litter or some other foul-tasting substance, sealing the mixture in a plastic bag and putting it in the garbage.)

Remember, most abused prescription drugs come from an adult's medicine cabinet. If you suspect your teen is using drugs, I recommend buying the best home drug test kit you can afford – the one that screens for the widest possible variety of drugs – and require your teen to use it. If your teen has tested positive for drugs in the past, it makes sense to administer tests at random and to look out for methods of beating the tests, such as using fake or substitute urine.

As a parent, you are on the front lines of this battle. It's up to you to recognize the signs of prescription drug abuse in your teen and respond appropriately. Thankfully, you likely already possess the keys to victory. In fact, they're probably the same parenting skills you've been using all along: observation, engagement and empathy.

Remember, too, if you feel overwhelmed or in any way unable to address teen substance abuse on your own, there is no shame in asking for help. There are thousands of professionals like myself around the country who are trained in child and adolescent behavior issues, including chemical dependency.

We're only a phone call away.​

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