Teens prescribed anti-anxiety or sleep medications more likely to abuse those drugs illegally

Substance abuse assessments needed before drugs are prescribed, researchers say.  Teens prescribed anti-anxiety or sleep medications may be up to 12 times more likely to abuse those drugs illegally than teens who have never received a prescription, often by obtaining additional pills from friends or family members, according to new research published by the American Psychological Association.

Based on surveys of more than 2,700 high school and middle school students from the Detroit area, almost 9 percent had been prescribed a potentially addictive benzodiazepine anti-anxiety medication (e.g., Xanax, Valium or Klonopin) or sleep medication (e.g., Ambien, Lunesta or Restoril) at some time in their lives. More than 3 percent of students had a current prescription during the study, which took place from 2009 to 2012, and those students were 10 times more likely than students who never had a prescription to obtain anti-anxiety or sleep medications illegally for reasons including so they could experiment or get high.

Students who were prescribed anti-anxiety medications before the three-year study but who no longer had a prescription were 12 times more likely to use someone else’s anxiety medication illegally than students who had never received a prescription. While students with a current prescription during the three-year study were more likely to abuse anti-anxiety and sleep medications, students who previously had a prescription for either drug were only at a heightened risk to abuse anxiety medications, which may provide greater euphoric effects than sleep medications.

“This is a wake-up call to the medical community as far as the risks involved in prescribing these medications to young people,” said lead researcher Carol J. Boyd, PhD, a professor at the University of Michigan School of Nursing. “When taken as prescribed, these drugs are effective and not dangerous. The problem is when adolescents use too many of them or mix them with other substances, especially alcohol.”

Students also were more likely to abuse anti-anxiety or sleep medications if they were white, female or had had a valid prescription for several years, the study found. These medications can impair driving and can be fatal when mixed with alcohol and/or other drugs, The research, published in the APA journal Psychology of Addictive Behaviors, is the first longitudinal study to examine adolescents’ illegal abuse of sleep and anti-anxiety medications, according to the authors.

“Prescribers and parents don’t realize the abuse potential,” Boyd said. “These drugs produce highly attractive sensations, and adolescents may start seeking the drugs after their prescriptions run out.”

The study involved 2,745 students from two middle schools and three high schools who completed online surveys twice a year for three years. The participants were evenly split between boys and girls, with an average age of 14 at the beginning of the study. The group was 65 percent white, 29 percent African-American and 6 percent “other” (Asian, Hispanic or American Indian/Alaskan Native). Most of the students came from well-educated families, with 80 percent having at least one parent with a college or graduate degree.

White students were twice as likely as African-American students to use someone else’s anti-anxiety or sleep medication illegally. Several studies have shown that adolescents and young adults are more likely to abuse potentially addictive medications, increasing the risk for overdose, substance abuse disorders and criminal activity. Both state and federal laws prohibit the use of someone else’s prescribed medication, along with the selling or giving of prescription drugs to someone without a prescription, which can be a felony.

“The public often thinks that nonmedical use of these prescription drugs is driven by doctor shopping and drug dealers, but it isn’t,” Boyd said. “It is driven by people with prescriptions who divert their pills to other people, who are usually friends or family members.”

The prescribing of anti-anxiety and sleep medications to teens has increased over the past decade, along with abuse of these drugs, according to several studies. A 2011 survey by the Substance Abuse and Mental Health Services Administration estimated that 3 percent of adolescents in the United States abuse these medications.

Before prescriptions are written, prescribers need to inform teens and their parents about the risks associated with abuse of anti-anxiety and sleep medications and the danger of sharing those drugs, Boyd said. A substance abuse assessment should be completed for each patient before prescriptions are written, and medication refills may need to be strictly limited, the study concluded.

Since the study was conducted in one area, the researchers noted that the results may not be similar across the nation.

Article: “A Prospective Study of Adolescents’ Nonmedical Use of Anxiolytic and Sleep Medication;” Carol J. Boyd, PhD, Elizabeth Austic, PhD, Quyen Epstein-Ngo, PhD, Philip T. Veliz, PhD, and Sean Esteban McCabe, PhD; University of Michigan; Psychology of Addictive Behaviors, online Nov. 24, 2014.

Full text of the article is available from the APA Public Affairs Office and athttp://www.apa.org/pubs/journals/releases/adb-adb0000026.pdf.

Contact: Carol J. Boyd at caroboyd@umich.edu.