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Prescription drugs: their use and abuse.

Prescription drugs have helped millions of people with any number of medical problems. Many people wouldn't even be alive without these medicines. But you've probably noticed that prescription drugs come with warnings such as: Caution: Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed.... Do not drive or operate machinery.... Take with food.... Avoid prolonged sunlight.

"The reason these drugs require a prescription is that they are powerful medications," says Wilson Compton, MD, director of the Division of Epidemiology, Services and Prevention Research, at the National Institute on Drug Abuse (NIDA).

Used at certain dosage levels in certain forms at certain times, prescription drugs are safe and effective. But when they are used for nonmedical purposes, that is called abuse, and abuse of prescription drugs is not safe. Abuse of a prescription drug--to get high, lose weight, or build up muscle--can have very serious health consequences and can even be deadly.


Unfortunately, prescription drug abuse is on the rise. While it is important to note that most teens do not abuse prescription drugs, the current level of abuse of certain prescription drugs concerns NIDA scientists. In 2004, nearly 15 million Americans ages 12 and up--that's 6.1 percent of the population--took a prescription drug for nonmedical purposes, according to a study by the federal government's Substance Abuse and Mental Health Services Administration.

The prescription drugs most often abused by teens are painkillers, antianxiety medications (benzodiazepines), stimulants, and steroids--powerful drugs that carry real health risks.

How many teens are abusing these drugs? Enough to cause a lot of concern.

According to a 2004 NIDA study, 9.3 percent of high school seniors said they had abused the painkiller Vicodin in the past year. "That's a huge and frightening number," says Dr. Compton. Also disturbing news is that 7.3 percent of 12th-graders had abused benzodiazepines at least once in the last year, 5.1 percent had abused Ritalin, and 5 percent said they had abused the powerful pain reliever OxyContin. Adding to concern, teens in some communities are engaging in dangerous trading sessions, where they gather whatever medications they can find--old prescriptions of their own, pills from their families' medicine cabinets--and swap them. The bar graph above illustrates abuse among teens of five different prescription drugs.


NIDA scientists are searching for reasons why teens abuse prescription drugs. One reason may simply be availability. The number of prescriptions being written has gone way up in recent years, especially for pain relievers and stimulants.

Another reason is that abusers may mistakenly believe that prescription drugs, because they come from a pharmacy and not a drug dealer, are safer to take, even at high doses or without a prescription. And still another might be that abusing prescription drugs follows a pattern of behavior among people who abuse other drugs.


Just how harmful are the most abused prescription drugs? Extremely harmful.

One of the most dangerous is OxyContin, a pill that is designed to deliver pain relief over a 12-hour period. After the patient swallows the pill, medicine is released into the body little by little. But some abusers bypass the time-release system by crushing or chewing the pills. That way, they get all of the drug in their system at one time, and the body responds very differently. It's like taking several doses of medicine all at once.

The risk of overdose then becomes huge. And an overdose of OxyContin can kill you.

To make matters worse, young people may abuse OxyContin at parties where alcohol is also on hand. This is a deadly situation because both OxyContin and alcohol can depress respiration (in other words, slow down a person's breathing or stop it altogether). When the two substances are taken together, the risk of serious harm or death becomes much greater than with either taken alone.

Sadly, last year this combination claimed the life of a 20-year-old student at the University of California, San Diego. Daniel died in his dorm room after he took OxyContin to get high, then drank alcohol at a party. Daniel had a 3.2 grade-point average. He wanted to be a lawyer. Prescription drug abuse killed that dream.

What about Vicodin, Ritalin, and Adderall? Can they kill you? Yes, definitely--but not nearly as easily as OxyContin can. Can they land you in the hospital? Yes. But the biggest known risk--and it is a real and serious risk--is addiction.


When a person becomes addicted to a drug, his or her brain is changed. Normally, the brain's pleasure center releases the neurotransmitter dopamine in response to positive experiences like a walk on the beach, a chat with friends, or victory in a big game. When a person becomes addicted to a drug, all those things lose their impact and diminish in importance. M1 that matters is finding and taking the drug that changed their brain to begin with.

"That's a terrible life sentence," says Dr. Compton. "It means your life gets narrower instead of bigger."


A recent NIDA-sponsored survey found that one in four teens with legitimate prescriptions said other kids had asked them for pills.

Students need to know that abusing prescription drugs is no different from abusing illegal drugs. If you wind up addicted to a painkiller or hospitalized because you've stopped breathing, it makes no difference whether the drugs that got you there were picked up from a legitimate pharmacy or bought from a drug dealer.

Now that you have the facts about prescription drug abuse, share them with your friends and family. Everyone needs to understand that abusing prescription drugs is a prescription for disaster.

Prescription Drug Health Alert for Teens

The following four categories show the dangers of the prescription drugs most abused by teens.


OxyContin[R] and Vicodin[R] are opioids. These drugs are prescribed to treat severe pain.

Dangers When Abused

* Extremely addictive

* Slowing down one's breathing or stopping it altogether (death)

* Particularly dangerous with alcohol


Xanax, Valium, and Librium are examples of benzodiazepines--central nervous system (CNS) depressants--prescribed to treat anxiety, acute stress reactions, and panic attacks. The more sedating benzodiazepines, such as Halcion and ProSom, are prescribed for short-term treatment of sleep disorders.

Dangers When Abused

* Can slow breathing and heartbeat, especially if combined with prescription pain medicines, certain over-the-counter cold and allergy medications, or alcohol

* Discontinuing prolonged use of high doses can lead to withdrawal and possible seizures


Ritalin and Adderall are prescribed mainly for attention-deficit/hyperactivity disorder. These drugs are known as stimulants.

Dangers When Abused

* Extremely addictive

* Extremely high body temperature

Anabolic Steroids

Anadrol, Oxandrin, and Durabolin are anabolic steroids--artificial versions of the hormone testosterone. They are prescribed in certain cases of delayed puberty or muscle wasting.

Dangers When Abused

* Infertility

* Breast development in males

* Facial hair in females

* Halted bone growth

* Liver tumors

* Cancer

* Premature heart attacks **

** Some of the health consequences of steroid abuse take months or years to develop and they may occur long after a person has stepped taking these drugs. For example, people who abuse steroids increase their risk for having heart attacks at a young age.

Tracking Prescription Drug Abuse

Wilson Compton, MD, heads NIDA's Division of Epidemiology, Services and Prevention Research. That means he's in charge of tracking drug-abuse trends in this country, then helping figure out what to do about them. We talked with him about his job and about prescription drug abuse.


A: We go directly to teens and ask about their use of drugs. We go to homes and interview teens personally as well as to schools to administer questionnaires.


A: How many kids are using? What are their attitudes and behaviors? Knowing this is useful in predicting future behavior and drug patterns. Also, I'd like to know where kids get these drugs. Do they get them from their friends, the medicine cabinet, the Internet, drug dealers?


A: If your friend said to you that they were only taking heroin occasionally, would you be concerned? If your friend said they were only taking crystal meth occasionally, would you be concerned? Prescription drugs have a lot of the same effects, and are just as dangerous as street drugs."</p>

<pre> Myths About Prescription Drugs--and the Facts! Myth:

Fact: Prescription drugs If they are not taken responsibly and come from a doctor exactly as the doctor intended, and a pharmacy, so prescription medicines can land you they must be safe. in the emergency room-or the morgue. Myth: Fact: It's OK for me to

Just because a medication has been use a prescription

prescribed doesn't mean it is from the medicine

appropriate and safe for everyone. cabinet that was

Many prescribed medicines are custom prescribed for

fit to the patient's medical history, someone in my

weight, allergies, etc. Bottom line: family.

Never take anyone else's

prescriptions. It's not only unsafe--it's illegal. </pre> <p>Wake-up Call: Steroid Abuse

If you follow the news, you've been hearing a lot lately about anabolic steroids in pro sports. These drugs are sometimes prescribed to treat body wasting in patients with AIDS and other diseases that result in loss of lean muscle mass. They are also prescribed to boys or men to treat conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some types of impotence.

But recently, some professional, amateur, and Olympic athletes have been accused of abusing steroids to improve their performance--to cheat, in other words.

Why do some athletes take steroids? The drugs build muscle and bone mass--mainly by stimulating the muscle and bone cells to make new protein. Athletes who abuse steroids can train longer and build new muscle more quickly.

But when used for this reason, steroids are dangerous. Steroids can disrupt the normal production of hormones in the body and can cause side effects ranging from stunted growth in young people, to facial hair in women or breast growth in males, to premature heart attacks, cancer, and serious psychiatric problems.</p> <pre> Percentage of High School Seniors Who Have Abused Prescription Drugs at Least Once in 2004 Vicodin 9.3% Benzodiazepines

7.3% Ritalin 5.1% OxyContin

5% Steroids 2.5% This data is taken from the 2004 Monitoring the Future survey, a yearly study of the behaviors, attitudes, and values of teens in America. For information on the latest findings, visit </pre> <p>TEACHER'S EDITION

Dear Teacher:

A serious threat to your students may be lurking in their families' medicine cabinets. New research by the National Institute on Drug Abuse (NIDA) and other federal agencies is revealing a troubling rise in prescription drug abuse among young people--and among adults as well. The increase in abuse of prescription painkillers by teens has been slight but at a persistent level of high use.

This installment of Heads Up: Real News About Drugs and Your Body gives students essential science-based information about prescription drug abuse and the harm posed by the most commonly abused medications. The article explains what prescription drug abuse is--and isn't--and dispels harmful myths.

In addition to sharing and discussing the article with your students, be mindful that parents and other adults should use prescription drugs as directed, then discard any leftover pills. Medications with potential for abuse--particularly pain relievers, antianxiety medications (benzodiazepines), and stimulants--should not be kept in easy-access locations such as medicine cabinets. Your assistance in delivering this important information to students is invaluable; it does make a difference.

Thank you for joining me and the team of NIDA scientists in our efforts to bring students the facts about drug abuse. Together, we can all look forward to a day when students across the country understand that abusing drugs--any drugs, whether prescription or street drugs--is never the right decision.

Sincerely, Nora D. Volkow, MD Director of NIDA

Lesson Plans for Student Activities

PREPARATION: Before beginning the lessons, make these photocopies: two copies for each student of Reproducible 1 for a pre-reading and post-reading quiz, and one copy for each student of Reproducible 2.

Lesson 1 Heads Up: What Do You Know About the Dangers of Prescription Drug Abuse?


To give students science-based facts about prescription drug abuse; to educate students about the most often abused prescription drugs and the harm they can cause; to help students understand that using medicines prescribed for someone else can be dangerous or deadly; and to assess students' knowledge of the topics before and after reading the article.


Life Science; Science in Personal and Social Perspective


Introducing the Topic

* Before the lesson begins, hold a class discussion based on these questions: What is a prescription drug? What does it mean to abuse a prescription drug? Is it ever OK to take a prescription drug that was not prescribed specifically for you? Can prescription drugs be as dangerous as illegal drugs?

* Tell students that they are going to see how much they know about prescription drug abuse and what the latest research is teaching us about it. Distribute copies of Reproducible 1. Tell students to write their names on the paper and label it No. 1. Then have them answer the questions. Collect and grade the papers.


* Have students read the article "Prescription Drugs: Their Use and Abuse." Next, hold a discussion based on questions that the article may prompt, such as: FVt3at are some possible reasons that prescription drug abuse is on the rise? List some myths about prescription drug abuse. How do you think people came to believe the myths? What can be done to dispel them? What do you think should be done to stop the abuse of anabolic steroids by professional athletes?

* Next, tell students it's time to see how much they've increased their knowledge. Give them a second copy of Reproducible 1. Tell them to write their names on the paper and label it No. 2. When students have finished, collect the papers, score them, and compare the results before and after the lesson.


* Conclude the lesson by asking students what they think ought to be done to end prescription drug abuse in their community. Does the answer lie in education, better control of the distribution of drugs, or tougher law enforcement? What could be done in each of those three realms that would help lower abuse rates among adults and teens?

Lesson 2 Heads Up: Understanding Social Neuroscience


Students gain an understanding about how social environment affects brain chemistry and susceptibility to drug abuse.


Science as Inquiry; Science in Personal and Social Perspective


Introducing the Topic

* Discuss with students what they know about the brain chemical" dopamine: it is a neurotransmitter that causes feelings of pleasure when it binds with dopamine receptors in the brain. Review how drug abuse can interfere with the dopamine system. (See Reproducible 2 for details.)

* Ask students if they think a person's environment can affect how likely he or she is to abuse drugs. Ask if they think the effect is totally psychological, or if environment could actually affect brain chemistry.

* Tell students they are going to read about a NIDA-sponsored experiment with monkeys that investigated how and why being in a socially stressful or enriched environment can affect susceptibility to drug abuse. Explain that this line of research is called social neuroscience. Discuss what they think the term might mean. Break it down by discussing the meaning of the individual words--"social" and "neuroscience."

* Hand out Reproducible 2. Have students read the sheet and answer the questions at the end.


1. The monkeys in the enriched environment had 20 percent more dopamine receptor function.

2. The monkeys that experienced a stressful environment. A possible reason may be that being in an enriched environment had a positive influence on whether the monkeys took drugs.

Answers to questions 3 and 4 will vary.

* Wrap up the lesson by discussing the following questions: What is social neuroscience? How can findings from social neuroscience help scientists find new ways to prevent drug abuse? Can you think of any social neuroscience experiments that could be conducted with humans?

Heads Up: Prescription Drug Abuse--A Quiz

Test your knowledge of prescription drug abuse by answering the questions below.

1. A prescription drug cannot legally be bought or sold without

a. a safety cap.

b. a doctor's permission.

c. a pharmacist's permission.

d. a parent's permission.

2. Which of the following is safe to do if you're in serious pain?

a. take a pain medication prescribed for your mother

b. take a pain medication prescribed for a friend

c. take double the dose that is prescribed for you

d. none of the above

3. Opioids are prescription drugs used to treat

a. viruses.

b. obesity.

c. infection.

d. pain.

4. When abused, opioids can result in death by

a. stopping one's breathing.

b. stroke.

c. speeding up the heartbeat.

d. causing the body to overheat.

5. Certain prescription stimulants are used to treat

a. sleeplessness.

b. attention-deficit/ hyperactivity disorder.

c. pain.

d. autoimmune disorders.

6. Abuse of prescription stimulants can result in

a. extemely high body temperature.

b. infection.

c. depressing respiration.

d. liver cancer.

7. Benzodiazepines are also known as

a. stimulants.

b. steroids.

c. antianxiety medications.

d. painkillers.

8. Which drug has been in the news because of its abuse by athletes who want to build strength and endurance?

a. Ritalin

b. opioids

c. OxyContin

d. anabolic steroids

9. Abusing steroids can result in

a. facial hair growth in women.

b. premature heart attacks.

c. psychiatric problems.

d. all of the above.

10. Two of the most commonly abused opioids are

a. Valium and Adderall.

b. OxyContin and Vicodin.

c. Xanax and Librium.

d. Oxandrin and Anadrol.

11. A recent survey of Americans ages 12 and older found that--abused a prescription drug at least once in 2004.

a. 1.3 percent

b. 4.3 percent

c. 6.1 percent

d. 9.3 percent


1. b; 2. d; 3. d; 4. a; 5. b; 6. a; 7. c; 8. d; 9. d; 10. b; 11. c.

Heads Up: Social Neuroscience--A New Frontier in the Study Of Drug Abuse

Introduction: Drug Abuse and Dopamine

Under normal circumstances, dopamine (a brain chemical) is released in your brain when something pleasurable happens. When a drug abuser takes a drug, it causes an unnaturally large flood of dopamine in the brain. Over time, the brain gets used to having all the extra dopamine around. As a result, the number of dopamine receptors in the brain starts to drop. Because of that, the abuser can't feel pleasure without the huge flood of dopamine that only drugs can provide.

By studying the dopamine system, NIDA scientists have discovered that people who happen to have fewer dopamine receptors in their brains are more likely to feel pleasure when exposed to drugs that enhance the dopamine system. That may in turn make them vulnerable to abusing drugs.

Now, NIDA researchers are trying to find out what causes variation in dopamine receptors. It is turning out that environment can actually influence brain chemistry, including the number of dopamine receptors in the brain. This has led to a new field of research called social neuroscience. This research examines how neurobiology and the social environment interact in the processes of initiation, maintenance, relapse, and treatment of abuse and addiction. Read below about a social neuroscience experiment involving monkeys, their environment, and drug use, then answer the questions below.

The Experiment: Social Environment and Dopamine Receptors


* Researchers measured the number of dopamine D, receptors in a group of monkeys' brains using positron-emission tomography (PET). At this time, the monkeys were housed individually.

* Researchers then housed the monkeys in groups of four, and social hierarchies formed naturally. Some monkeys became dominant and some became subordinate. For those that became dominant, the new environment modeled "environmental enrichment," but for those that became subordinate, it modeled "socially derived stress."

* After the social hierarchies were formed (3 months), the researchers again scanned the monkeys' brains using PET. They discovered that the monkeys that had experienced a socially enriched environment had 20 percent more dopamine receptor function than when they had been housed individually. The dopamine receptor levels of the monkeys that were experiencing socially derived stress, however, were unchanged.

* After the last PET scan, the monkeys were taught to operate machines that dispensed cocaine. They could take cocaine whenever they wanted it.

Findings The dominant monkeys took much less of the drug than the subordinate monkeys.

Implications These findings suggest that, regardless of an individual's past, positive environmental change may result in biological changes that "protect" the individual from the pleasurable or motivational effects of drugs.</p> <pre> Dominant Monkeys Subordinate Monkeys Environment Enriched

Stressed Dopamine receptor function 20% higher

Unchanged Response to available cocaine Took a little Took a lot </pre> <p>You're the Scientist

Imagine that you're a scientist trying to understand and interpret this experiment. Answer the following questions on the back of this page.

1. How did experiencing an enriched environment affect the concentration of dopamine receptors in the monkeys' brains?

2. Which monkeys took more of the drug-those that experienced an enriched environment, or those that experienced a stressful environment? What is a possible reason for this?

3. What are some stressful environments for humans? What are some examples of enriched environments?

4. Based on this research, what can people do to protect themselves from drug abuse and addiction?
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Publication:New York Times Upfront
Geographic Code:1USA
Date:Feb 20, 2006
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