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(13) Drugs & Child’s

   Adolescent Substance Abuse Risk Factors

 DC13

Who is more likely to abuse prescription drugs?

There are certain individuals who are more likely to misuse prescription drugs. Schepis and Sarin (2008) found the following characteristics: past year history of alcohol, nicotine, cannabis and cocaine or inhalant use; and past history of major depression. Sex differences were found, predominantly for opioids; females are more likely to steal medication or obtain it for free, whereas males are more likely to purchase medication or acquire it from a physician. White adolescents are more likely to buy opioids, whereas African American adolescents are more likely to misuse opioids obtained from a physician. Across medication classes, adolescents who recently acquired medication by purchasing it have the worst risk profile in terms of concurrent substance use and severity of prescription misuse. While opioid withdrawal is relatively benign, drug overdose can be fatal.

Although heroin is an illegal drug, it is worth mentioning here. A number of adults that I treated started abusing prescription opioids when they were younger to treat pain conditions. This pain can result from common things such as a tooth extraction or an injury that results in fractures and back pain. They would then use prescribed opioids more than intended and engage in aberrant drug-seeking behaviors, eventually moving to using street opioids, such as heroin. Heroin is a highly addictive drug and is the most widely abused and rapidly acting of the opiates. It is derived from morphine, a naturally occurring substance from the poppy plant. Pure heroin is a white powder with a bitter taste and is rarely sold on the streets. Color differences are due to impurities. Another form of heroin, black tar heroin, is primarily available in the western and southwestern United States, with its color varying from dark brown to black. Heroin can be injected, smoked, or snorted, and injection is the most efficient way to administer low-purity heroin. Heroin can also be introduced through the skin, known as popping.

Terms:

Black tar - A form of heroin that is primarily available in the western and southwestern United States, with its color varying from dark brown to black.

Popping - Introducing heroin into the top layers of the skin.

 What are scheduled drugs?

The Drug Enforcement Administration (DEA), a federal arm of the Department of Justice, has issued guidelines and classification of drugs with addictive potential. Prescription and dispensing practices are governed by regulations, and violations result in penalties.

In some states, stimulant medications prescribed for ADHD are written in triplicate forms and can only be given monthly. The original prescription is given to the patient, one is kept by the physician for his or her records, and the other is kept by the pharmacy for record keeping. This aims to encourage appropriate medication monitoring and avoid misuse and diversion. In New York, although benzodiazepines are classified as Schedule IV drugs, they are also written in triplicate forms to discourage misuse and diversion.

Physicians are given licenses to prescribe controlled substances; the license comes with a DEA number, without which no controlled medications can be prescribed. In New Jersey, there is an additional license number, the controlled drug substance number, which has to be renewed by physicians annually to prescribe these medications. The DEA has allowed physicians to electronically prescribe stimulants, which allows the patients better access to their medication and still offers physicians the ability to monitor use of the medications.

 What is methamphetamine, and what are its effects?

Methamphetamines are highly addictive central nervous system stimulants that can be injected, snorted, smoked, or orally ingested. Methamphetamine users feel a short yet intense rush when the drug is initially administered. The immediate effects of methamphetamine include increased activity and decreased appetite. Most methamphetamines distributed to the black market are produced in fly-by-night laboratories, which are sometimes even found in households. The ease of production and significant profits obtained from selling methamphetamine resulted in increased availability of illicit supply in the United States.

Of particular concern is how pseudoephedrine, a drug commonly found in cough and cold medicines, has been used to illegally manufacture methamphetamines. Requiring that this otherwise safe and effective over-the counter (OTC) medication be available only by prescription may make it difficult to access for those who use it for its intended purposes. One way to reduce product misuse while also allowing access to the drug for consumers is to maintain the lowest effective dose in OTC preparations, which is 10 mg for pseudophedrine, and to restrict the maximum amount allowed for a single purchase.

 

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