Among teenagers and young adults treated in emergency rooms for any reason, 10.4 percent admit they have misused a prescription painkiller at least once in the last year.
Misuse includes taking drugs to get high, taking more of the drug than was prescribed, or taking drugs prescribed to someone else.
Researchers say prescription drug abuse is at epidemic levels nationwide with overdoses killing more people than auto accidents in many states.
A new study published online in the journal Pediatrics raises the possibility that emergency room visits could become important occasions for detecting and addressing prescription drug problems among young people.
Researchers drew their data from a large, confidential, tablet-based survey of 2,135 people between the ages of 14 and 20 years, conducted in 2010 and 2011 during visits to the at the University of Michigan’s Health System’s adult and pediatric emergency departments.
The study asked teens and young adults about their use of the prescription opioids fentanyl, oxycodone, hydrocodone, methadone, buprenorphine, and suboxone, and the sedatives Valium, Serepax, Ativan, Xanax, Librium, Rohypnol, and GHB, among others.
It’s the first time this issue has been studied in an emergency department setting—even though ER doctors often prescribe opioid painkillers and sedatives for emergency use. They also care for many patients who have accidentally or intentionally overdosed on these drugs.
In fact, the Centers for Disease Control and Prevention has estimated that 100 deaths per day, and around 700,000 emergency department visits per year, result from prescription drug overdoses.
Some fall under the radar
School-based studies have found rates of misuse among young people to be around 8 percent. But such studies miss those who have dropped out of school or did not continue their education past high school.
The findings suggest that emergency department could be an effective setting for screening teens and young adults for prescription drug misuse, and for intervening early before problems arise, says Lauren Whiteside, who led the study during her postdoctoral research fellowship.
It’s also important for emergency physicians to be aware that patients could be seeking drugs for misuse or diversion to others when they come to the ER.
The study reveals several risk factors that are associated with non-medical use of prescription painkillers and sedatives.
For instance, those who misuse painkillers are more likely to receive an intravenous opioid painkiller during an ER visit. And across the board, those who misuse prescription drugs are significantly more likely to also abuse alcohol and non-prescription drugs such as cough medicine, or to have used marijuana, in the past year. They are also more likely to have ridden with a drunken driver.
“These patients are often using the emergency department for their medical care, not primary care settings,” Whiteside says. “So, in order to curb this problem and address overdose and addiction, the ED is a good place to start.”
Because the study was performed in one emergency setting, further study is needed to validate the findings. And more research to develop and test screening tools and interventional tactics will be needed.
The ER as a setting for screening and intervention has also been raised in research on other issues including alcohol abuse, non-prescription “hard” drug abuse and violence.
“One of the main differences between non-medical prescription opioid and sedative misuse and other drug use is that the emergency physician is providing the substance,” Whiteside says. “It’s a really difficult thing to tackle and requires a multipronged effort.
“It will likely take a concerted effort at the state level, with improved information systems aiding prescribing physicians to identify youth at risk, a change in prescribing practices that take into account the epidemic and the public health crisis, and improved early screening and intervention to change the current rising trend of overdose deaths related to prescription medications.”
Source: University of Michigan