Teens don’t have it easy these days…social media, celebrity influence, school pressure. It’s no surprise they’re looking for ways to reduce stress or anxiety, help with school or athletic performance or just take a break from reality. Teens are vulnerable, and biologically predisposed to taking risks. Unfortunately, they have a much higher predisposition to addiction later in life. As a parent to a 12-year old boy and a 17-year old girl, I’m right there, living it day to day. As a hospital-based pediatrician working in the ICU, I see the tragic consequences of not dealing with this issue head on. So let’s talk about the facts, the warning signs and the action plan. 

The Painful Truth

  • About 2,500 teens abuse prescription drugs for the first time EVERY DAY in America.
  • More Americans die from prescription drug abuse than from cocaine, heroin, ecstasy and methamphetamines COMBINED.
  • Prescription painkillers are the drugs of choice among 12- and 13-year olds. 
  • Almost 70% of those who abuse prescription medications report they get them easily from family and friends.
  • The most abused prescription drugs among teens are opioids (Oxycodone/hydrocodone, Oxycontin and Vicodin), central nervous system depressants (Valium, Xanax), and ADD/ADHD meds (Concerta, Adderall, Ritalin).

We can all agree that prescription and over-the-counter drugs can lead to addiction, serious health problems or overdose and even death. Despite this knowledge, less than half of teens see these medications as dangerous and most do not believe they can be harmful; after all, they are legal, prescribed by a doctor and used by their own parents for pain or anxiety. Teens believe prescription drugs are MUCH safer than illegal “street” drugs.

The Warning Signs

As parents, staying informed and vigilant can literally save our child’s life. What do we look for? Here are a few signs that something might be going on. Keep in mind that some of these changes can be a normal part of adolescence-why can’t we catch a break? We have to be providers and role models and now detectives. But believe me, this one is one not to skip.

Behavioral changes

  • Has changed relationships with family members or new friends
  • Avoids eye contact or even conversation with parents
  • Locks bedroom/bathroom doors
  • Sudden increase in appetite at home
  • Disappears for long periods of time
  • Loss of interest in extracurricular activities, hobbies or sports
  • Declining grades in school or trouble with work

Mood personality shifts

  • Mood changes or emotional instability
  • Sad, withdrawn, depressed
  • Silent, uncommunicative
  • Hostile, defensive, angry, uncooperative
  • Less motivated
  • Unable to focus

Health & Hygiene Issues

  • Unusually tired, slow to move
  • Runny nose, not caused by allergies or illness
  • Changes in weight (weight gain or loss)
  • Excessive thirst
  • Poor hygiene, messy appearance
  • Red, flushed cheeks or face

Don’t Panic! When I read this list, I said to myself: “check, check, holy cow check!” Yes, teens can be moody and more tired and sometimes unable to focus (thank you IG and Snapchat), but only YOU know your child, and only YOU as a parent can know if these changes are more than just a “teen phase.” If your teen checks more than the usual boxes, get help! Start with your child’s pediatrician or family doctor and voice your concerns.  

The Action Plan

What can we do as parents? The first challenge is to become aware of the problem, educate yourself about the issue and remain vigilant. Sadly, on a recent survey, only 24% of teens reported that their parents had talked to them about the dangers of abusing prescription drugs. The Partnership for Drug-Free Kids (https://drugfree.org)

recommends a 3-step approach for parents: (1) educate, (2) communicate, and (3) safeguard.


  • Educate yourself on the dangers of medication misuse among teens and be aware of the statistics for your area. 
  • Learn about the signs of drug abuse in teens
  • Encourage schools to include prescription and over the counter drugs when discussing drug abuse in middle schools and high schools


  • Talk to you child, over and over, about this dangerous and potentially deadly problem. Make your child aware of the fact that even legal medications prescribed by doctors can have SEVERE consequences when misused and abused. 
  • Communication needs to start early! Early middle school is a great time to have open and honest discussions with your child and remember the message will need to be reinforced over the years.
  • There are some great documentaries to start a conversation with your child. 


  • If your child/teen has been prescribed an opioid for pain control after an injury or surgery, make sure you discuss with him/her the dangers of taking more than has been prescribed, the potential for addiction, and take charge of dispensing the medication. Keep all pills in a secure location. 
  • Dispose with care! Prescription drugs should be disposed of properly. NEVER flush them down the toilet! Pills should be crushed, mixed with coffee grounds or cat litter, and placed in a can or bag before throwing them in the trash.
  • There are prescription medication drop-off boxes in many police departments and even some pharmacies nationwide. Check with your local pharmacy or go the Drug Enforcement Agency website: www.deadiversion.usdoj.gov.

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