Risky
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Barbara Tone, RN For years, young people have looked to illicit drugs and alcohol to escape, experiment, or fit in, but a small percent are now turning to prescription drugs in their search to belong. One of the most commonly abused prescription drugs is Ritalin (methylphenidate), a widely prescribed stimulant most often used to treat attention deficit hyperactivity disorder (ADHD). It’s not usually the young people who have prescriptions for Ritalin who are abusing it, experts believe. But young people who take Ritalin are sometimes pressured to share their pills with friends or acquaintances. “It’s a problem because the kids who are on Ritalin have ADHD and, therefore, some impulsive problems; they may be on the fringe for peer acceptance and, as part of the adolescent age group, may not think through the consequences,” said Judith Vessey, PhD, RN, a pediatric nurse practitioner and professor of nursing at the Johns Hopkins University School of Nursing in Baltimore. In colleges across the country, Ritalin is reportedly being used as a “study aid.” Eric Heilgenstein, MD, head of psychiatric services at the University of Wisconsin-Madison Health Service, has been examining the use of Ritalin among college students. “Students are using [Ritalin] both orally and intranasally,” he said. “No one knows how significant the distribution is, because those who use it don’t show up in traditional ways. It’s almost impossible to get yourself into an ER using Ritalin.” 'Shocking’ behavior Why young people take such risks is a mystery, but risk taking seems an inherent part of the adolescent experience. “My sense is that adolescents need to shock on some level,” Vessey said. “As adults get less shockable, the behaviors escalate.” A December 1998 report from the Community Epidemiology Work Group of the National Institute on Drug Abuse found pockets of abuse of a variety prescription medications. According to the report, which included adolescents, prescription drugs are showing up in various spots throughout the country. Clonazepam (Klonopin), an anticonvulsive and relaxant, is being combined with beer by juveniles in Texas. In Boston, it’s being called the “street drug of the ’90s.” Ketamine, an anesthetic and veterinary drug, is appearing in the club scene and was involved in one death in San Diego. It is usually snorted, but is being injected by adolescents in Boston and Minneapolis. In addition, drugs that are illegal in the United States or available only by prescription are often more easily obtained in other countries. Many are brought across the border and sold to teen-agers here. Fenfluramine and phentermine (fen-phen), the diet drugs recently banned in this country but still available in Mexico, are being brought into Texas and sold to adolescents. Numerous benzodiazepines—such as clonazepam, diazepam (Valium), and alprazolam (Xanax)—are also brought from Mexico, experts say. Adults can help Adults play an important role in keeping young people from abusing prescription drugs. “Many kids have only been given information about illicit drugs,” Vessey said. “They are well-versed in the ‘just say no’ lingo, but no one formally teaches them about prescription or even over-the-counter drugs. Parents need to give information on both sides of the coin.” Education about all kinds of drug abuse needs to start early, said Susan Krupnick, MSN, RN, president of the International Society of Psychiatric and Mental Health Nurses and psychiatric liaison nurse at Baystate Medical Center in Springfield, Mass. “Adults need to reward truth telling ... and not go into a knee-jerk reaction.” Nurses can make a real difference if they see a child heading in the wrong direction, Krupnick said. “Most of the research bears out that a child is more resilient if any adult shows them how to think about things. It doesn’t have to be a parent,” she said. “It can be a priest, a neighbor, a school or parish nurse, a neighbor who’s a nurse. A good adult in their life can really make a difference.” |
