Close this search box.
Close this search box.

Prescription Drug Abuse in Adolescents

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

For decades, many parents worried about their adolescents experimenting with or getting addicted to “hard” drugs, such as meth, heroin, or cocaine.  The good news is that those drugs aren’t as common among teens as they once were.  Unfortunately, prescription drugs are increasingly taking their place.  These drugs are much more accessible because they’re found in countless medicine cabinets and nightstand drawers in homes across the country.

When abused, prescription drugs are every bit as dangerous and potentially addictive as street drugs.  Combined with alcohol some of these drugs can cause very serious side effects – including death.  For many teens, these drugs end up being “gateway” drugs to heroin, meth, and other illicit drugs.

Your awareness and willingness to be proactive is crucial if your teen is abusing prescription drugs.  This brief guide is designed to help you know what to look for and what to do if you suspect your teen has a prescription drug abuse problem.

Adolescent Prescription Drug Abuse Statistics

Many parents find it difficult to accept the possibility that their One of the most difficult things for many parents to accept is the possibility that their child is abusing drugs of any kind.  If that sounds like you, then hopefully the following statistics and surveys of teens regarding prescription drug abuse will encourage you to reconsider:

  • An estimated 67% of parents have had a conversation with their teens about the risks and dangers of prescription drug abuse
  • At least 33% of teens don’t see a problem taking medication that hasn’t been prescribed for them
  • Nearly 3 out of every 4 teens who abuse prescription drugs get them from one of their friends or relatives
  • At least 1 in 5 teens think their parents would be okay if they got caught abusing prescription medications
  • Approximately 67% of teens between the ages of 12 to 17 years started abusing prescription drugs prior to age 16
  • For kids aged 12 and 13 years, painkillers are the top drug of choice
  • 20% of teens have experimented with hydrocodone (Vicodin)
  • Over 3 out of 5 teens are confident they could easily obtain painkillers – either at home or from a relative or friend
  • Only 1% of parents believe their teen is using study drugs, while nearly 10% of teens report using them
  • Nearly 1 in 3 teens believe prescription drugs are safer to use than street drugs, such as heroin, cocaine, or meth

Looking for and Recognizing the Signs of Prescription Drug Abuse

It’s easy to assume that only “troubled” or “lower class” teens use drugs.  That was a common perception when street drugs were many parent’s biggest fear.  Prescription drug abuse, however, is a problem for teens from all walks of life, including star athletes and honor students to high school dropouts and social misfits – regardless of their socio-economic background.  Don’t assume your child has never experimented or at least been tempted.

Before considering the signs to look for it’s important to be aware of the prescription drugs most commonly abused by teens.  Five of the most popular are:

  • OxyContin (oxycodone – a potent narcotic used to treat pain)
  • Vicodin (hydrocodone acetaminophen – also a potent painkiller)
  • Xanax (alprazolam – a benzodiazepine used primarily to treat anxiety)
  • Valium (diazepam – a benzodiazepine used primarily to treat anxiety)
  • Adderall (an amphetamine used to treat ADHD and narcolepsy)

The warning signs will vary somewhat depending on the type of drug being used.  One of the key things to remember when looking for signs of prescription drug abuse is this:

  • Look for and pay close attention to any changes from your teen’s normal behavior, mood, or personality.  

Signs to watch for include: 

  • Euphoria
  • Unusually high energy levels
  • Staying awake for long periods of time
  • Restlessness
  • Paranoid thoughts
  • Drowsiness
  • Hallucinations
  • Trouble sleeping
  • Daytime sleepiness
  • Anxiety
  • Low appetite
  • Stomach upset
  • Rapid weight loss
  • Dry nose and mouth
  • Dilated pupils
  • Decrease in personal hygiene or self-care
  • Withdrawal from friends and family
  • Secretive behavior
  • Decline in academic performance
  • Mood swings
  • Personality changes
  • Irritability
  • Agitation
  • Erratic behavior
  • Spending increasing amounts of time alone in his or her room
  • Increased demand for privacy
  • Borrowing, stealing, or selling possessions to get money
  • Memory problems

It’s important to remember that most of the warning signs listed above could be caused by something other than drugs, such as high stress or an undiagnosed mental health disorder.

Knowing the First Steps to Take   

Being proactive when you strongly suspect – or know beyond the shadow of a doubt – that your teen is abusing prescription drugs is the most important thing you do.  Don’t allow denial or wishful thinking – that this will somehow go away on its own if given time – cloud your judgment.  Instead, take the following initial steps to help your teen:

1 – Talk to your teen.  Have a candid but calm conversation, keeping your emotions in check.  Lecturing or angrily confronting your child will almost always backfire.  Instead, show a genuine willingness to listen and understand.  Keep in mind that your teen may not readily admit to drug abuse, often out of fear, denial, or confusion.  Be patient.  Express your concerns openly and honestly without scolding or being judgmental.

2 – Set up an appointment for an evaluation.  You have a few options here.  For starters, your family doctor or child’s pediatrician can do a physical exam including lab tests to check for drugs.  Not all substances are detected by standard tests, so it’s possible to get a false negative.  Labs also won’t be accurate if too much time has passed.  Ask your doctor for a referral or recommendation if tests come back positive or if all signs point to drug use.  An initial exam can also help rule out medical issues that may be playing a role or causing suspicious symptoms.

Another option is to have an experienced mental health professional evaluate your teen.  Many kids start abusing alcohol or drugs to alleviate symptoms of depression, anxiety, bipolar disorder, and other mental health issues.  A psychiatrist or psychologist can determine if an untreated psychiatric disorder or other emotional issues are driving the prescription drug abuse.

A third option to consider for an evaluation is to contact a drug and alcohol treatment center for an evaluation.

3 – Get your child into treatment.  Once your child has been evaluated you’ll be given treatment recommendations.  These will depend on your child’s unique needs and the severity of his or her drug problem.  Treatment may include:

  • Individual or group therapy or drug counseling – This level of drug treatment usually involves weekly sessions lasting one to two hours. These sessions may also be incorporated into a more intensive level of treatment.
  • Dual diagnosis treatment – This treatment is strongly recommended if your child has been diagnosed with a mental health disorder in addition to a substance disorder. Treatment focuses on treating both disorders, rather than focusing on only one or the other.
  • Drug rehabilitation – Drug rehab can occur at various levels of intensity depending on your teen’s specific needs. (More on this below.)
  • Medication – Medication may be prescribed for your teen as part of treatment. Medication can help alleviate withdrawal symptoms, reduce agitation or psychotic symptoms caused by the drug being abused, or help treat a co-occurring mental health disorder such as depression.
  • Family therapy – Drug abuse always impacts the whole family. Additionally, many adolescents abuse prescription drugs and other substances in an attempt to cope with family stress and conflict.  Family therapy can help address these issues.

It’s crucial to remember that abruptly stopping some prescription drugs – e.g. painkillers or benzodiazepines (such as Xanax or Valium) – can be extremely dangerous.  Some individuals require medically supervised detox as the first step in treatment.  Have your child assessed by a professional before insisting he or she stop cold turkey.

Supporting and Encouraging Your Child

Knowing how to best support and encourage your child can be difficult, especially when faced with the challenge of drug abuse.  One of the most valuable things you can do is keep the lines of communication open, honest, and loving.  Strive to set aside negative emotions, such as anger and disappointment, when you’re interacting with your child.  Remind yourself that you’re dealing with a child who’s still trying to figure out life and find his or her own path.

Other helpful things you can do:

  • Remove any temptations from home; for example, keep prescription medications in a locked drawer or cabinet – and urge relatives and friends to do the same
  • Let your teen know you’re there for him or her
  • Don’t pressure your teen to open up to you
  • Refrain from lecturing, nagging, and scolding
  • Offer hope and reassurance in a realistic and genuine way (e.g., avoid “Pollyanna-ish optimism)
  • Respect what your teen is going through even if you don’t understand it
  • Educate yourself about prescription drug abuse, including the jargon used by teens
  • Spend quality time with your teen, doing something that he or she enjoys
  • Educate yourself about the recovery process so you’ll know what to expect
  • Be respectful in your communication; don’t “talk down” to, talk over, or constantly find fault with your teen
  • Actively participate in your teen’s recovery (encourage your spouse or partner to participate as well)
  • Be open to family therapy – and learning how you can improve as a parent
  • Be a good role model for your teen; if you’re abusing alcohol, drugs, or any other substances (e.g. food) be willing to acknowledge and get help for your own problem

What to Do When Things Escalate

One of the biggest challenges for parents with a teen who’s abusing or addicted to prescription drugs is the unpredictable impact they can have on his or her mood and behavior.  For example, euphoria, paranoid thoughts, mood swings, agitation, hallucinations, confusion, agitation, and erratic behavior can quickly create precarious and even dangerous situations.

Your top priority is to keep everyone safe.

If things do escalate – for example, your child’s behavior or mood is rapidly spiraling out of control or reaches a crisis point – reach out for help immediately. You can:

  • Contact your child’s provider
  • Enlist the help of a close family member or friend for support or assistance
  • Take your child to the nearest hospital emergency room (if you can get him or her there safely)
  • Call 911

When Individual Therapy isn’t Enough 

Prescription drug abuse can be difficult to treat.  It’s not uncommon for teens to require more than weekly individual therapy or drug and alcohol counseling to get clean and sober and stay that way successfully.  If your child:

  • Is continuing to abuse prescription drugs or other substances
  • Doesn’t have a stable support network
  • Has a co-occurring mental health disorder, such as anxiety or bipolar disorder
  • Is actively thinking about suicide or engaging in suicidal behaviors of any kind
  • Is psychotic or manic
  • Is unable to handle day to day activities on his or her own, or without frequent assistance

then it’s time to consider a more intensive level of treatment.  This may involve:

  • Outpatient drug rehab
  • Day treatment / Intensive outpatient treatment (IOP) /  Partial hospitalization
  • Residential or inpatient drug rehab
  • Hospitalization

Outpatient Drug Rehab – Outpatient drug treatment is the next level of treatment above weekly therapy sessions or substance abuse counseling.  Although outpatient rehab programs vary somewhat, clients often go to treatment 3 times a week for 3 hours per session. One of the advantages is that your teen can typically continue living at home while attending school with minimal interruption.

Day Treatment – This level of drug is a slightly higher level than outpatient drug rehab.  It’s also often called intensive outpatient treatment (IOP) or partial hospitalization.  Adolescents go to treatment daily, usually for 4 hours per day, and attend school at least part time.  Many teens can live at home, but may opt for a sober living facility if additional support is needed.

Residential or Inpatient Drug Rehab – Residential drug treatment – also often referred to as inpatient rehab – involves having your teen live at a non-hospital treatment facility 24/7.  This intensive level of treatment usually lasts between 28 to 120 days, depending on your child’s unique treatment needs and progress.  In addition to receiving treatment on a full-time basis, one of the greatest advantages of residential rehab is being in an environment that is completely free from drugs and alcohol.

Day treatment and residential treatment can be particularly beneficial for adolescents who need dual diagnosis treatment (for a co-occurring mental health condition).

Hospitalization – Hospitalization may be necessary if your child is suicidal, psychotic, or manic, or if he or she is in need of 24/7 medical monitoring until stable. The latter is often due to an intentional or accidental overdose or a severe reaction to a substance.

Each of these more intensive levels of treatment (except for medical – as opposed to psychiatric – hospitalization) usually provides a variety of therapeutic activities, including individual and / or group therapy.  Family therapy may also be offered depending on the program.

Taking Care of Yourself

Helping your teen with a prescription drug abuse problem can be a very trying ordeal for any parent.  The impact on your mental, emotional, and physical health may be significant – especially if you neglect yourself as you try to help your child.  He or she will be relying on you more than ever – even if your relationship is rocky right now.

A few key things you can do to ensure your own well-being are:

  • Get support from others – family, friends, a therapist, your church, support groups (local or online)
  • Get plenty of sleep
  • Make time for yourself
  • Learn to relax and manage your stress – exercise, meditation, yoga, and relaxation exercises can all be helpful stress reducers

Discovering that your teen is abusing prescription drugs can be devastating for any parent.  But it’s not the end of the world.  It can get better.   Countless teens – and their families – recover and heal from this very challenge every year.  And yours can too!

Related Posts

Enjoying these insights?

Subscribe here, so you never miss an update!

Connect with Other Parents

We know parents need support, too. That is exactly why we offer a chance for parents of teens to connect virtually in a safe space! Each week parents meet to share resources and talk through the struggles of balancing child care, work responsibilities, and self-care.

More questions? We’re here for you.