Teen Substance Abuse Expert Sees Dark Side of Opioid Abuse

From “pharming” to pill parties, teens are abusing prescription drugs in dangerous ways, and can become addicted quickly, warns an adolescent substance abuse specialist at Children’s Hospital Boston.

“I see teens who become addicted to oxycodone by the third time they take it—they get hooked very quickly,” says Patricia Schram, MD. “We’re seeing a lot of teens who find pills and think it’s fun to try them.” She and her colleagues at Children’s Hospital Boston Center for Adolescent Substance Research see teens who have become addicted to opioids through “pharming”—trying medicines they find in their own family’s medicine cabinets or those of friends and family. They also see teens who have been rushed to the hospital after pill parties, where everyone brings pills they find at home and shares them with friends. “They don’t know what they’re taking or what could happen to them, and then they end up in the hospital in bad shape,” she says.

Although Dr. Schram considers opioid abuse to be the most worrisome trend among teens, she and her colleagues are also seeing teens who abuse inhalants, the cold and cough medicine ingredient dextromethorphan, and newer substances such as K2, salvia and bath salts. She will be speaking about trends in teen substance abuse this November at the Association for Medical Education and Research in Substance Abuse (AMERSA) National Conference in Arlington, VA.

While many teens she sees come from families with addiction issues, Dr. Schram emphasizes that anyone can become addicted to opioids. “This can happen in any family, even those without a history of addiction,” she says.

Importance of Parental Involvement

Teens often come to the Center for Adolescent Substance Research through referrals from pediatricians, psychiatrists, law enforcement or parents of other children who have received treatment at the center, Dr. Schram notes. “We only work with teens if their parents or guardians agree to be involved,” she says.

The treatment program involves an evaluation of both the teen and their parents, who are interviewed separately by a pediatrician and mental health professional. Then the team of professionals makes a diagnosis and recommendation for treatment, which often includes Suboxone (buprenorphine and naloxone) for teens addicted to opioids.

“The program is very strict, with lots of rules and parental involvement,” Dr. Schram says. “We make contracts with the teens, give weekly drug tests and ask them to make regular visits. We also provide education on opioid dependence for both the teens and their parents.” The treatment may also involve individual and/or family therapy. “We generally keep the teens on Suboxone for at least 12 months, and then begin to taper off,” she explains.

Prevention is Key

According to Dr. Schram, parents are more focused on forms of substance abuse such as alcohol and marijuana, and are often unaware of the dangers of prescription drug abuse in teens. “Parents have to keep their eyes and ears open to anything that kids can use to get high,” she says. “They have to lock medication away.” With many parents focused on working hard to provide food and a roof over the heads of their children, it can be difficult to always know what their teens are doing, she acknowledges.

However, there are some simple things that parents can do to help protect against opioid abuse, Dr. Schram observes. She cites a study that found that teens were less likely to abuse opioids if their parents often checked their homework, if they had been frequently praised by their parents and if they perceived strong disapproval of marijuana from their parents. “Parents need to keep talking to their teens,” she says.