Straight Talk on Prescription Drugs

First published 2010. To view the latest Heads Up content, click here.

reporter_marie_french.jpgOverall teen drug use is declining, but prescription-drug abuse remains high. This is mainly because teens do not see the dangers, says one of the nation’s top scientists.

“Teenagers believe that if a doctor gives a drug to you, it cannot be so terrible to abuse,” says Dr. Nora D. Volkow, director of the National Institute on Drug Abuse in Bethesda, Md. “They think prescribed drugs are safer to abuse than illegal drugs. They are not.”

In a sit-down interview with teen reporter Marie French, Dr. Volkow explains why prescription-drug abuse can be just as dangerous as illegal drugs in terms of health risks and addiction.

What’s the worst that can happen?

“Death,” says Dr. Volkow.


What are the effects of prescription-drug abuse—either one-time or long-term use?

DR. VOLKOW: There isn’t much research on one-time use, so it’s hard to say overall what the negative effects may be, except, of course, that you may overdose. Another risk is that you may love the way it makes you feel, and that starts to change your brain. The brain is wired to learn very rapidly about things that you like, that give you pleasure. So if, for example, you take a prescription painkiller and you like it, you might take it again in the future. And if you keep taking it, you could become addicted, which is why I say, Why risk it?—unless it’s something a physician prescribes for you to treat a problem. Do you really want to reach a point where you are doing something only because you cannot stop, as if you’ve lost control of your own brain? It’s just not worth it.



What’s the likelihood of someone becoming addicted to prescription drugs?

DR. VOLKOW: Your likelihood of becoming addicted is dependent on a number of factors—the drug itself, how you take it, your genes, and your age. If you abuse a pain medication like OxyContin®, the risk of becoming addicted can be equivalent to that of heroin—especially if you snort or inject the drug. Actually, if a teen starts with a prescribed painkiller and gets hooked, he or she may shift to heroin because it is cheaper.


What long-term health effects do addicted teens face?

DR. VOLKOW: When you become addicted, there are many negative health and social effects. With smoking, there is damage to your heart and lungs, and it puts you at risk for a variety of cancers. When you are an alcoholic, you increase your risk of getting into an accident or damaging your liver and your brain. Even if you are not addicted, when you are high or drunk, you become uninhibited and could do things you wouldn’t ordinarily do—like drive drunk or drugged. When you become addicted to drugs, they rule your behavior. The things that are normally important to you become unimportant. You may get into fights with your family, even steal from them. If you have ever loved someone who is addicted, then you know it’s pretty horrible.



I’ve heard of people taking stimulants, like Adderall® or Ritalin®, when they have a test—like the SATs. Why shouldn’t they?

DR. VOLKOW: There are many reasons why you shouldn’t do it. One is that there is not really good scientific evidence that stimulants will even improve your performance—unless you are being treated for ADHD.

So some students may take these drugs to help them stay awake at night to study, but coffee does the same thing. The disadvantage of stimulants over coffee is that, for people who are vulnerable, they may become psychotic and paranoid. That’s not the best way to go into an exam.


More than 50 percent of teens have reported getting the prescription drugs they abuse from their friends or from their home medicine cabinets. Does that show a need for physicians to be more aware when they’re prescribing drugs?

DR. VOLKOW: Absolutely. You are touching on the responsibility of physicians and parents. Anyone prescribing an addictive medication should consider the risks and determine what’s most helpful for each patient. For example, you might just need two or three days of a prescription or maybe just an over-the-counter pain reliever will do. Once a prescription medication is in your medicine cabinet, it could become a temptation for abuse. It is for this very reason that we are working to raise awareness of this concern among medical students, physicians, and dentists—as well as parents, many of whom don’t realize they are leaving something potentially dangerous around for their kids to abuse.

“People who are addicted end up taking drugs—not to feel high and good—but instead to feel less bad.”
—Dr. Nora D. Volkow  


What would you say to teenagers to stop them from abusing prescription drugs?

DR. VOLKOW: Well, I think kids start abusing them because they want to get high or feel good at a party. Or they want to use them to help them study, lose weight, or for pain relief. We’ve already discussed some of the reasons not to use stimulants to study or painkillers without a prescription. But as far as getting high—my advice is that there are many things that can make you feel very good that don’t require drugs. Sports, for example, or dancing, or going out with friends. It’s whatever you like. You really don’t need drugs. You don’t. When you take drugs, your brain resets itself. So what that means is that when you take a drug—especially when you keep taking it—and its effects eventually wear off, you become much less sensitive to normal pleasures, like social interactions, going to a movie, chocolate. Now, that tends to recover, especially if you are just taking drugs occasionally. But if you continue, then the capacity of the brain to recover becomes diminished. When you’re addicted, you will feel less pleasure in general. People who are addicted end up taking drugs—not to feel high and good—but instead to feel less bad. They feel awful when they are not taking the drug.


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