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Column originally published Aug 16, 2005

Parents Need To Safe-Guard Pain Killers From Being Abused

Question: A few months ago, I sprained my back at work. I had fair amount of pain, and my doctor gave me some pills to ease the pain. Unfortunately, I became dizzy and sleepy, so I only took a couple of pills and left the rest in the medicine cabinet. My back did get better over time. I didn’t pay much attention to the pill bottle until last week, when I noticed that it was missing. We have a teenage daughter and a five-year-old son. When I confronted our daughter, she insisted that she knew nothing about those pills. It was only after a number of heart-to-heart talks that she finally admitted to taking the bottle of pills to a ‘drug party,’ where she traded the pain-killers for some orange pills that she said helped her to pay attention in school. Since elementary school years, her teachers have told us that she has difficulty paying attention, and she is a daydreamer in class, but her marks are still good. Our doctor told us that she will outgrow the problem, so we never considered that she would need medicine. We are terrified by what has happened, and what her friends are doing with those pain-killers. The medicine that our daughter got was prescribed for another student who likely needs it. Please give us some advice as to what we should do.


You have touched on a subject that many physicians are extremely concerned about, the problem of addiction to prescription medicine in our society, especially in our youths.

Teenage years are the most turbulent years of a person’s life. Teenagers are keenly aware of the physical changes happening in their body, as well as their need to establish a sense of identity and independence from their parents. Some express their independence in the music they listen to, the clothes that they wear, or the way they have the hair styled. Others get tattoos on any imaginable (or unimaginable) parts of their body, or have as many piercing as they can get.

In North America, as well as other developed countries around the world, many youths start to experiment with drugs during their teenage years. For a long time, the greatest concern has been illegal or street drugs. However, in recent years, prescription drugs have become the choice for many teenagers. There are many reasons for this change. One of them is the availability of prescription drugs, and they are more potent than ever before.

Many people have accused physicians for over-prescribing pain-killers. There is probably some truth in this. However, the problem is more complex than it seems. I think the problem is somewhat similar to the over-prescription of antibiotics.

Many of my colleagues feel that when they see patients in their office, in walk-in clinics, or in emergency rooms, they are being pressured to prescribe antibiotics when the problems appear to be caused by viruses only. We all know that virus cannot be killed by antibiotics. However, many patients would become upset if they do not receive a prescription. May be this is a reflection of our society, wanting to have ‘quick fixes.’ As a result, we end up with superbugs that are resistant to multiple antibiotics.

In a similar fashion, many physicians feel that when a patient complain of having pain for whatever reason, they have to respond by giving something to control the pain. After all, the Hippocratic Oath that all physicians sworn to requires them to relieve pain and suffering of their patients.

Pain can be caused by physical injury. However, stress and mental illness can also present as pain. It is often difficult, if not impossible, for physicians to discern whether the pain originated from a physical injury, or due to other reasons, unless the patient is willing to provide the history. Furthermore, it is often difficult to assess the severity of pain that one suffers, because pain is a very subjective experience.

As a result, physicians are left with the dilemma of whether to trust the patient and how to help. This may be a little easier if the doctor is the patient’s family physician, he/she can draw on the previous history to assist in making the decision. However, with our present health care situation, many across the country have no family physician. They depend on walk-in clinics and emergency rooms to get their health care. With no prior history of the person, just imagine how hard it is for the physician to make that decision.

The other factor is that pain medications are more potent nowadays than ever before. Pain medicine works on the chemicals in the brain to ease the pain. By its nature, when taken inappropriately, pain medicine can produce unintended effects that drug abusers want.

I agree with you that you should be concerned about what your daughter and her friends are doing. The trading or sharing of medications is dangerous. They do not know the side effects of many of these medications, especially when combined with alcohol or other street drugs.

The best way for parents to do to avoid this problem is to make sure that all medications are kept in a safe place (like locking them up) instead of putting them in medicine cabinets or drawers. Even simple pain medicine like acetaminophen is used by teenagers who attempted suicide. You can also return any unused pain-killers and other prescription medicine to your local pharmacist for safe disposal.

I should also discuss another issue that you brought up about your daughter. From what you have described, there is a possibility that she might have Attention Deficit Hyperactivity Disorder, also called ADHD. The diagnosis of this condition requires detailed history from the parents, the teachers, as well as your daughter.

However, if she truly has ADHD, she may recognize that her brain is not functioning the way that it should be: she cannot focus when she needs to. One has to give her credit for trying to find something to help herself, although I disagree with the way that she went about it.

The best thing that you can do now is to let your daughter know that you are concerned about her stealing of the pain-killers, and that she has lost your trust, and she needs to earn it back over time. You should discuss with her about the danger of her friends using pain-killers without physician supervision, as well as the potential of drug addiction. Although the pills that she got might have helped her, she still needs to get the proper diagnosis before she can be treated.

You should also get in touch with your family physician right away to get referred to a specialist who is familiar with ADHD. If she does not receive the proper help, your daughter may start to falter in her education, and lose her self esteem. Many people with ADHD who didn’t get the proper help had turned to alcohol and drugs instead.