THIRD EDITION 

How Teens 

Abuse Medicine 

Prescription for Disaster
To locate your local Poison Control Center or for assistance on recommended treatment for the ingestion of 

household products and medicines, go to the American Association of Poison Control Centers,

http://www.aapcc.org/ or call the Poison Help Line at 1-800-222-1222, 24 hours a day, 7 days a week. 
GetSmartAboutDrugs 

Prescription for Disaster

How Teens 

Abuse Medicine 

A DEA Resource for Parents 

This publication is designed to be a guide to help the reader understand and identify the current 

medications that teens are abusing. It is not all-inclusive; every dosage unit or generic form of the 

medications cannot be listed due to space constraints and the frequent introduction of new drugs. 

For more information, visit the following DEA websites:

For general information: www.dea.gov 

For parents, caregivers, and educators: www.getsmartaboutdrugs.com 

For teens: www.justthinktwice.com 

04 Prescription Drugs – Overview 

05 Over-the-Counter Medications 

06 Non-Medical Use of Prescription Drugs 

08 How Big is the Problem? 

09 Reading the Rx Label 

10 How Teens Abuse Medicine 

14 Why Teens Abuse Medicine?

15 Internet, Social Media, Drugs & Teens 

22 Misconceptions 

23 Drugged Impaired Driving 

24 Illegal Pharmacies 

26 What is Drug Addiction? 

27 Common Drugs of Abuse 

48 What You Can Do 

52 DEA’s Role 

53 Resources 
 

 

 

Prescription Drug Abuse 

A “prescription drug” is a drug that is available only with 

authorization from a healthcare practitioner to a pharmacist. 

The prescription drugs that are most abused fall under 

three categories: 

g Opioids

Medications that relieve pain such as Vicodin®, 

OxyContin®, or codeine
 

g Depressants 

Substances that can slow brain activity such as benzodiazepines used to 

relieve anxiety or help someone sleep, like Valium® or Xanax® 

g Stimulants 

Increase attention and alertness and are used for treating attention deficit 

hyperactivity disorder (ADHD) include drugs such as Adderall® or Ritalin® 

Abusing opioids can cause severe respiratory depression or death and can 

be addictive. 

Abusing depressants can cause sleepiness, impaired mental functioning, 

blurred vision, nausea and can be addictive. 

Abusing stimulants can cause irregular heartbeat, paranoia, high body 

temperatures and can be addictive. 
Prescription Drug Abuse | Over-the-Counter (OTC) Medications

 

Over-the-Counter (OTC) Medications 

Over-the-counter (OTC) medicines are drugs you 

can buy without a prescription. They are safe and 

effective when you follow the directions on the label 

and as directed by your health care professional. 

FDA, Understanding Over-the-Counter Medicines 

http://www.fda.gov/Drugs/ResourcesForYou/Consumers/ 

BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/default.htm 

In the United States, the Food and Drug Administration

(FDA) decides whether a medicine is safe enough to sell

over-the-counter. 

Taking OTC medicines still has risks. Some interact with other medicines, 

supplements, foods or drinks. Others cause problems for people with certain 

medical conditions. 

U.S. National Library of Medicine, Over-the-Counter Medicines 

https://www.nlm.nih.gov/medlineplus/overthecountermedicines.html 

4 5 
 

Non-Medical Use of Prescription Drugs 

Most prescription drugs are safe and effective when 

used correctly for a medical condition and under a 

doctor or dentist’s supervision. But they can have serious 

side effects if not used correctly. Using a prescription 

incorrectly for non-medical reasons can lead to abuse, 

addiction, and even death. 

What is Non-Medical Use of Prescription Drugs? 

g taking more than the prescribed dose of a prescription drug;

g taking a drug prescribed for another person or taking a drug obtained

illegally or without a legitimate prescription; 

g deliberate poisoning with a pharmaceutical by another person; and

g

any use of a prescription drug, an over-the-counter pharmaceutical, or a

dietary supplement that Emergency Department medical staff document 

in the patient’s medical record as misuse or abuse. 

Source: SAMHSA, Drug Abuse Warning Network, 2011: 

National Estimates of Drug-Related Emergency Department Visits, 2013. 
Abusing prescription opioid pain relievers, like 

OxyContin® and Vicodin®, may lead to heroin use. 

Heroin is cheaper and easier to obtain and produces a 

similar high. 

Heroin use has become more prevalent nationwide, and 

as a result there has been a 286% increase in heroinrelated deaths since 2002. 

Heroin Use Has INCREASED Among

Most Demographic Groups 

2002-2004* 2011-2013* % CHANGE 

SEX 

Male 2.4 3.6 50% 

Female 0.8 1.6 100% 

AGE, YEARS 

12-17 1.8 1.6 -- 18-25 3.5 7.3 109% 

26 or older 1.2 1.9 58% 

RACE/ETHNICITY 

Non-Hispanic white 1.4 

Other 2 

3 

1.7 

114% 

-- 

ANNUAL HOUSEHOLD INCOME 

Less than $20,000 3.4 

$20,000-$49,999 1.3 

$50,000or more 1 

5.5 

2.3 

1.6 

62% 

77% 

60% 

HEALTH INSURANCE COVERAGE 

None 4.2 6.7 60% 

Medicaid 4.3 4.7 -- Private or other 0.8 1.3 63% 

Heroin Addiction and Overdose

Deaths are Climbing 

SOURCES: National Survey on Drug Use and Health (NSDUH). 2002-2013. 

NationalVitalStatisticsSystem.2002-2013. 

Non-Medical Use of Prescription Drugs

Source: : Centers for Disease Control and Prevention, Vital Signs, July 2015 

6 7 
How Big is the Problem? 

Although most people take prescription medications responsibly, 6.5 million 

persons or 2.5% of the population (12 years and older) were current users of 

prescription drugs for non-medical reasons. 1.9 million persons aged 12 or older

were classified as dependent on or abused pain relievers. 

Source: Drug Facts Prescription Drugs 

http://www.teens.drugabuse.gov/drug-facts/prescription-drugs 

According to a national survey, 17.8% of high school students took a prescription

drug without a doctor’s prescription (such as OxyContin®, Percocet®, Vicodin®, 

codeine, Adderall®, Ritalin® or Xanax®), once or more in the past year. When looking 

at high school students’ use by state, Arkansas had the highest use with 21.5% of 

students reporting they took a prescription drug without a doctor’s prescription, while 

Utah had the lowest use with 8.7% of students reporting that they took a prescription 

drug without a doctor’s prescription. 

Source: Youth Risk Behavior Survey, CDC, 2013 

Prescription drug abuse is when 

someone takes a medication prescribed 

for someone else, takes their own 

prescription in a way not intended by a 

doctor, or takes a medication to get high. 

Source: Prescription Drugs & Cold Medicines 

http://www.drugabuse.gov/drugs-abuse/prescription-drugs-cold-medicines 
How Big is the Problem? | Reading the Rx Label

Reading the Rx Label 

Labels on prescription and OTC drugs contain information 

about ingredients, uses, drug interactions, warnings, and 

directions that are important to read and understand. It is 

especially important to teach teens how to read labels and 

use prescription and OTC drugs safely. 

What Are The Types of Drug Interactions? 

Drug-drug interactions occur when two or more drugs react with each other. This may 

cause you to experience an unexpected side effect. For example, mixing a drug you take 

to help you sleep (a sedative) and a drug you take for allergies (an antihistamine) can 

slow your reactions and make driving a car or operating machinery dangerous. 

Drug-condition interactions may occur when an existing medical condition makes 

certain drugs potentially harmful. For example, if you have high blood pressure, you 

could experience an unwanted reaction if you take a nasal decongestant. 

It is also important to recognize that everyone’s metabolism and brain chemistry 

are different, and the same drugs can have very different effects on individuals. 

Experimenting with medicine to get high is extremely dangerous, and mixing drugs to 

get high can be deadly. 

8 9 
How Teens Abuse Medicine 

Prescription drugs are the most commonly abused substances 

by teens after marijuana and alcohol. When teens abuse 

prescription drugs and take them in different amounts or for 

other reasons than as they are prescribed, they affect the 

brain and body in ways very similar to illicit drugs. 

When prescription drugs are abused, they can be addictive and have harmful health 

effects such as overdose (especially when taken along with other drugs or alcohol). An 

overdose is when a drug is swallowed, inhaled, injected, or absorbed through the skin in 

excessive amounts and injures the body. Overdoses are either intentional or unintentional. 

If the person taking or giving a substance did not mean to hurt themselves or others, then 

it is unintentional. 

Source: CDC, Injury Prevention & Control: Prescription Drug Overdose, Understanding the Epidemic 

http://www.cdc.gov/drugoverdose/epidemic/index.html 

In a national survey, among 12th graders, 7.7 percent used Adderall non-medically in the 

past year. Source: 2015 Monitoring the Future Study. 

Some teens use Adderall® or Ritalin® to try and boost their test performance to improve

their grades. Studies show that these stimulants do not help learning when used by 

persons who do not have ADHD.

Source: DrugFacts: Stimulant ADHD Medications: Methylphenidate and Amphetamines 

http://www.drugabuse.gov/publications/drugfacts/stimulant-adhd-medicationsmethylphenidate-amphetamines 

Remember: Sharing prescription drugs with family members or friends is illegal. 

 


 


 

drug dealer or other stranger, 0.1 

percent bought them on the Internet.

How Teens Abuse Medicine

Where do teens get their prescription drugs? 

Many teens obtain prescription drugs from their 

family or friends. 

Teens find prescription drugs and OTC drugs in their 

home medicine cabinet or on the kitchen shelf. 

For persons aged 12 or older who used pain relievers, 

non-medically in the past year: 

53.0 percent got the drug they used most

recently from a friend or relative for free.

21.2 percent received them through a

prescription from one doctor.

10.6 percent bought the drug from a

friend or relative.

4.3 percent got pain relievers from a

10 11 

Source: 2013 National Survey 

on Drug Use and Health 
 
 


 


 

 

 

 

 
 


 


 


 


 

 

 

 


 

 

 

 

How Teens Abuse Medicine 

Possible warning signs of teen drug use 

Teens are known to have mood swings. However, some behavior may indicate more serious 

issues, such as abuse of drugs and alcohol. Here are some of the warning signs of drug use. 

g Problems at school 

Frequently forgetting homework.

Missing classes or skipping school.

Disinterest in school or school activities.

A drop in grades. 

g Physical signs

Lack of energy and motivation.

Red eyes and cheeks or difficulty focusing – alcohol use.

Red eyes and constricted pupils – marijuana use.

A strange burn on your child’s mouth or fingers – smoking something

(possibly heroin or methamphetamine) through a metal or glass pipe.

Chronic nosebleeds – cocaine abuse.

g Neglected appearance 

Lack of interest in clothing, grooming, or appearance is not normal. 

Teenagers are usually very concerned about how they look. 
 

 

 

 

 

 

 

 

 

 

 

 

 


 


 


 


 


 


 


 


 


 


 


 

How Teens Abuse Medicine

g Changes in behavior

Teenagers enjoy privacy, but be aware of excessive attempts to be alone.

Exaggerated efforts not to allow family members into their rooms.

Not letting you know where they go with friends, or whom they go with.

Breaking curfew without a good excuse.

Changes in relationships with family.

g Changes in friends 

No longer friends with childhood friends.

Seems interested in hanging out with older kids.

Acts secretive about spending time with new friends.

g Money issues 

Sudden requests for money without a good reason.

Money stolen from your wallet or from safe places at home.

Items gone from your home. (May be sold to buy drugs.)

g Drug paraphernalia

Finding items in your child’s room, backpack, or car related to drug use. 

Source: www.getsmartaboutdrugs.com 

12 13 
Why Teens Abuse Medicine 

Teens abuse prescription drugs for several reasons including:
 

g To get high. Many prescription drugs 

can make you feel good. 

To feel better.Teens who suffer from 

stress-related disorders and depression 

may try prescription drugs. 

To help concentrate doing schoolwork 

g

g

to get better grades. 

g To perform better in sports. 

g Curiosity and to try a daring behavior. 

In some cases, boys and girls will abuse some type of prescription 

drugs for a specific purpose. For example, boys are more likely to 

abuse prescription stimulants to get high, while girls tend to abuse 

them to stay alert or lose weight. 

Source: Drug Facts Prescription Drugs 

http://www.teens.drugabuse.gov/drug-facts/prescription-drugs 
Why Teens Abuse Medicine | Internet, Social Media, Drugs & Teens

Internet, Social Media, Drugs & Teens 

Many teens obtain illegal drugs, particularly prescription 

drugs, from their families, friends, or relatives. Since 

prescription drugs are widely available in the home, teens 

often do not have to go far to find ways to get high. Other 

teens turn to the Internet and social media for prescription 

drugs, and the World Wide Web plays a big role in 

providing information and advice to teens. 

here are a few things to consider 

14 15 
 

 

Internet, Social Media, Drugs & Teens 

Your teen probably knows a lot more about the Internet than you do. It’s never 

too late for parents to jump in and get acquainted with various websites, communication 

methods, networking systems, and the lingo teens use to fly under parents’ radars. 

Some pharmacies operating on the Internet are legal, and some are not. Some 

of the legal Internet pharmacies have voluntarily sought certification as “Verified 

Internet Pharmacy Practice Sites” (VIPPS®) from the National Association of Boards of 

Pharmacy. “Rogue” pharmacies pretend to be authentic by operating websites that 

advertise powerful drugs without a prescription or with the “approval” of a “doctor” 

working for the drug trafficking network. Teens have access to these websites and are 

exposed to offers of prescription drugs through email spam or pop-ups. Parents should 

be aware of which sites their teens are visiting and should examine credit card and 

bank statements that may indicate drug purchases. 
Internet, Social Media, Drugs & Teens

Social media sites play a role in providing information and 

advice to teens on how to use prescription drugs to get high. 

Teens are exposed to offers of prescription drugs through 

social media sites, email spam, or pop-ups. 

It is never too late for parents to get acquainted 

with various websites, social media sites, and 

the slang terms teens use to communicate 

while texting and using social media.

Parents should be aware of which sites their teens are visiting and should examine credit 

card and bank statements that may indicate medication purchases. They should also 

check the browser to see which sites their teen is visiting on their computers and cellphones. 

16 17 
Internet, Social Media, Drugs & Teens 

Teens sometimes brag about their drugging and drinking on social networking sites 

such as Facebook, Twitter, and YouTube. Posting pictures of themselves in compromising 

scenes may hurt their reputation and opportunities for employment and education. Their 

behavior is out there in the open for future employers, college admissions offices, and 

others to see. 

The Internet is a tremendous resource for teens to learn about the dangers of drug 

abuse. However, it is also full of information about how to use prescription drugs to get high– 

how much to use, what combinations work best, and what a user can expect to experience. 

24% of teens go online “almost constantly,” facilitated by the widespread availability 

of smartphones. Aided by the convenience and constant access provided by mobile devices, 

especially smartphones, 92% of teens report going online daily – including 24% who say they 

go online “almost constantly,” according to a new study from Pew Research Center. More 

than half (56%) of teens – defined in this report as those ages 13 to 17 – go online several 

times a day, and 12% report once-a-day use. Just 6% of teens report going online weekly, 

and 2% go online less often. 

Source: Teens, Social Media & Technology Overview 2015 

http://www.pewinternet.org/2015/04/09/teens-social-media-technology-2015// 
Internet, Social Media, Drugs & Teens

Compared to teens that have never seen pictures of kids getting drunk, passed 

out, or using drugs on social networking sites, teens that have seen these images 

are much likelier to have friends and classmates who abuse illegal and 

prescription drugs. 

Compared to teens that do not watch suggestive teen programming, teens that 

watch one or more shows are more than one- and-a-half times likelier to try to get 

prescription drugs without a prescription within a day or less. 

Source: CASA, National Survey XVI 

18 19 

 


 


 


 


 


 

Internet, Social Media, Drugs & Teens 

71% of teens use more than one social network site 

Teens are diversifying their social network site use.

A majority of teens – 71% – report using more than one

social network site out of the seven platform options they

were asked about. Among the 22% of teens who only

use one site, 66% use Facebook, 13% use Google+,

13% use Instagram and 3% use Snapchat.

Source: Teens, Social Media & Technology Overview 2015 

http://www.pewinternet.org/2015/04/09/teens-social-media-technology-2015// 
Internet, Social Media, Drugs & Teens

 

 

There are thousands of websites dedicated to the 

proposition that drug use is a rite of passage. So-called 

experts are more than happy to walk your kids through 

a drug experience. 

don’t let them. 

20 21 
 

Misconceptions 

“Street drugs” is a term that refers to drugs that are commonly 

known as illegal drugs – cocaine, heroin, methamphetamine, 

marijuana, and others. Many teens wrongly believe that 

prescription drugs are safer than “street drugs” for a variety 

of reasons: 

g These are medicines. 

They can be obtained from doctors, dentists, pharmacies, friends g or family members. 

g It is not necessary to buy them from traditional “drug dealers.” 

Information on the effects of these drugs is widely available g in package inserts, advertisements, and on socal media sites. 

Parents and teens need to understand that when over-the-counter and 

prescribed medications are used to get high, they are every bit as 

dangerous as “street drugs.” And when prescribed drugs are used by or 

distributed to individuals without prescriptions, they are every bit as illegal. 
Misconceptions | Drug-Impaired Driving

Drug-Impaired Driving 

What is drug-impaired driving? 

Driving under the influence of over-the-counter medications, prescription drugs, or illegal drugs. 

Why is drug-impaired driving dangerous? 

Over-the-counter (OTC) medications and prescription drugs affect the brain and can alter perception, 

mental processes, attention, balance, coordination, reaction time and other abilities required for safe 

driving. Even small amounts of some drugs can have a serious effect on driving ability. 

Source: National Institute on Drug Abuse (NIDA) 2013. 

A recent national survey showed 20% of nighttime weekend drivers tested positive for illegal,

prescription, or OTC drugs that can impair driving. 

Source: Drug- Impaired Driving, Feb. 2015, GAO-15-293. NHTSA 2014 Drug-Impaired Driving Survey. 

What substances are used the most when driving? 

After alcohol, marijuana is the most commonly used drug. 

What happens when you use drugs and drive? 

Marijuana can decrease a person’s ability to drive a car. It slows reaction time, impairs a driver’s 

concentration and attention, and reduces hand-eye coordination. It is dangerous to drive after mixing 

alcohol and marijuana. Driving after using prescription drugs or over-the-counter medicine, such as cough 

suppressants, antihistamines, sleeping aids, and anti-anxiety medications may impair driving ability. 

No one should drive after using marijuana or other drugs, and should not get in a car with a 

driver who has used marijuana or other drugs! 

Remember: any medications act on parts of the brain that can impair driving ability. Many 

prescription drugs have warning labels against the operation of machinery and driving motor vehicles 

for a certain period of time after use. 

You are more likely to be injured or in an accident while driving under the influence of drugs. 

22 23 
Illegal Pharmacies 

Some pharmacies operating on the Internet are illegal. 

No one should use a website to purchase a prescription drug unless – 

g 1. the person has obtained a valid prescription from a medical practitioner who has

conducted an in-person medical evaluation of the person and 

g 2. the website is operating in accordance with the Ryan Haight Act.

Report Suspicious Internet Pharmacies 

If you or your teen is aware of someone distributing prescription drugs or selling them on a 

suspicious Internet pharmacy site, you can report it to the DEA 24 hours a day, 365 days a 

year, by using the RxAbuse online reporting tool located at www.deadiversion.usdoj.gov or 

by calling the DEA hotline toll free at 1-877-RxAbuse (1-877-792-2873). 
Illegal Pharmacies

Ryan Haight 

Francine Haight, Ryan’s mother, shares her son’s story

with the world: “Ryan Thomas Haight overdosed and died

on February 12, 2001, on narcotics (Vicodin®) that he had

easily purchased on the Internet. A medical doctor on the

Internet that he never saw prescribed them, an Internet

pharmacy mailed them to his home. He was only 17 when

he purchased them; he was only 18 when he died.” 

Through the efforts of Francine Haight and members of Congress, with support of 

DEA, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 was 

enacted. The Act aims to remove and prosecute unscrupulous or rogue Internet 

pharmacies that sell controlled prescription medicines to persons without a 

prescription from a registered physician. These pharmacies lack quality assurance 

and accountability. This law has enabled the DEA to prosecute cybercriminals 

supplying controlled substances and to shut down the illegal online pharmacies. 

24 25
 
What is Drug Addiction? 

Addiction is described as a chronic, relapsing brain disease 

that is characterized by compulsive drug seeking and use, 

despite harmful consequences. It is considered a brain disease 

because drugs change the brain; they change its structure and 

how it works. The brain changes can be long lasting and can 

lead to many harmful and self-destructive behaviors. 

Source: The Science of Drug Abuse and Addiction: The Basics 

http://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics 

The misuse of prescription drugs may lead to abuse and then to addiction. 

Some pharmaceuticals have the same potential for abuse, dependence, and addiction as 

heroin. They share many of the same properties and effects as “illegal drugs.” It is important 

for parents to know and understand that using medications outside the scope of sound 

medical practice is drug abuse. 

Dependence on a drug means that the body adjusts to allow for them and can’t function 

normally without them. 
What is Drug Addiction? | Common Drugs of Abuse

g

g

g

g

g

Common Drugs of Abuse 

Categories of Drugs: 

Illegal drugs and legitimate medications are categorized according to their medical use, potential 

for abuse, and their potential for creating physical or psychological dependence. 

There are five classes of drugs of abuse: 

Narcotics 

Stimulants 

Depressants 

Hallucinogens 

Anabolic Steroids 

Within each class are substances that occur naturally and substances created in laboratories 

(synthetics). When they are used appropriately in the practice of medicine, these substances 

can have very beneficial properties. When used for non-medical purposes, including the desire 

to get high, these drugs can cause great harm and even death. 

26 27 
narcotics g

heroin, morphine, methadone, and other opioids 

substances that dull the senses and relieve pain 

Narcotic 

Medicines 

Forms 

Adverse 

Effects 

OD 

Used to treat mild to severe pain (anything from dental surgery to terminal

cancer). Also used to suppress coughs, treat diarrhea, induce anesthesia, 

and treat heroin addiction. 

Liquid, tablet, capsule, skinpatch, powder, syrup, lollipop, diskette,

suppository, and injectable forms. 

Euphoria, drowsiness, and slowed breathing. Skin, lung, and brain 

abscesses; endocarditis (inflammation of the lining of the heart); 

hepatitis; and AIDS are commonly found among narcotics abusers who 

inject drugs or engage in other risky behaviors. 

Slow and shallow breathing, clammy skin, confusion, convulsions, coma,

and possible death. 
{ } 

{ } 

{ } 

 

 

 

 

 | | | 

| 

| 

Common Drugs of Abuse

Narcotic medications available only with a prescription: 

(Note: Lists are not all-inclusive.) 

codeine cough syrup 

robitussin a-c syrup® mytussin ac cough syrup® 

Cough syrups sometimes include other ingredients such as antihistamines 

(promethazine). Some controlled substances, including cough syrups, can be dispensed 

by a pharmacist without a prescription (21 C.F.R. 1306.26). 

slang names: Lean, Purple Drank, Sippin Syrup 

fentanyl 

duragesic patch® actiq lozenge® 

Fentanyl is a very powerful painkiller, 80 times more powerful than morphine. It is 

used in combination with other drugs to treat extreme pain. The biological effects of

fentanyl are indistinguishable from those of heroin, with the exception that some forms 

of fentanyl may be hundreds of times more potent. Encounters with fentanyl that are not

medically supervised are frequently fatal. This narcotic is most commonly used by wearing

or chewing a patch or sucking on a lozenge, but like heroin, it may also be smoked or

snorted. A new effervescent tablet, Fentora®, is now available to place between the 

cheek and gum. 

slang names: Tango and Cash, Perc-a-Pop (Actiq®) 

hydrocodone 

vicodin® lortab® lorcet® hydrocodone with acetaminophen 

Hydrocodone products are used for pain relief and cough suppression and produce 

effects comparable to oral morphine. Hydrocodone products are the most frequently 

prescribed opioids in the United States, and they are also the most abused narcotic

in the United States. 

28 29 
{ } 

{ } 

 

 

 

| | | 

| 

narcotics 

methadone 

dolophine® methadose® 

Methadone has been used for years to treat heroin addicts. It is also used as a powerful

painkiller. From 1999 to 2004, the Centers for Disease Control and Prevention (CDC)

reported that the rate of methadone deaths in younger individuals (15-24) increased

11-fold. For people who are not regular users of methadone, the drug can be dangerous

and must be used with a doctor’s supervision. 

Methadone carries more risks than other painkillers because it tends to build 

up in the body and can disrupt a person’s breathing or heart rhythm. According 

to the CDC report, 4 of every 10 overdose deaths from a single prescription 

painkiller involved methadone, twice as many as any other prescription 

painkiller. As methadone prescriptions for pain have increased, so have 

methadone-related nonmedical use and fatal overdoses. CDC researchers found 

that six times as many people died of methadone overdoses in 2009 compared 

to methadone-related deaths in 1999. 

Source: CDC Press Release, Methadone linked to 30 percent of prescription painkiller overdose deaths 

http://www.cdc.gov/media/releases/2012/p0703_methadone.html 

oxycodone 

oxycontin® oxycodone with acetaminophen percodan® percocet® 

Oxycodone products are very powerful painkillers. Oxycodone is widely used in

clinical medicine. It is marketed either alone as controlled release (OxyContin®)

and immediate release formulations (OxyIR®, OxyFast®), or in combination

with other non-narcotic analgesics such as aspirin (Percodan®) or acetaminophen

(Percocet®). Oxycodone’s behavioral effects can last up to five hours. The drug is

most often administered orally. The controlled-release product, OxyContin®, has 

a longer duration of action (8-12 hours). 

slang names: Oxycotton, Percs, OC, OX, Oxy, Hillbilly Heroin, Kicker. 
} 

} 

} 

} 

} 

} 

} 

Common Drugs of Abuse

Other abused narcotics 

{ meperidine } demerol®

{ hydromorphone dilaudid®

{ oxycodone with acetaminophen endocet®

{ codeine fiorinal®

{ morphine oramorph sr®

{ oxycodone with acetaminophen roxicet®

{ pentazocine talwin®

{ cough syrup with hydrocodone tussionex®

How are narcotics abused? 

Oral (swallowing pills or liquid). In the case of fentanyl, Actiq® is sucked; fentanyl 

patches are worn on the skin, and abusers sometimes scrape off the fentanyl from 

the patch or chew the patch to get high. Hydrocodone and oxycodone pills are most

frequently taken orally but can be crushed and snorted. Crushing the pills negates the

time-release features of some medications, so the user experiences the full power and 

effect all at once. Cough syrups can be drunk or mixed in sodas or sports drinks. 

Where would a teen obtain narcotics? 

Friends, relatives, medicine cabinets, pharmacies, nursing homes, hospitals, hospices,

doctors, social media and purchased on the Internet. They can also be purchased on 

the street. 

30 31 
 

 

{ 

{ 

{ 

{ 

narcotics 

5mg 7.5mg 10mg 

lortab® } 

10mg 20g 40mg 80mg 

oxycontin® } 

*5-500mg *10-660mg *7.5-750mg 

*hydrocodone bitartrate-acetaminophen 

vicodin® } 

600mcg 400mcg 600mcg 

actiq® } 
{ }

Common Drugs of Abuse

glossary 

32 33
 

With repeated use of narcotics, tolerance and dependence develop.

Tolerance occurs when the person no longer responds to the drug in the way 

that person initially responded. Stated another way, it takes a higher dose of the

drug to achieve the same level of response achieved initially.

Source: NIDA, The Neurobiology of Drug Addiction: Definition of Tolerance

http://www.drugabuse.gov/publications/teaching-packets/neurobiology-drug-addiction/sectioniii-action-heroin-morphine/6-definition-tolerance

Physical Dependence is not equivalent to addiction, and may occur with

the regular (daily or almost daily) use of any substance, legal or illegal, even when 

taken as prescribed. It occurs because the body naturally adapts to regular exposure 

to a substance. When that substance is taken away, symptoms can emerge while the 

body re-adjusts to the loss of the substance. Physical dependence can lead to craving 

the drug to relieve the withdrawal symptoms.

Source: NIDA, Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)

http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-basedguide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence
 


 

stimulants g

cocaine, crack, methamphetamine, amphetamines, khat 

substances that stimulate bodily activity

and reverse fatigue (“uppers”) 

Stimulant

Medicines
 

Forms 

Adverse 

Effects 

OD 

Many stimulants have legitimate medical use and are scheduled by the 

DEA. Caffeine and nicotine are stimulants that are not controlled. 

Stimulant medicines are used to treat obesity, attention deficit and

hyperactivity disorders (ADHD/ADD), and narcolepsy. Pseudoephedrine,

found in allergy and cold medications to relieve sinus congestion and 

pressure, is also a stimulant chemical. Cocaine and methamphetamine 

have a currently accepted medical use in treatment. Crack cocaine and 

khat have no legitimate medical uses. 

Powder, “rocks,” “crystal,” pills, and smokable and injectable forms. 

Alertness, excitation, euphoria, increase in blood pressure and pulse rates,

insomnia, and loss of appetite. Abuse is often associated with a pattern of 

binge use–sporadically consuming large doses of stimulants over a short

period of time. Heavy users may inject themselves every few hours,

continuing until they have depleted their drug supply or reached a point

of delirium, psychosis, and physical exhaustion. During this period of 

heavy use, all other interests become secondary to recreating the initial 

euphoric rush. Because accidental death is partially due to the effects of

stimulants on the body’s cardiovascular and temperature-regulating

systems, physical exertion increases the hazards of stimulant use. 

Agitation, increased body temperature, hallucinations, convulsions,

and possible death. 
{ } 

{ } 

{ } 

{ } 

{ } 

 

 

 

 

| | 

| | | 

Common Drugs of Abuse

Stimulant medications available only with a prescription: 

(Note: Methamphetamine and cocaine have limited legitimate medical uses. Lists are not all-inclusive.) 

amphetamines 

adderall® dexedrine® desoxyn® (methamphetamine) 

Amphetamines are used to treat ADHD/ADD. 

slang names: Ice, Crank, Speed, Bennies, Black Beauties, Uppers 

methylphenidate and dexmethylphenidate 

concerta® ritalin® focalin® focalin xr® 

These drugs are used to treat ADHD/ADD. 

slang names: Pellets, R-Ball, Skippy, Vitamin R, Illys 

gOther abused stimulants

phentermine adipex® | ionamin®

benzphetamine didrex®

phendimetrazine prelu-2®

These drugs are used in weight control. 

34 35 
stimulants 

How are stimulants abused? 

Oral (swallowing pill forms of stimulants), smoked (crack, methamphetamine),

crushed and snorted, injected. 

Where would a teen obtain stimulants? 

Friends, relatives, doctors, pharmacies, schools, Internet, social media and 

street drug dealers. 
 

 

{ } 

{ } { }

{ } 

{ } { } 

 

Common Drugs of Abuse

 

5mg 10mg 20mg 10mg 

ritalin® 

37.5mg 100mg 200mg 

provigil® adipex® 

5mg 10mg 

dexedrine® 

25mg 10mg 

5mg 20mg 

focalin® focalin xr® 

36 37 
depressants g

alcohol, valium®, xanax®, tranquilizers, sleeping pills, rohypnol®, ghb 

substances that induce sleep, relieve stress,

and reduce anxiety (“downers”) 

Depressant 

Medicines 

Forms 

Adverse 

Effects 

OD 

Used to treat anxiety, insomnia, seizure disorders, and narcolepsy.

Also used to relax muscles and to sedate. 

Mainly pills and liquids. GHB is often found in liquid form. 

Slurred speech, disorientation, drunken behavior without the odor of

alcohol, impaired memory, vivid and disturbing dreams, and amnesia. 

Shallow respiration, clammy skin, dilated pupils, weak and rapid pulse,

coma, and possible death. 
{ } 

{ } 

{ } 

{ }

{ } 

{ } 

{ } 

 | | | | 

| 

Common Drugs of Abuse

Depressant medications available only with a prescription: 

(Note: Lists are not all-inclusive) 

benzodiazepines 

valium® xanax® halcion® ativan® klonopin® 

Benzodiazepines are used as sedatives, hypnotics, anti-convulsants, muscle relaxants,

and to treat anxiety. Many times they are abused in combination with other drugs or 

to counteract the effects of other drugs. 

slang names: Downers, Benzos 

sleeping pills 

ambien® sonata® 

These depressants are used to treat insomnia. 

gOther abused depressants

chloral hydrate somnote®

barbiturates, such as amo-, seco- and pentobarbital 

GHB xyrem®

carisoprodol soma®

ketamine ketalar®, ketacet®

Please note that even though ketamine is a depressant, it is abused by kids for its 

psychedelic effects. 

38 39 
depressants 

How are depressants abused? 

Oral (swallowing pills). 

Where would a teen obtain depressants? 

Friends, relatives, doctors, hospitals, Internet, street drug dealers. 

Jason Surks was 19 and in his second year of college, studying to be a 

pharmacist, when he died of an overdose of depressant pills. After his death,

his parents discovered that he had been ordering controlled substances from 

an Internet pharmacy in Mexico. His mother, Linda, writes: “I thought to 

myself that this couldn’t be possible. I work in prevention, and Jason knew 

the dangers—we talked about it often. I think back to the last several 

months of my son’s life, trying to identify any signs I might have missed. 

a parent’s

story 

“I remember that during his first year in college, I discovered an unlabeled pill bottle in his room. I 

took the pills to my computer and identified them as a generic form of Ritalin. When I confronted 

Jason, he told me he got them from a friend who’d been prescribed the medication. He wanted 

to see if they would help him with his problem focusing in school. I took that opportunity to 

educate him on the dangers of abusing prescription drugs and told him that if he really thought 

he had ADD (Attention Deficit Disorder), we should pursue this with a clinician. He promised 

he would stop using the drug. But as a pre-pharmacy major, maybe he felt he knew more about 

these substances than he actually did and had a ‘professional curiosity’ about them.” 

Source: As recounted on www.drugfree.org/memorials. 
 

{ } { } 

{ } { } 

{ } 

{ } 

 

 

Common Drugs of Abuse

1mg 2mg 7.5mg 

ativan® restoril® 

1mg 2mg .5mg 3mg 

xanax® xanax xr® 

2mg 5mg 10mg 

valium® 

.5mg 1mg 2mg wafer, 1mg 

klonopin® 

40 41 
anabolic steroids g

testosterone 

drugs used to enhance performance,

increase muscle mass, and improve appearance 

Anabolic 

Steroids 

Forms 

Adverse
 

Effects
 

Synthetically produced variants of the naturally occurring male hormone 

testosterone are used to promote muscle growth, enhance performance,

or improve physical appearance. Prescribed by doctors for loss of testicle 

function, breast cancer, low red blood cell count, hypogonadism, delayed 

puberty, and debilitated states resulting from surgery or sickness (cancer 

and AIDS). Administered to animals by veterinarians to promote feed 

efficiency, improve weight gain, and treat anemia and tissue breakdown

during illness or trauma. 

Tablets, sublingual tablets, liquid drops, gels, transdermal patch,

subdermal implant pellets, water-based injectable solutions, oil-based

injectable solutions. 

Males: In adults, shrinking of testicles, reduced sperm count, infertility,

development of breasts, acne, fluid retention, and increased risk of prostate

cancer. In boys, early sexual development, acne, and stunted growth. 

Females: Acne, oily skin, deepening of voice, increased body and facial hair, 

menstrual irregularities, and fluid retention. Also, in girls,stunted growth. 

Both: Harm to heart, liver dysfunction, liver tumors, liver cancer, increased

blood pressure, increased LDL cholesterol, enlargement of the heart, heart

attacks, stroke, hepatitis, HIV, anger, hostility, and male pattern baldness. 

Upon discontinuation: Prolonged periods of depression, restlessness,

insomnia, loss of appetite, decreased sex drive, headaches, and irritability. 
 

Common Drugs of Abuse

{ } 

 

 

Steroids available only with a prescription: 

(Note: Lists are not all-inclusive) 

anabolic steroids 

anadrol® | andro® | deca-durabolin® | depo-testosterone® | dianobo® 

durabolin® | equipoise® | oxandrin® | thg® | winstrol® 

There are over 100 different types of anabolic steroids. 

slang names: Arnolds, Gym Candy, Pumpers, Roids, Stackers, Weight Trainers, 

Gear Juice 

How are steroids abused? 

Steroids are taken orally, injected, taken under the tongue, or applied with topical

creams that allow steroids to enter the bloodstream. There are different regimens

for taking steroids to increase body mass; they are widely published and available on

the Internet. 

Where would a teen obtain steroids? 

Friends, gyms, school, teammates, coaches, trainers, social media and the Internet. 

42 43 
{ } 

anabolic steroids 

three parents’ stories 

These three young men were athletes who sought ways 

to enhance their performance. Each of them turned to 

steroids, and each of them suffered the depression that 

comes when steroids are stopped. 

depo-testosterone® 
{ } 

{ } 

{ } 

Common Drugs of Abuse

taylor hooton 

Died at age 17. It took a while for his parents to connect Taylor’s recent weight and muscle increases

with his uncharacteristic mood swings and violent, angry behavior. He’d been using a cocktail

of steroids and other hormones to bulk up, and the drugs were wreaking havoc on his body and

emotions. Taylor went to his room and hanged himself. It was only after his death that the whole

picture came into focus. 

rob garibaldi 

 

Died at age 24. When supplements and workouts did not produce the desired results, Rob turned to

steroids. According to Rob, he first obtained steroids from his trainer at the University of Southern

California, whose name Rob never divulged. With a wink and a nod, they kept his use a secret. 

The desire and need to look bigger, be stronger, and avoid losing muscle gains already achieved 

prompted him to continue steroid use. Over time, Rob gained 50 pounds and became the 

powerhouse the steroids promised. Drinking alcohol or taking any other drug, including 

prescription medication, compounds the adverse effects of steroids. The most dangerous effect 

of steroids is suicide. His parents said: “We know, without a doubt, steroids killed our son.” 

efrain marrero 

Died at age 19. Efrain had been secretly using steroids to prepare for football season. He had been a

standout offensive lineman in high school and was now playing at the junior college level. However,

he decided he wanted to move from the offensive line to more of a “glory” position at middle

linebacker. Any football fan seeing Efrain would recognize the significant physical transformation it

would take for him to make that happen. As his parents tell it, “Efrain began using steroids, under

the impression that it would make him bigger, stronger, faster, and earn him the title and recognition

he so much desired.” Unaware of the serious side effects of steroids, Efrain began to experience

severe paranoia and deep depression. Frightened, he turned to his parents for help, who took him to

the family doctor. The doctor assured them that the steroids would leave Efrain’s system soon and

that no further action was required. No one knew that quitting steroids cold turkey was unwise; the

physician failed to provide an appropriate course of action. Three weeks later, Efrain shot himself in

the head. 

44 45 
over-the-counter g 

robitussin®, coricidin hbp®, nyquil® 

medications with DXM (hallucinogen) 

OTC 

Medicines 

with DXM 

Forms 

Adverse 

Effects

OD 

There are well over 100 medicines that contain dextromethorphan

(DXM), either as the only active ingredient or in combination with other 

active ingredients. 

These medications (store brands as well as brand names) can be

purchased over-the-counter in pharmacies, some grocery stores, and some

other outlets. 

Liquid, gelcaps, pills, powder. 

High doses produce confusion, dizziness, double or blurred vision, slurred

speech, loss of physical coordination, abdominal pain, nausea and vomiting,

rapid heart beat, drowsiness, numbness of fingers and toes, and disorientation.

DXM abusers describe different “plateaus” ranging from mild distortions of

color and sound to visual hallucinations,“out-of-body” dissociative sensations,

and loss of motor control. (Note: Many OTC products listing DXM as an active

ingredient may also contain antihistamines, acetaminophen, or other substances,

which have other side effects.) 

Unable to move, feel pain, or remember. 
Common Drugs of Abuse

gHow are OTCs with DXM abused?

Cough syrup is drunk either alone or in combination with soft drinks or alcohol.

Gelcaps and pills are swallowed or crushed and put into drinks. 

Where would a teen obtain OTCs with DXM? 

Friends, relatives, pharmacies, grocery stores, discount department and warehouse 

stores. DXM is also available on the Internet. 

Warning signs of cough medicine abuse include: 

Empty cough medicine boxes or bottles in child’s room,

backpacker or locker. 

Child buys large amounts of cough medicine when not ill. 

Bottles of cough medicine in medicine cabinet are missing. 

Child visits websites with information on how to use DXM to get high. 

Source: http://stopmedicineabuse.org. 

trends 

46 47 
What You Can Do 

Because prescription drugs are legal, they are easily 

accessible. Parents, law enforcement, educators, 

the medical community, and all levels of government 

have a role to play in reducing the nonmedical use of 

prescription drugs. 

Talk with your teen about the consequences of using prescription and OTC drugs

non-medically and the importance of healthy choices. 

Choose the right time to talk. When talking to your child, be sure your

child is sober or has not been using drugs before talking about drugs and alcohol. 

Voice your suspicion. Begin by expressing your concerns without making

accusations. 

Be specific. Explain what you observed to make you concerned. For example,

you found missing pills or an empty pill bottle. Or your child’s appearance 

indicates a problem. 
What You Can Do

learn the facts 

Be prepared for strong reactions. Your child may accuse you of snooping 

or say you’re crazy. Stay calm. 

Reinforce what you think about drug use. Tell her how much you care for 

him or her. 

Get help from the experts. Contact the school counselor, school nurse, or 

family doctor about your concerns. 

TIP: A teen that is using drugs or alcohol needs to be evaluated by a professional 

for a possible substance abuse disorder. 

Ask teens what they find out about prescription drugs at school, at friends’ homes, at 

parties, and on social media sites. 

Get information about teen abuse of prescription drug medications. Learn what the 

medication is used for, what it looks like, its effects and interactions, and how teens are 

using it. 

48 49 
What You Can Do 

Understand the power and danger of these medications. Many medications, 

particularly narcotic pain relievers (opioid medications), are very powerful and are 

designed to relieve extreme pain. New medications are continually being approved for 

medical use, and it is important to be informed about the drugs’ uses and properties. 

Follow disposal guidelines. Learn how to dispose of unused medicines by visiting 

the DEA Diversion website http://www.deadiversion.usdoj.gov/drug_disposal/. Read 

more about safe drug disposal and get information on drug poisoning. 

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm101653.htm 

Ask your doctor, dentist, and pharmacist about the medications you are prescribed. 

Ask about their side effects, interactions, and potential addictiveness. 

Review what is in your medicine cabinet. Lock up powerful medications in a safe 

place, not in the family medicine or kitchen cabinet. Count your pills when you receive 

them, and periodically check to see how many are in the container. Avoid keeping 

prescription painkillers or sedatives around “just in case.” 
What You Can Do

learn the facts 

Read the labels. The prescription label includes important information about how

much to take, interactions, and the ingredients. Many generic prescriptions are 

substituted for brand name drugs. Usually, the generic name of the drug is printed with 

the brand name, so that the customer knows which medication they receive. It may be 

easy to overlook the fact that the doctor has prescribed a very powerful narcotic painkiller. 

Remember: Use of Rx medicines without a doctor’s recommendation can be just

as dangerous as using illegal drugs. Improper use can have serious health effects, 

including addiction and overdose. 

50 51 
DEA’s Role 

DEA plays a critical role in preventing non-medical use and

abuse of prescription drugs. 

DEA investigates physicians who sell prescriptions to drug dealers or who 

overprescribe drugs; pharmacists who falsify records and then sell the drugs; 

employees who steal from drug inventory; executives who falsify orders to cover 

illicit sales; prescription forgers; and persons who commit armed robbery of 

pharmacies and drug distributors. 

DEA investigates illegal Internet pharmacies. Rogue pharmacies exist to profit from 

the sale of controlled prescription medications to buyers who have not seen a doctor 

and do not have a prescription from a registered physician. The pharmacies lack 

quality assurance and accountability, and their products pose a danger to buyers. 

DEA works with state, local, and foreign partners to interdict controlled substances 

and chemicals used to make drugs. 

DEA’s authority to enforce laws and regulations comes from the Controlled 

Substances Act, Title 21 of the United States Code. DEA also provides factbased timely information to the public about the dangers of illegal drugs and 

the non-medical use of prescription drugs through publications, websites and 

presentations. 
resources 

Center for Disease Control (CDC), Prescription Drug Overdose http://www.cdc.gov/drugoverdose/ 

Community Anti-Drug Coalitions of America (CADCA) www.cadca.org 

Consumer Healthcare Products Association (CHPA), D.A.R.E., and the Partnership for Drug-Free Kids provide 

information on over-the-counter cough medicines at www.StopMedicineAbuse.org 

Drug Abuse Resistance Education (D.A.R.E.) provides an information kit and curricula on helping communities 

respond to Rx and OTC abuse at www.dare.org/drug-abuse-trends-change-dare-america-responds

Drug Enforcement Administration (DEA) www.dea.gov 

DEA Office of Diversion Control www.deadiversion.usdoj.gov 

DEA’s website for teens 

www.JustThinkTwice.com 

DEA’s website for parents, caregivers & educators 

www.GetSmartAboutDrugs.com 

Institute for Behavior and Health, Inc. provides information on drugged driving at www.stopdruggeddriving.org 

National Institute on Drug Abuse (NIDA) provides information on prescription and over-the-counter drugs at 

www.nida.nih.gov 

National Institute of Mental Health’s Library of Medicine – www.nlm.nih.gov/medlineplus;
 

Spanish version www.nlm.nih.gov/medlineplus/spanish/medlineplus.html
 

National Suicide Prevention Lifeline www.suicidepreventionlifeline.org; 1-800-273-TALK
 

NIDA’s Teen Website on Prescription and Over-The-Counter Drugs www.teens.drugabuse.gov/peerx/
 

Office of National Drug Control Policy (ONDCP) www.whitehouse.gov/ondcp/
 

Partnership for Drug-Free Kids provides information for parents on teen prescription drug abuse www.drugfree.org.
 

All photos courtesy of Wolters Kluwer Health

—MediSpan or the Drug Enforcement Administration

DEA’s Role 52 53 


GetSmartAboutDrugs A DEA Resource for Parents 

www.GetSmartAboutDrugs.com www.DEA.gov 

www.JustThinkTwice.com www.DEAdiversion.usdoj.gov