SECOND EDITION

How Teens

Abuse Medicine GetSmartAboutDrugs

Prescription for Disaster

A DEA Resource for Parents

www.GetSmartAboutDrugs.com

www.JustThinkTwice.com

www.DEA.gov 

www.DEAdiversion.usdoj.gov
To locate your local Poison Control Center, or for assistance and counseling in identifying 

and responding to a pill or other medicine you find:

www.poisonprevention.org/emergency.htm 

Or call 800-222-1222, 24 hours a day, 7 days a week.

Revised August 2012

First Edition December 2008

“As America faces an explosive prescription drug abuse problem, parents 

need to be aware that their family medicine cabinet and the Internet 

have become today’s back alley drug dealers. Teens need to understand 

that abusing prescription drugs is every bit as dangerous as abusing 

‘street’ drugs. With this booklet, DEA shows the good news for families: 

That there are simple ways to limit access to these drugs and to keep our 

teens drug-free.” 

Michele Leonhart, Administrator, Drug Enforcement Administration
GetSmartAboutDrugs

How Teens

Abuse Medicine

Prescription for Disaster

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, go to www.dea.gov or consult the additional resources at the back of this book. 

A DEA Resource for Parents
{ Prescription Drug Abuse

How Teens Abuse Medicine

Prescription Drug Basics

At What Costs? 

Street Drugs vs. Pharmaceuticals

Common Drugs of Abuse

The Internet, Drugs, and Teens

What You Can Do

DEA’s Role

Additional Resources

04

06

12

14

18

20

42

48

54

55

USA Today, “Teens use Internet to Share Drug Stories” 

by Donna Leinwand, June 19, 2007

Millions of teens are using very powerful pain medications 

to get high. Some of these are the same medications doctors 

use to treat pain in terminal cancer patients. 

For many teens, using prescription or 

over-the-counter medications is their first 

introduction to getting high. Until recently, 

teens began their drug use with marijuana.

{

{
Although most people take prescription medications responsibly, an estimated 52 

million people have used prescription drugs for non-medical reasons at least once 

in their lifetime. (NIDA, Nov. 2011)

Prescription medication, such as those used to treat pain, attention deficit 

disorders, and anxiety, are being abused at a rate second only to marijuana among 

illicit drug users. (NIDA, Nov. 2011)

In 2010, approximately 7 million people (2.7% of the U.S. population) were 

current users of psychotherapeutic drugs taken non-medically.

5.1 million people used pain relievers

2.2 million people used tranquilizers

1.1 million people used stimulants 

.4 million people used sedatives (NSDUH 2010, Sept. 2011)

According to the 2010 National Survey on Drugs Use and Health, an estimated 

2.4 million Americans used prescription drugs non-medically for the first time in 

the past year. This averages about 6,600 initiates per day, of which one-third are 

12 to 17 years of age. 

In 2010, about one-fourth (26%) of first time drug users began with non-medical use 

of prescription drugs. (NSDUH 2010)

In 2010, one in every 20 people in the United States age 12 and older – a 

total of 12 million people – reported using prescription painkillers non-medically. 

(NSDUH, CDC Press Release, Nov. 2011)

Almost 5,500 people start to misuse prescription painkillers every day. (Pamela Hyde, 

SAMHSA Administrator, CDC Press Release, Nov. 2011)

Over half a million emergency department visits in 2010 were due to people misusing 

or abusing prescription painkillers. (Highlights of the 2010 DAWN Findings on DrugRelated Emergency Department Visits, July 2012)

Non-medical use of prescription painkillers costs health insurers up to $72.5 billion 

annually in direct health care costs.

Prescription Drug Abuse 4 5

prescription for disaster

Prescription Drug Abuse

g
How Teens Abuse Medicine 6 7

prescription for disaster

How Teens Abuse Medicine

Despite recent reductions in several areas of teen 

drug use, teens are continuing to use prescription and 

over-the-counter medications to get high. It’s a serious 

problem that affects all of us.

Many parents don’t know enough about this problem, 

and many teens don’t understand the dangers of using 

the medications to get high. 

The latest attitude surveys tell us that:

Nearly one in five teens (17%) say they have used prescription medicine at least 

once in their lifetime to get high. 

More than one in ten teens (12%) report lifetime use of over-the-counter cough or 

cold medicines to get high. 

One out of ten teens (10%) report using pain medications (OxyContin® and Vicodin®) 

to get high in the past year; six percent say they’ve used pain medications in the past 30 

days to get high.

Emergency room visits, as a result of prescription medications, increased by 45% 

between 2004 and 2010 among children under the age of 20. (Highlights of the 2010 

DAWN Findings, July 2012)

Nearly three in five teens (58%) now say that they strongly disapprove of their peers 

using prescription medication to get high. This is up from 52% in 2010.

Source: Partnership for a Drug Free America, 2011 Partnership Attitude Tracking Survey (PATS)
Marijuana/Hashish }

Synthetic Marijuana }

Vicodin }

Adderall }

Salvia }

Tranquilizers }

Cough Medicine }

MDMA (Ecstasy) }

Hallucinogens }

OxyContin }

Sedatives }

Inhalants }

Cocaine (any form) }

Ritalin }

How Teens Abuse Medicine 8 9

Prescription and Over-the-Counter Medications Account for 

Most of the Commonly Abused Drugs: Past Year Use Among 

High School Seniors

0.0% 10.0% 20.0% 30.0% 40.0%

Categories are not mutally exclusive

Source: University of Michigan, 2011 Monitoring the Future Study

Source: 2011 Monitoring the Future

Recent drug surveys also provide evidence that the problem of intentional medicine 

abuse has grown. Six of the top ten drugs abused by 12th graders are prescription 

and over-the-counter medications.

After marijuana, prescription and over-the-counter medications account for most of 

the top illicit drugs abused by 12th graders in the past year.

In 2011, 22% of 12th graders indicated misuse of a prescription drug without 

medical supervision in their lifetime; and 15% over the past year.

One in 12 high school seniors reported past year non-medical use of the 

prescription pain reliever, Vicodin®.

One in 20 high school seniors report abusing OxyContin®.

Additionally, recent drug surveys found that teens generally get their prescription 

drugs from friends and family; 70% of 12th graders said they were given the 

drugs by a friend or relative. 

illicit drug non-medical use of prescription medication

How Teens Abuse Medicine
How Teens Abuse Medicine

In 2010, the abuse of prescription medications was highest 

among young adults aged 18–25 years of age, with 5.9% 

reporting non-medical use within the past month. (NSDUH 2010)

 The experts give some reasons why teens might turn to 

prescription drugs to get high:

 To party,

 Self-medication,

 Escape and boredom,

 Preservation of friendships, romantic relationships, and family life,

 Competing for college admission, including competition for advance 

placement and honors courses in high school,

 To balance between schoolwork, grades, and extracurricular activities, 

like sports and clubs,

 Academic stress in college, and

 The desire to have the “ideal” physical appearance. 

In 2010, three percent of youth 12 to 17 years of age were current medical 

users of psychotherapeutic drugs.

 Of 12 to 13 year olds, two percent were current medical users 

of psychotherapeutic drugs.

 Of 14 to 15 year olds, three percent were current medical users 

of psychotherapeutic drugs.

 Of 16 to 17 year olds, almost four percent were current medical 

users of psychotherapeutic drugs.

Using prescription drugs to get high is not a problem limited to 

young teens.

The use of these drugs by college students has increased dramatically within the past 

decade. According to a 2007 report by the National Center for Addiction and Substance 

Abuse at Columbia University (CASA), “Wasting the Best and the Brightest: Substance 

Abuse at America’s Colleges and Universities,” between 1993 and 2005 the proportion 

of students abusing prescription drugs increased:

343% for opioids like Percocet®, Vicodin®, and OxyContin®

93% for abuse of stimulants like Ritalin® and Adderall®

450% for tranquilizers like Xanax® and Valium®

225% for sedatives like Nembutal® and Seconal®

10 11

g

How Teens Abuse Medicine
Prescription Drug Basics

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

authorization from a healthcare practitioner to a pharmacist. 

An “over-the-counter” medication is a drug that is sold without 

a prescription.

Both kinds of drugs come with explicit instructions on how 

to use the drug, and these instructions should be followed 

to avoid adverse consequences. The Food and Drug 

Administration (FDA) approves all drugs on the market and 

provides sound advice to consumers. 

Source: www.fda.gov 

Over-The-Counter (otc) 

OTC drug labels contain information about ingredients, uses, warnings, and directions that 

are important to read and understand. The label also includes important information about 

possible drug interactions. Further, drug labels may change as new information becomes 

known. That’s why it’s especially important to read the label every time you use a drug. 

Drug-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

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. 

g

g

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Prescription Drug Basics 12 13
At What Costs? g Drug poisonings, emergency room visits, drugged driving

Mark Bauer’s father, Phil Bauer, writes: “A few years ago, my life was 

changed forever. On May 27, 2004, my youngest son, Mark, was a week 

away from graduating from high school. Mark’s day went something 

like this: He woke up and went to school and played in the student/staff 

basketball game. When he came home from school he lifted weights 

and ate dinner. He then went to work and returned home at about 9:30 

that night. When he got home, Mark talked to us about the game that 

day, and we knew what a special day it had been for him.

“That was the last conversation we ever had with Mark.... He never woke up the next day. 

On Friday, May 28, 2004, his mom and I found his lifeless body in bed. Mark died from an 

accidental overdose of prescription drugs, including OxyContin® and morphine.” 

a parent’s

story

At What Costs? 14 15

“Overdoses involving prescription pain killers are at epidemic levels and now kill more 

Americans than heroin and cocaine combined.” 

CDC Director Thomas Frieden, MD, MPH, Nov. 1, 2011

Drug Poisonings

In 2009, the 39,147 drug-induced deaths exceeded the number of deaths from 

motor vehicle crashes (36,216).

The death toll from overdoses of prescription painkillers has more than tripled in the 

past decade. More than 40 people die every day from overdoses of narcotic pain 

relievers like hydrocodone (Vicodin®), methadone, oxycodone (OxyContin®), and 

oxymorphone (Oxpana®). (CDC Vital Signs Press Release, Nov. 2011)

There was a 91% increase in drug poisoning deaths among teens aged 15 – 19 

between 2000 (30%) and 2009 (57%) due to prescription drug overdose.

(CDC Press Release, April 16, 2012)

Drug induced deaths now outnumber gunshot deaths in America. (ONDCP Strategy)
At What Costs? g Drug poisonings, emergency room visits, drugged driving

At What Costs? 16 17

Emergency Room Visits

Emergency room visits involving misuse or abuse of pharmaceuticals increased 115% 

between 2004 and 2010, from 626,472 visits to 1,345,645 visits. This compares to 

about 1,171,024 emergency room visits involving illicit drugs in 2010. During this 

period, emergency room visits for misuse and abuse of pharmaceuticals for those 20 

or younger increased 45%, from 116,176 to 168,409 people.

Of the 2.3 million emergency department visits involving drug misuse or abuse in 

2010, 1.3 million visits involved pharmaceuticals. 

People 20 years of age or younger accounted for 18.8% of all drug-related 

emergency department visits in 2010. About half of these visits involved drug misuse 

or abuse.

About half of emergency department visits (659,969) for misuse or abuse of 

pharmaceuticals involved pain relievers. Hydrocodone products were responsible for 

115,739 visits and oxycodone products for 182,748 visits. 

 Source: The DAWN Report: Highlights of the 2010 DAWN 

Findings on Drug-Related Emergency Department Visits, 

SAMHSA, July 2012

Drugged Driving

Drugged driving is a public health threat and one that we all need to be concerned 

about, especially where our children are involved. Driving under the influence of any 

drugs that act on the brain impairs one’s motor skills, reaction time, and judgment. 

This puts not only the driver at risk but also passengers and others who share the road.

(NIDA, Drugged Driving)

Teens are the least experienced drivers, which increases their risk of being involved 

in an accident. When you combine the lack of experience with substances that impair 

cognitive and motor skills, you increase the chances of tragic results. Vehicle accidents 

are one of the leading causes of teen deaths.

An analysis of the National Highway Traffic Safety Administration’s Fatality Reporting 

System revealed that almost one in four (23%) of fatally injured drivers who tested 

positive for drugs were under the age of 25. (ONDCP Press Release, Oct. 2011)

One in three (33%) motor vehicle accidents with known drug test results tested 

positive for drugs in 2009. (ONDCP Press Release, 2010)

Involvement of drugs in fatal crashes has increased by five percent over the past five 

years, even though the overall number of drivers killed by motor vehicle crashes has 

declined. (ONDCP Press Release, Nov. 2010)
Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), explains 

how the legitimately prescribed drug Ritalin® (methylphenidate), when abused, can 

act in the same way as cocaine: 

“For example, the stimulant methylphenidate (Ritalin®) has much in common with cocaine: 

they bind to similar sites in the brain, and they both increase the brain chemical dopamine 

through the same molecular targets. And when both drugs are administered intravenously, 

they cause a rapid and large increase in dopamine, which a person experiences as a rush or 

high. However, when methylphenidate is taken orally, as prescribed, it elicits a gradual and 

sustained increase in dopamine, which is not perceived as euphoria and instead produces the 

expected therapeutic effects seen in many patients.” 

Source: Testimony before the House Government Reform Committee, July 26, 2006

{how does it work?}

Street Drugs vs. Pharmaceuticals

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

known as illegal drugs—cocaine, heroin, methamphetamine,

marijuana, and others. Many teens mistakenly believe that 

pharmaceuticals (prescription drugs) are safer than “street 

drugs” for a variety of reasons:

These are medicines.

They can be obtained from doctors, pharmacies, friends

or family members.

It’s not necessary to buy them from traditional “drug dealers.” 

Information on the effects of these drugs is widely available

in package inserts, advertisements, and on the Internet.

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.

gand OTC medicines

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Street Drugs vs. Pharmaceuticals 18 19
Common Drugs of Abuse

Illegal drugs and legitimate medications are categorized according 

to their medical use, potential for abuse, and their potential for 

creating physical or psychological dependence.

Dependence means that the body adjusts to allow for them and can’t function normally 

without them. When drugs are used in a manner that is inconsistent with the medical or 

social patterns of a culture, it is called drug abuse. Addiction is defined as compulsive, 

drug-seeking behavior where acquiring and using a drug becomes the most important 

activity in a user’s life. 

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. 

Categories of Drugs 

There are five classes of drugs of abuse: Narcotics, Stimulants, Depressants, Hallucinogens,

and Anabolic Steroids.

Within each class are substances that occur naturally and those 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 damage and even death. 

Dangerous and Addictive 

Drugs are placed into five different schedules by DEA according to their medical use 

and potential for abuse and dependence. Schedule I drugs have no accepted medical 

use and have not been shown to be safe for people to use. Drugs in Schedules II-V have 

medical uses and different potentials for abuse. 

Within the five classes, individual drugs are ranked according to their abuse potential.

When controlled substances are prescribed by a doctor and used according to directions,

they can be safe and effective. 

“Street drugs” and legitimate medications often have the exact same addictive 

properties. It is important to remember that people can react to drugs differently, and 

even drugs that are considered to have a low abuse potential can be addictive and 

possibly fatal to some users. 

g

g

Common Drugs of Abuse 20 21
{ codeine cough syrup }

robitussin a-c syrup® | mytussin ac cough syrup®

Cough syrups sometimes include other ingredients such as antihistamines

(promethazine). 

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® | lorecet® | 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. 

Narcotic medications available only with a prescription:

(Note: Lists are not all-inclusive.)

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, 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, 

possible death. 

narcotics g

heroin, morphine, methadone, and other opioids

substances that dull the senses and relieve pain

Common Drugs of Abuse 22 23
g

{ 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.

{ 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.

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, Internet. They can also be purchased on the street.

narcotics

Common Drugs of Abuse 24 25
5mg 7.5mg 10mg

10mg 20g 40mg 80mg

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

600mcg 400mcg 600mcg

*hydrocodone bitartrate-acetaminophen

With repeated use of narcotics, tolerance and dependence develop. 

Tolerance is a state in which a drug user becomes less sensitive to the drug’s 

effects after repeated use. The user must take more of a drug and take it more often 

to achieve the same painkilling, sedating, or euphoric effect. Tolerant users can 

consume doses far in excess of the dose they started with or that an average person 

could safely tolerate.

Physical Dependence is a state that develops as a result of repeated use of 

a drug. A dependent person must consume a drug in order to prevent a withdrawal 

syndrome. This syndrome can range from mild to severely unpleasant and lifethreatening depending on the drug and pattern of use.

Psychological Dependence is marked by drug craving, an intense 

desire to take the drug, which can focus all of the person’s thoughts and desires on 

obtaining and using the drug. While physical dependence will go away in days or 

weeks after drug use, psychological dependence can continue for years.

{ glossary }

narcotics

{ lortab® }

{ oxycontin® }

{ vicodin® }

{ actiq® }

Common Drugs of Abuse 26 27
{ 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

Other abused stimulants

{ phentermine} adipex® | ionamin®

{ benzphetamine } didrex®

{ phendimetrazine } prelu-2®

These drugs are used in weight control.

stimulants g

cocaine, crack, methamphetamine, amphetamines, khat

Stimulant medications available only with a prescription:

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

substances that stimulate bodily activity 

and reverse fatigue (“uppers”) 

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, 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, 

possible death.

g

Stimulant 

Medicines

Forms

Adverse 

Effects

OD

Common Drugs of Abuse 28 29
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, medicine cabinets, Internet, 

street dealers.

stimulants

5mg 10mg 20mg 10mg 

37.5mg 100mg 200mg

{ ritalin® }

{ adipex® }

5mg 10mg 

{ dexedrine® }

{ provigil® }

25mg 10mg 

{ focalin® } { focalin xr® }

Common Drugs of Abuse 30 31

5mg 20mg 
{ benzodiazepines }

valium® | xanax® | halcion® | ativan® | klonopin®

Benzodiazapines 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. 

Other abused depressants

{ choloral hydrate } somnate®

{ 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. 

depressants g

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

substances that induce sleep, relieve stress,

and reduce anxiety (“downers”)

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, amnesia. 

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

coma, possible death. g

Depressant medications available only with a prescription:

(Note: Lists are not all-inclusive)

Depressant

Medicines 

Forms

Adverse

Effects

OD

Common Drugs of Abuse 32 33
How are depressants abused?

Oral (swallowing pills). 

Where would a teen obtain depressants?

Friends, relatives, medicine cabinet, doctors, hospitals, Internet, street dealers.

depressants

1mg 2mg 7.5mg

1mg 2mg

{ ativan® } { restoril® }

2mg 5mg 10mg 

{ valium® }

{ xanax® }

{ klonopin® }

.5mg 1mg 2mg wafer, 1mg

{ xanax xr® }

Common Drugs of Abuse 34 35

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.

.5mg 3mg
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, Internet.

anabolic steroids g

testosterone

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, 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, 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, male pattern baldness.

Upon discontinuation: Prolonged periods of depression, restlessness, 

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

drugs used to enhance performance,

increase muscle mass, and improve appearance

Anabolic

Steroids 

Forms

Adverse

Effects

Common Drugs of Abuse 36 37

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
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. 

three parents’ stories

anabolic steroids { 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 

{ depo-testosterone the head. ® }

Common Drugs of Abuse 38 39
How 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, medicine cabinets. DXM is also 

available over the Internet. 

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.

g

Common Drugs of Abuse 40 41

There is little in current teen culture—music, movies, fashion, and 

entertainment—that promotes or even mentions cough medicine abuse. 

The one exception is the Internet. A number of disreputable websites 

promote the abuse of cough medicines containing dextromethorphan. 

The information on these sites includes recommending how much to 

take, suggesting other drugs to combine with DXM, instructing how to 

extract DXM from cough medicines, promoting drug abuse in general, 

and even selling a powder form of dextromethorphan for snorting. You 

should be aware of what your teen is doing on the Internet, the websites 

he or she visits, and the amount of the time he or she is logged on. 

Source: Partnership for a Drug-Free America, 

“What Every Parent Needs to Know About Cough Medicine Abuse,” www.drugfree.org.

trends
recognize the signs

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 for prescription drugs, and the world wide web 

plays a big role in providing information and advice to 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. 

{ ashley duffy }

Ashley Duffy, 18, knew her parents wouldn’t tap into her online journal, so she wrote freely 

about her drug use. She says she used the Internet to contact her dealer and connect at 

parties with people who had drugs. 

“Kids are really open about it. I see posts from other people describing a night on acid or 

whatever,” says Duffy of West Chester, Pennsylvania, who underwent treatment and says 

she has been drug-free for 16 months. “I think they think their parents are clueless. And I 

guess they are.”

Source: USA Today, “Teens use Internet to Share Drug Stories” by Donna Leinwand, June 19, 2007

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 

Pharmacies. “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.

The Internet, Drugs, and Teens 42 43

here are a few things to consider

The Internet, Drugs, and Teens 
recognize the signs

The Internet, Drugs and Teens 44 45

The Internet, Drugs, and Teens 

{ 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. 

“It is too easy to meet and chat with strangers on Internet websites that glorify the use of drugs 

and who can easily talk our children into experimenting. These websites encourage our children to 

take drugs and share their highs, which is extremely dangerous and can lead to death,” Francine 

Haight said.

Source: USA Today, “Teens use Internet to Share Drug Stories” by Donna Leinwand, June 19, 2007

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 in October 

2008. The act focuses on removal from the web and prosecution of unscrupulous or rogue 

internet pharmacies that exist to profit from the sale of controlled prescription medicines to 

buyers who have not seen a doctor and don’t have a prescription from a registered physician. 

These pharmacies lack quality assurance and accountability, and their products pose a danger to 

buyers. This law makes it harder for cybercriminals to supply controlled substances and easier 

for DEA to prosecute them, and has resulted in the reduction of these online pharmacies. 

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

such as Facebook, Twitter, and YouTube. 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.

“Teens who spend more time on social networking sites are more likely to smoke, drink, and 

use drugs.” 

The survey of 12 to 17 year olds found that 70% spent time on social networking sites. 

Of the 70%, 40% have seen pictures on the sites of teens getting drunk, passed out, or 

using drugs. Half of these teens saw these pictures when they were 13 years of age or 

younger; 90% first saw them when they were 15 or younger.
The Internet, Drugs, and Teens 46 47

The Internet, Drugs, and 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.

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
learn the facts

“Enough prescription painkillers were prescribed in 2010 

to medicate every American adult around-the-clock for 

a month. Although most of these pills were prescribed 

for medical purposes, many ended up in the hands of 

people who misused or abused them.” (CDC Vital Signs, Nov. 2011)

We know that 70% of youth get their prescription drugs from family and friends, yet fewer 

parents report safeguarding prescription medications. “Anyone can access prescription 

medicines in the medicine cabinet” went from 50% in 2010 to 64% in 2011, meaning 

medications are available to anyone in their homes. 

Slightly over two-thirds of parents of ninth through twelfth graders say they have ever had 

a discussion with their children about prescription medicine to get high. This is down from 

82% in 2009. 

Teens that report learning a lot from their parents about the risks of drugs are half as likely 

as those who learn nothing from their parents to have ever used prescription medicines to 

get high, but only 16% say they have discussed prescription medicine with their parents 

in the past year. 

What You Can Do 48 49

Take the time to talk to your children about prescription medications and over-the-counter 

drugs. Let them know that just because a doctor has prescribed it or you can buy it in the 

store does not mean it is safe for them to use. Just because it’s not bought from a drug 

dealer does not mean it’s safer. Just because you use it does not mean that it is safe for 

them to use. 

Set an example. If your children see you taking drugs make sure they know what you are 

taking and why. Kids are smart, and they will know if you are abusing drugs. They watch 

and often emulate their parents. 

Studies have also revealed that parents are increasingly misusing or abusing prescription 

medications themselves. Nearly one in five parents (18%) reports using a prescription 

medicine that was not prescribed to them three or more times in their lifetime. Fifteen 

percent of parents say they’ve used a prescription medicine not prescribed to them at 

least once in the past year, a 25% increase from 2010. More frequent past-year misuse of 

prescription medicines (three or more times) is up 50% from 2010 (5%) to 2011 (10%).

Source: PATS 2011

What You Can Do 
learn the facts

Keeping prescription drugs out of the hands of teens is

important, and there are things you can do:

Get information about prescription drug medications abused by teens. 

Learn what the medication is used for, what it looks like, its effects and interactions, 

and how teens are using it. 

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

narcotic painkillers (opioid medications), are extremely 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. 

Ask your teens what they are experiencing at school, at friends’ homes, and 

at parties. Share with them what you have learned about the dangers of abusing 

prescription drugs. 

What You Can Do 50 51

Ask your doctor and pharmacist about the medications you are being 

prescribed. Ask about their side effects and potential addictiveness. Ask which 

category the drug is: Narcotic, stimulant, depressant, steroid? 

Review what is in your medicine cabinet. Keep powerful medications in a 

safe place, not in the family medicine or kitchen cabinet, under lock if necessary. 

Count your pills when you receive them, and periodically check to see how many are 

in the container. 

Read the labels. A drug label includes important information about a prescription 

drug. Many generic prescriptions are substituted for brand name drugs, and it may

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

painkiller, for example.

Different pharmaceutical companies produce many products that have the same 

basic ingredients. Usually, the generic name of the drug is printed in addition to the

brand name, making it clearer that the customer is receiving ibuprofen/oxycodone 

HCL, for instance. 

What You Can Do 
Medicine Take-Back Programs

Medicine Take-Back programs are an excellent way to remove expired, unwanted, or 

unused medicines from your home, and reduces the chances that others may accidently 

or intentionally take the medicine.

In an effort to further address the abuse and misuse of unused controlled substances in 

households throughout the country, DEA, working with state and local law enforcement 

agencies, implemented the National Take-Back Initiative. The purpose of the initiative is 

to provide a venue for people who want to dispose of unwanted and unused prescription 

drugs, particularly controlled substances from our nation’s medicine cabinets. 

The first National Take-Back Day, September 25, 2010, citizens turned in over 121 tons 

of pills. Due to the success of this initiative, three more Take-Back days have been held. 

In total, over 774 tons of medication has now been removed from circulation. 

In September, right after the first Take-Back Day Initiative, Congress passed the Secure 

and Responsible Drug Disposal Act of 2010, which amends the Controlled Substances 

Act to allow an “ultimate user” of controlled substance medications to dispose of them 

by delivering them to entities authorized by the Attorney General to accept them. This 

act also allows the Attorney General to authorize long term care facilities to dispose of 

their residents’ controlled substances in certain instances. DEA is in the process of 

drafting regulations to implement the Act. 

While a uniform system for prescription drug disposal is being finalized, DEA will 

continue to sponsor Take-Back opportunities in coordination with state and local 

organizations, as a service to our communities.

 Additional information on the safe disposal of medications can 

be found on the U.S. Food and Drug Administration’s website 

at www.fda.gov/Drugs/ResourcesForYou/Consumers. 

What You Can Do 52 53

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, please call the DEA hotline. Callers will be able to 

make confidential reports by dialing toll free 1-877-RxAbuse (1-877-792-2873) around 

the clock, 365 days per year. The hotline is staffed by bilingual operators employed 

by DEA. This is a toll-free call from Mexico as well. During normal business hours, the 

caller will be connected directly to someone at the responsible DEA Domestic Field 

Office. After-hours tips will be forwarded by an internal, secure email system for further 

investigation and follow-up by DEA Special Agents and Diversion Investigators. 

What You Can Do 
DEA’s Role 54 55

DEA plays a critical role in preventing prescription 

drug abuse. 

DEA investigates physicians who sell prescriptions to drug dealers or abusers; 

pharmacists who falsify records and subsequently sell the drugs; employees 

who steal from inventory; executives who falsify orders to cover illicit sales; 

prescription forgers; and individuals who commit armed robbery of pharmacies 

and drug distributors.

DEA investigates unscrupulous Internet pharmacies. Rogue pharmacies exist to 

profit from the sale of controlled prescription medications to buyers who have 

not seen a doctor and don’t 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 precursor chemicals.

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

Substances Act, Title 21 of the United States Code. DEA also provides objective and 

timely information to the public about the dangers of drugs through publications, 

websites and presentations. 

DEA’s Role 

Community Anti-Drug Coalitions of America (CADCA), the Consumer Healthcare Products 

Association (CHPA), D.A.R.E., and the Partnership at DrugFree 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.com/home/featurs/RX.asp.

Drug Enforcement Administration (DEA) www.dea.gov

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

 DEA’s teen website www.JustThinkTwice.com

 DEA’s parent website 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.

 NIDA’s teen website on prescription and over-the-counter drugs 

www.teens.drugabuse.gov/peerx/

National Institute of Mental Health’s Library of Medicine www.medlineplus.gov 

 Spanish version www.medlineplus.gov/Spanish

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

 ONDCP’s teen website www.abovetheinfluence.com 

 ONDCP’s parent website www.theantidrug.com 

Partnership at Drug Free provides information for parents on teen prescription drug abuse at 

www.drugfree.org.

All photos courtesy of Wolters Kluwer Health

—MediSpan or the Drug Enforcement Administration

additional resources