Study: One in two teens misuse their Rx drugs

Although prescription drug misuse is declining among teens, one in two patients tested between the ages of 10 and 17 years are not using their medications appropriately, potentially putting their health at risk, according to a new analysis.

The Quest Diagnostics Health Trends study, "Prescription Drug Misuse in America: Diagnostic Insights in the Continuing Drug Epidemic Battle," found that the overall rate of prescription drug misuse for patients of all ages was 53% in 2014, a decline of 16% relative to the misuse rate of 63% in 2011. Patients in the 10-to-17-years age group showed the greatest improvement in appropriate prescription drug use compared to all other age groups over the four-year period.

In 2011, 70% of adolescents tested by Quest Diagnostics showed evidence of prescription drug misuse compared to 52% in 2014. These findings align with research from the National Institute of Drug Abuse, which revealed a decline in high school students’ misuse of prescription drugs over the past two years.

Related:New weapons combat opioid addiction

The analysis is based on an analysis of approximately 2.5 million de-identified test results on patients of all ages in 48 states and the District of Columbia (2011to 2014). All patients were tested using a proprietary prescription drug monitoring service and reporting methodology from Quest Diagnostics. This service tests of up to 26 commonly prescribed and abused drugs, including pain medications, central nervous system medications, and amphetamines, as well as certain illicit drugs such as marijuana, and cocaine. The test reports indicate if prescribed drug(s), drug metabolite(s), and other drugs are in a specimen, as indicated by the ordering healthcare provider. All specimens were screened by immunoassay-based methods and all positive results were confirmed by mass spectrometry, the most sensitive and specific drug testing method, performed in Quest's clinical laboratories.

Dr McClure(Drug misuse is defined as evidence, based on lab test results, that a patient is using or combining non-prescribed drugs or skipping doses in a manner that is inconsistent with the ordering physician’s directions.)

“While these findings suggest the misuse rate is declining, one in two patients tested is using their prescribed medications in ways that may put their health at risk,” says Leland F. McClure, PhD, director, medical science liaison, Quest Diagnostics. “ Moreover, we observed significant patterns of misuse in our nationally representative database regardless of age, gender, geography or public or private payer type. This is troubling because it strongly suggests-using objective lab data-that there truly is no good way to predict which patient may abuse a prescribed therapy.”

NEXT: Patients using medications in "wasteful and dangerous" ways

The findings show that a large percentage of patients prescribed opioids and other medications are using them in ways that are wasteful and even dangerous, according to McClure. The percentage of patients who did not take their medications consistently, increased from 40% in 2011 to 44% in 2014.

“This suggests some patients prescribed therapies are not using them, promoting waste,” he says. “It is important to note that drug misuse may be inadvertent, such as when a patient forgets to take a prescription- or tell his or her doctor about all his or her medications. Coordination of care between physicians treating-and prescribing medications-for the patient may help to reduce the potential for intended or inadvertent drug misuse.” 

Related:AMCP fights back: Abuse-deterrent opioid coverage mandate

In addition, 35% of patients tested in 2014 showed evidence of combining drugs without a clinician’s oversight, compared to 32% in 2011, indicating heightened potential for dangerous drug combinations.

Another key finding that overall, 33,396 (1.5%) patient test reports had abnormal specimen validity results. Specimen validity tests determine whether a urine specimen has been diluted, adulterated, or substituted to obtain a negative drug test result.

“This finding suggests that specimen validity testing may be an important adjunct to prescription drug monitoring to minimize the potential that patients attempt to mask drug abuse,” McClure says.

In August 2015, FDA granted special approval of pediatric use of OxyContin in patients aged 11 to 16 years old, under specific conditions.

“Our data is a stark reminder that diligent monitoring of prescription drug regimens in young patients is absolutely critical,” McClure says.