Prescribing of Controlled Medications to Adolescents and Young Adults in the United States

• Published in: Pediatrics (Evanston) 2010-12, Vol.126 (6), p.1108-1116
• Main Authors: FORTUNA, Robert J, ROBBINS, Brett W, CAIOLA, Enrico, JOYNT, Michael, HALTERMAN, Jill S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Central Nervous System Stimulants - pharmacology; Company distribution practices; Controlled substances; Cross-Sectional Studies; Distribution; Drug Prescriptions; Drugs; Drugs and youth; Female; Forecasts and trends; General aspects; Humans; Hypnotics and Sedatives - pharmacology; Incidence; Injuries; Juvenile drug abuse; Male; Market trend/market analysis; Medical sciences; Medical treatment; Pediatrics; Prescribing; Prescription drugs; Prescriptions (Drugs); Retrospective Studies; Substance-Related Disorders - epidemiology; Substance-Related Disorders - prevention & control; Teenagers; United States - epidemiology; Young Adult; Young adults
• ISSN: 0031-4005; 1098-4275; 1098-4275
• DOI: 10.1542/peds.2010-0791

The nonmedical use of prescription drugs by adolescents and young adults has surpassed all illicit drugs except marijuana, yet little is known about prescribing patterns. We examined the prescribing of controlled medications to adolescents aged 15 to 19 and young adults aged 20 to 29. We used cross-sectional data from the National Ambulatory Medical Care Survey (N = 4304 physicians) and the National Hospital Ambulatory Medical Care Survey (N = 2805 clinics; N = 1051 emergency departments) between 2005 and 2007. We also used consecutive data from 1994 to describe trends. A controlled medication was prescribed at 2.3 million visits by adolescents and 7.8 million visits by young adults in 2007. Between 1994 and 2007, controlled medications were prescribed at an increasing proportion of visits from adolescents (6.4%-11.2%) and young adults (8.3%-16.1%) (P < .001 for trend). This increase was seen among males and females, in ambulatory offices and emergency departments, and for injury-related and non-injury-related visits (all P < .001). A controlled medication was prescribed during 9.6% of all adolescent visits and 13.8% of young-adult visits for non-injury-related indications and at 14.5% of adolescent visits and 27.0% of young-adult visits for injury-related reasons. Controlled medications were prescribed at a substantial proportion of visits for common conditions, such as back pain, to both adolescents (23.4%) and young adults (36.9%). Controlled medications are prescribed at a considerable proportion of visits from adolescents and young adults, and prescribing rates have nearly doubled since 1994. This trend and its relationship to misuse of medications warrants further study.