Despite concerns about rising rates of abuse and overdose from prescription opioids across all age groups, a new survey from the University of Michigan found that most parents are not very concerned about misuse of these drugs by their children and teens. Additionally, there appeared to be little support by parents for policies that might help in controlling misuse of opioid pain-relievers by youths.
The survey conducted in the United States — and the report released on January 23, 2013, as part of the University of Michigan Mott Children’s Hospital National Poll on Children’s Health — revealed some surprising findings:
- Overall, only about a third (35%) of the parents polled were very concerned about the misuse of opioid medications by children and teens in their communities.
- Even fewer, fewer than 1 in 5 (19%) were very concerned about misuse of prescription opioids in their own families. Black parents (38%) and Hispanic parents (26%) were more likely than white parents (13%) to be very concerned about misuse of these drugs in their homes.
- The survey also confirmed that prescription pain medications are commonplace in U.S. households with children. More than a third (35%) of parents reported that, in the last 5 years, they had received at least 1 pain medication prescription for their children; more than half of those prescriptions were for an opioid analgesic.
- Additionally, within the past 5 years, two-thirds (66%) of parents had received at least 1 pain medication prescription for themselves or another adult in the household.
- Although there has been much concern about overdose deaths attributed to opioid pain relievers, almost half (45%) of the surveyed parents did not favor a requirement that they return unused pain medication to the prescriber or pharmacy, and 30% were against notifying the prescriber of how much of the medication was used.
- Only 41% supported a policy that would require visiting the prescriber before receiving an opioid analgesic refill.
There was some support for 2 policies that might help to discourage opioid medication misuse:
- Two-thirds (66%) of respondents strongly support requiring parents to show identification when picking up opioid analgesics for their children.
- More than half (57%) strongly support policies disallowing opioid medication prescriptions from more than one healthcare provider.
The survey report [PDF available here] concludes that the limited level of concern and the lack of strong support for policy changes suggest that the public may not recognize the seriousness the problem surrounding the misuse of opioid pain relievers among youth. According to Sarah J. Clark, MPH — Associate Director of the Child Health Evaluation and Research Unit at the University of Michigan — “This is a national problem and a growing problem. The results of this poll are a signal that parents may not be aware of the significant rates of misuse of narcotic pain medicine, which highlights the tremendous challenge of addressing this national problem.”
COMMENTARY: The survey, conducted by GfK Custom Research for Mott Children’s Hospital, was administered in September 2012 to a randomly selected, stratified group of parents (N=1,304) who each had at least one child age 5 to 17. The margin of error in the data was estimated to be ±2%-4% and possibly higher within subgroups.
The sample is believed to closely resemble the overall U.S. population, and data were weighted to reflect population distributions according to the U.S. Census Bureau. However, as with all surveys of this nature that extrapolate relatively small samples to an entire population, the results should be accepted with some circumspection.
Assuming that the survey data fairly represent public opinion, the results depict a somewhat discouraging perspective when it comes to parents’ understanding of opioid-related problems and their willingness to accept responsibility by supporting new strategies for addressing those concerns. There also were some interesting racial differences evident in survey responses.
Although, according to the report, rates of prescription opioid abuse are 3 times higher among white teens than their black or Hispanic peers, black and Hispanic parents appear to be more concerned than their white counterparts about the misuse of opioid medications in their families. Meanwhile, white parents seem less likely to support policies to limit children’s access to these drugs.
For example, black and Hispanic parents were more likely to strongly support, and white parents more likely to not support, a requirement to return unused opioid analgesics to the prescriber or pharmacy. Furthermore, white parents were more likely than black or Hispanic parents to not support requiring an office visit to obtain a pain medication refill. While these 2 policies might be questionable in terms of their overall impact on opioid misuse among youth, they are proactive steps and it is disconcerting that white parents appear to be so disinterested.
Clearly, public information and education campaigns to date addressing prescription opioid misuse by youth have missed their mark. From this survey, we do not gain a full appreciation of the attitudes and beliefs behind parent’s responses, but there is certainly a need for better strategies within communities to encourage parents to assume greater responsibility for becoming part of the solutions rather than being bystanders to the problems.
Lastly, and this may seem rather trifling, we must take issue with how the authors of this survey report repetitively use the term “narcotic” when referring to opioid pain relievers. We have edited this term in our article above — replacing “narcotic” with “opioid medication” or “opioid analgesic” — and previously discussed this concern in an UPDATE [here] and in Pain-Topics e-Briefing [PDF here].
Today, “narcotic” is used by law enforcement and some government agencies pertaining largely to illicit drugs, such as the opioid heroin, but also inclusive of cocaine, methamphetamine, “designer drugs,” and others. Any healthcare organization that uses the term “narcotic” to denote legitimately prescribed opioid medications is not only inaccurate and behind the times, but possibly conveying a pejorative bias whether intentionally or not that these analgesics are inherently evil and harmful. This will not contribute to better understandings and constructive actions among the public, in our opinion.
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3 comments:
A comment and then some speculations on what might be the root of the surprising answer. Comment 1st, kudos to the black & hispanic parents for their honest awareness of the teenage drug culture. The importance of valuing family and standing by all members, even to a point those impaired, are certainly strengths that bring hope to any culture or community.
First of all, among other parents, I have problems getting my kid's acute pain needs addressed, in any clinical setting. A sample of the pain they endured w/ no help from the suggested doses of tylenol were; broken bones, bruised spleen, lung & small intestine, 2nd degree burns, kidney infections due to lupus, etc. These were white children, in school, sports, church w/ no evidence of drug abuse in the picture This was acute pain, where the use of opiate medication is not in debate as in chronic pain. Yet these PEOPLE were automatically assumed to be irresponsible party animals w/ no supervision due to their age. That is called discrimination, I can't imagine our chances if we weren't middle class whites with insurance. Without an educated advocate (me) their recoveries would have been longer, at risk for more complications and just plain more torturous.
PainTopics posted a great article pointing out the surprising results of digging deeper into teenage opiate use. A considerable % were using the unprescribed opiate for PAIN - not to get high. The sports culture in our society is out of control and there are many of my kid's friends who pass through our home w/ a damn good start on chronic injuries-before age 18! And our local NBA team's High School Athlete of the Month is sponsored by none other than a big name knee rehab clinic. These places are making big money from OUR ALLOWED, ENCOURAGED & NEGLECTFUL treatment of our own children.
Secondly, it could be that today's parents have been around the drug culture long enough to know that it has shifts based on technology, designer drug chemistry breakthroughs, economic and social factors quite separate from the practice of medicine. Today's opiate abuses will be replaced by something else in 5 years. And yet pain patients, such as ourselves and the aging parents we are caring for, will still be stuck w/ the same cobbled together laws that saved no children, helped no addicts, but cost billions of dollars and terribly inconvenienced or tortured legitimate patients & their caregivers.
Look at Washington State, one w/ some of the toughest opiate medication restrictions in the nation. PainTopics reported that in a recent year, even before the brunt of the laws had taken effect, heroin overdoses were up 115%, Now that's progress. A pain patient went w/o their meds for the noble cause of it not falling into a diverters hands. The addict, unlike the pain patient, isn't going to suffer to conform to the new laws-they switch to a newer, less familiar, less consistent drug and wind up dying. That person's parent's grief is no less because their child died of one drug over the other. And the constant is that the pain patient suffered for NOTHING. This IS THE NORMAL PATTERN. Medical treatment of pain & medical treatment of addiction are 2 separate issues and will never be solved with one bandaid.
Just a vain hope: maybe today's parents know that drug abuse and addiction are about more than what substance or celebrity is in the media today, that the War on Drugs has wasted billions of dollars while only escalated the violence & the imbalance of power & resources, and that perhaps that wasted money could have been better spent to find out why our youth have such gaping holes in their soul that turning to drugs is a such a prominent consideration in their minds to ease their pain. Maybe we parents want some real medical, scientific, statistical WORK done by our legistlators before we get behind any more bandaid measures.
As both a parent of a pre-teen and a person who has had chronic pain for nearly 30 years (since the age of 7), I understand the importance of keeping opioid pain medications out of the hands of children who do not need them for their own pain. I know all too well the curiosity of younger children with anything they find around the house, as well as the temptation opioids are to older children, who may either abuse them or who may use them to help other kids with their abuse. I have a few reasons why I am, at this time, not overly concerned about my child's access to my opioid (or any other) medications. Also, I know part of the reason many parents aren't concerned about the misuse of opioid medications by children and teens in their communities and their own families is most likely due to the typical parental attitude of "Not in my backyard." and most especially "Not my perfect angel(s)!"
I have an 11 yr old son, and while I'd love to say that my son would NOT touch my pain medications, as a former teen, I know that it's very possible he might at some point! As much as I love my son, I do not see him through rose-colored glasses. While I know my child is not perfect, I can honestly say at this time I have less concerns about him stealing my pain medication than I do other forms of disobedience. Peer pressure can have a major effect as can wanting to rebel. But at this time, he is seen as a leader rather than a follower by his teacher.
There are other reasons I am not overly concerned about my son using and/or giving my pain medications to other kids. First, he knows how dangerous they can be. We've discussed the risks of addiction in people who take them when they do not need them for a medical reason.
Since I was dealing with pain long before having him, he has grown up around me having medications. I admit I keep my medications, including opioid pain meds, in my reach pretty much at all times. But because I do that, they are rarely out of my sight. This may also be why some other parents are not concerned about their children having access to their parents' medications. These parents who are not concerned may have them locked up and either use a combination lock where the combination is not written down or may use a keyed lock where there is only one key which is in the parents' possession at all time. Of course nothing is 100% safe. Kids can figure out ways to get into something if they want to try hard enough.
Another reason for my lack of concern about him abusing any kind of medication at this time is that we have a hard enough time getting him to take medications when he needs them. Cold medicine, allergy medicine, even simple ibuprofen for a headache are all things he HATES to take.
My son knows that at my pain visits, my pain doctor checks my medications to see how much I have left. I used to go monthly and have been increased to 2 months between visits. He has been with me enough to know that I take my meds with me to each visit, and per my pain contract (which I was more than happy to sign as it protects both the doctor and me), they are counted each visit. Not only does he know that, he knows that with very little effort I can easily find out if I am missing ANY of my pain meds because it is rare I miss a dose, and when I do, it's usually noted on my calendar. Therefore I can always do a med count to ensure I have the number of pills I am supposed to have if there is any question.
The last reason I honestly do not see my son stealing any of my meds, but especially my pain meds, at this point in time especially, is that he remembers how I am when I am untreated/under-treated for pain. He does not like seeing me in pain, and so he knows that stealing my meds means I can't take them which leaves me in pain. Not to mention the fact that he knows it would be stressful to think that he stole my meds and he knows stress adds to my pain.
got this from medline plus.....read please
State Estimates of Nonmedical Use of Prescription Pain Relievers
In Brief
Combined 2010 and 2011 data indicate that the rate of past year nonmedical use of prescription pain relievers among those aged 12 or older was 4.6 percent nationally and ranged from 3.6 percent in Iowa to 6.4 percent in Oregon
Of the 10 States with the highest rates of past year nonmedical use of prescription pain relievers in 2010 and 2011, 7 were in the West region; of the 10 States with the lowest rates, 4 were in the Midwest region, and 4 were in the Southern region
Comparisons of combined 2009 and 2010 data with combined 2010 and 2011 data showed that past year nonmedical use of prescription pain relievers among persons aged 12 or older decreased in 10 States (Kentucky, Louisiana, Massachusetts, Mississippi, New Hampshire, New York, Ohio, Oklahoma, Rhode Island, and West Virginia), and did not increase in any State
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