Medication Misuse: What Health Care Professionals Should Know and Do

The following are important steps you can take to help prevent prescription drug misuse and promote the health and well-being of young people.

Know the facts

Regardless of specialty, it’s important to understand the many ways in which prescription drug misuse can compromise health and exacerbate existing physical and mental health conditions. Try to understand why young people misuse medications and what the individual, family, social and environmental factors are that put some at higher risk of misuse and addiction than others.

The more young patients and their parents turn to you for information and support, the better informed the public will be about the risks of prescription drug misuse and how best to intervene when it occurs. Knowing a patient’s family medical and social history, whether the patient has co-occurring mental health disorders, and how prescription medications are used and talked about in the home, and how they are stored and monitored, are important for helping to protect youth who may be susceptible.

Educate patients and their caregivers

Some parents and caregivers choose to avoid discussing substance use with their children, making it critical for health professionals to step up and be a credible source of information to young patients and their families. It is important to educate all patients and their caregivers, on a routine basis and regardless of perceived risk level, about the danger of prescription drug misuse and how best to prevent and reduce it. Messages should be clear, based in science and research rather than intuition or anecdote, and individualized for each patient and family’s unique circumstances.

Prescribe carefully and monitor patient medication use and symptoms regularly

Whenever possible and appropriate, offer non-prescription medication alternatives to treat young people for pain and mental health problems. Keeping these powerful drugs out of the hands of young people is the first step in preventing addiction and stopping them from reaching unintended users. In the event an opioid pain reliever or other controlled substance is absolutely necessary, try to prescribe conservatively, starting out with the lowest therapeutic dosage in low quantities and for the shortest possible duration. Patients should be reassessed for potential benefits versus harms of continued use if the dosage or duration is being adjusted. The prescriber education initiative, Search and Rescue, is a helpful resource and provides health care professionals with tools to help patients with medication misuse and addiction.

Screen and intervene

Screening young patients for prescription drug misuse is one of the most important measures a health care professional can take.^[1] The American Academy of Pediatrics recommends the Screening, Brief Intervention and Referral to Treatment (SBIRT) approach as part of all pediatric primary care routine visits and has prepared an extensive list of resources for addressing the opioid epidemic with young patients.

Depending on the extent of the patient’s prescription drug misuse, a number of intervention and treatment options are available. One consistent research finding is that including the family, when possible, in all stages of the intervention and treatment process is highly beneficial and yields the best outcomes for young patients.^[2] Brief advice from the clinician alone may be sufficient for some patients, while full treatment might be appropriate for others. Treatment typically involves age-appropriate psychosocial therapies, such as cognitive-behavioral therapy, motivational enhancement therapy and family interventions. There also is a range of medications that have been approved for the treatment of opioid use disorder, are highly effective in treatment and are recommended for use in severe cases by the American Academy of Pediatrics.

Support research and advocacy

It is important to advocate for appropriate media modeling of prescription drug consumption and its consequences, as well as policies and regulations that protect youth from access to and use of these drugs. Support funding for quality research into the prevention, intervention and treatment of youth prescription drug misuse, as well as family involvement in all aspects of care to ensure optimum outcomes for young patients.