One-fourth of teens have misused or abused a prescription drug at least once in their lifetime, a 33 percent increase over the last five years, a new study finds. One in eight teens say they have taken Ritalin or Adderall when it was not prescribed for them, according to the study by the Partnership for Drug-Free Kids and the MetLife Foundation.

The Partnership Attitude Tracking Study (PATS) found parents and caregivers have lax attitudes and beliefs about teen medicine abuse. Almost one-third of parents say they believe prescription stimulants such as Ritalin or Adderall, used to treat attention deficit hyperactivity disorder (ADHD), can improve a teen’s academic performance, even if the young person does not have ADHD.

Of teens who said they abused prescription medications, 20 percent did so before age 14. One-third of teens say they believe “it’s okay to use prescription drugs that were not prescribed to them to deal with an injury, illness or physical pain.” The study found 27 percent incorrectly believe that misusing and abusing prescription drugs is safer than using street drugs.

“These data make it very clear: the problem is real, the threat immediate and the situation is not poised to get better,” Steve Pasierb, President and CEO of the Partnership for Drug-Free Kids, said in a news release. “Parents fear drugs like cocaine or heroin and want to protect their kids. But the truth is that when misused and abused, medicines – especially stimulants and opioids – can be every bit as dangerous and harmful as those illicit street drugs.”

Tracey and Jeff Gerl of Cypress Texas thought they had adequately warned their son, Nick, about the dangers of drugs. Yet he started smoking marijuana at age 12. He and his friends took prescription drugs such as Ritalin, Xanax and codeine from their parents’ medicine cabinets. His parents realized something was wrong when Nick was 14, and sent him for substance abuse treatment, where he stayed for 7 ½ months. He has been sober for a year. Tracey Gerl says she should have trusted her intuition when she first thought Nick might be using drugs. She told the Associated Press, “If it doesn’t seem right, it’s not. Don’t ever be naive to think it’s not my kid.”

The new study puts the spotlight on the issue of teen abuse of ADHD medication, according to Alain Joffe, MD, MPH, Director, Student Health and Wellness Center at Johns Hopkins University and Former Chairman, American Academy of Pediatrics Committee on Substance Abuse. “We need to make sure that children and adolescents receive a thorough assessment before being placed on stimulant medications, and that if medication is prescribed to a child, it should only be as one component of a comprehensive ADHD management plan,” he said. “We don’t really know what long-term effects these ADHD medications will have on the still-developing brains of adolescents who do not have ADHD. We do know they can have significant side effects, which is why they are limited to use with a prescription.”

Teen abuse of prescription painkillers such as OxyContin and Vicodin has remained stable since 2011. The study found 16 percent of teens reported abusing or misusing any prescription pain relievers at least once in their lifetime, and 10 percent said they did so in the past year.

Parents are much more likely to talk to teens about marijuana or alcohol than prescription drugs. Teens reported that during the last conversation they had with their parents about substance abuse, only 16 percent said they discussed the misuse or abuse of prescription painkillers, and 14 percent discussed any type of prescription drug. In contrast, 81 percent said they have discussed marijuana and 80 percent have discussed alcohol.