teens and prescription drugs!!!

8/14/2019 TEENS and prescription drugs!!!

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TEENAND

PRESCRIPDRUGAn Analysis of Recent Trendson the Emerging Drug Threat

OFFICE OF NATIONAL DRUG CONTROL POLICYEXECUTIVE OFFICE OF THE PRESIDENT

FEBRUARY 2007


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TABLE OF CONTENTS

Introduction

Pr val nc and Incid nc

M th vs. R alit

Availabilit and Acc ssibilit

G nd r Di r nc s

T p s o Pr scription Drugs Abus d b T ns

D p nd nc and Tr atm nt

App ndix: D nitions

Annotat d R r nc List


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TEENS AND PRESCRIPTION D

A numb r o national studi s and publish d r portsindicat that th int ntional abus o pr scrip-tion drugs, such as pain r li v rs, tranquiliz rs,stimulants and s dativ s, to g t high is a growingconc rnparticularl among t nsin th Unit dStat s. In act, among oung p opl ag s 12 17,pr scription drugs hav b com th s cond mostabus d ill gal drug, b hind marijuana.

Though ov rall t n drug us is down nationwidand th p rc ntag o t ns abusing pr scriptiondrugs is still r lativ l low compar d to marijuanaus , th r ar troubling signs that t ns vi wabusing pr scription drugs as sa r than ill galdrugs and par nts ar unawar o th probl m.This r port xamin s this m rging thr at bs king to id nti tr nds in th int ntional abuso pr scription drugs among t ns.

EXECUTIVE SUMMARY

T ns ar turning awa rom str t drugs and using pr scription drugsto g t high. N w us rs o pr scription drugs hav caught up with n w

us rs o marijuana.

N xt to marijuana, th most common ill gal drugs t ns ar using to g t

high ar pr scription m dications.

T ns ar abusing pr scription drugs b caus th b li v th m ththat th s drugs provid a m dicall sa high.

Th majorit o t ns g t pr scription drugs asil and or r ,

o t n rom ri nds or r lativ s.

Girls ar mor lik l than bo s to int ntionall abus pr scriptiondrugs to g t high.

Pain r li v rs such as Ox Contin and Vicodin ar th most commonl

abus d pr scription drugs b t ns.

Adol sc nts ar mor lik l than oung adults to b com d p nd nton pr scription m dication.

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PREVALENCE AND INCIDENCEN xt to marijuana, th most common ill gal drugst ns ar using to g t high ar pr scription m di-

cations. T ns ar turning awa rom str t drugsand using pr scription drugs to g t high. Ind d,n w us rs o pr scription drugs hav caught upwith n w us rs o marijuana.

For th rst tim , th r ar just as man n wabus rs (12 and old r) o pr scription drugs asth r ar or marijuana. (SAMHSA, 2006)

Among 12 17 ar olds, th gap b tw n n wmarijuana us rs and n w pr scription drugus rs is shrinking. B tw n 2003 and 2005, thgap clos d b 5.9 p rc nt.

In 2005, th stimat d numb r o 12 17 arolds who start d using pr scription drugs in th12 months prior to th surv was 850,000,compar d with 1,139,000 marijuana initiat s.In 2003 th stimat s w r 913,000 or pr -scription drugs, compar d to 1,219,000 mari-

juana initiat s. (NSDUH, 2004 and 2006)

Thr p rc nt, or 840,000 t ns ag s 12 17,

r port d curr nt abus o pr scription drugsin 2005, making this ill gal drug cat gor ths cond most abus d n xt to marijuana (7%).(NSDUH, 2006)

In 2005, 2.1 million t ns abus d pr scriptiondrugs. (NSDUH, 2006)

T ns ag s 12 17 hav th s cond high stannual rat s o pr scription drug abus a t r

oung adults (18 25). (SAMHSA, 2006)

Pr scription drugs ar th most commonlabus d drug among 12 13 ar olds.(NSDUH, 2006)

T ns (12 17) and oung adults (18 25) w rmor lik l than old r adults to start abusingpr scription drugs in th past ar.(SAMHSA, 2006)

On third o all n w abus rs o pr scriptiondrugs in 2005 w r 12 17 ar olds.

(NSDUH, 2006)

T ns (12 17) in W st rn and South ast rnstat s ar mor lik l to abus pr scription painr li v rs

Arkansas (10.3%), K ntuck (9.8%),Montana (9.6%), Or gon (9.3%), Oklahoma(9.1%), T nn ss (8.9%), and W st Virginia(8.9%) l ad th countr in t n abus opr scription pain r li v rs. (SAMHSA, 2007)

Th most r c nt r s arch on d aths in th U.S.du to poisoning ov r a v ar p riod (1999-2004) shows that n arl all poison d aths in thcountr ar attribut d to drugs, and most drugpoisonings r sult rom th abus o pr scriptionand ill gal drugs. (CDC, 2007)

Th numb r o th s d aths incr as d rom12,186 in 1999 to 20,950 in 2004a 62.5p rc nt chang ov r v ars.

Types of Illicit Drug Use Among

Teens Aged 1 -17 (Percentage)2005 NATIONAL SURVey ON DRUG USe

AND HeALTH, SAMHSA. 2006

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15

10

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MARIJUANA

PRESCRIPTION DRUGS

INHALANTS

17.4%

11.9%

10.5%

13.3%

8.3%

4.5%

6.8%

3.3%

1.2%

LIFETIME PAST YEAR PAST MONTH


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MYTH VS. REALITYT ns ar abusing pr scription drugs b causth b li v th m th that th s drugs provid

a m dicall sa high.

N arl on in v t ns (19% or 4.5 million)r port abusing pr scription m dications thatw r not pr scrib d to th m. (PATS, 2006)

T ns admit to abusing pr scription m dicinor r asons oth r than g tting high, including

to r li v pain or anxi t , to sl p b tt r, toxp rim nt, to h lp with conc ntration or to

incr as al rtn ss.(Bo d, McCab , Cran ord and young, 2006)

Wh n t ns abus pr scription drugs, tho t n charact riz th ir us o th drugs asr sponsibl , controll d or sa , with thp rc ption that th drugs ar sa r than str tdrugs. (Fri dman, 2006)

Top Five Drugs Used by 1th

Graders in the Past YearMARIJUANA

MONITORING THe FUTURe STUDy,THe UNIVeRSITy OF MICHIGAN. 2006

Mor than on third o t ns sa th l sompr ssur to abus pr scription drugs, and nin

p rc nt sa using pr scription drugs to g thigh is an important part o tting in with th irri nds. (Seventeen, 2006)

Four out o 10 t ns agr that pr scriptionm dicin s ar much sa r to us than ill galdrugs, v n i th ar not pr scrib d b a doctor.(PATS, 2006)

On third o t ns (31% or 7.3 million) b li vth r s nothing wrong with using pr scrip-tion m dicin s without a pr scription onc in awhil . (PATS, 2006)

N arl thr out o 10 t ns (29% or 6.8 million)b li v pr scription pain r li v rs v n inot pr scrib d b a doctorar not addictiv .(PATS, 2006)

VICODIN

AMPHETAMINES

COUGH MEDICINE

SEDATIVES & TRANQUILIZERS *SEDATIVES AND TRANQUILIZERS ARE EACH 6.6%

6.6%

6.9%

8.1%

9.7%

31.5%

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AVAILABILITY AND ACCESSIBILITYTh majorit o t ns g t pr scription drugs asiland or r , o t n rom ri nds and r lativ s.

N arl hal (47%) o t ns who us pr scriptiondrugs sa th g t th m or r rom a r lativor ri nd. T n p rc nt sa th bu pain r li v rs

rom a ri nd or r lativ , and anoth r 10 p rc ntsa th took th drugs without asking.(NSDUH, 2006)

Mor than thr in v (62% or 14.6 million)t ns sa pr scription pain r li v rs ar asto g t rom par nts m dicin cabin ts; hal ot ns (50% or 11.9 million) sa th ar asto g t through oth r p opl s pr scriptions;and mor than hal (52% or 12.3 million) sapr scription pain r li v rs ar availabl v r -wh r . (PATS, 2006)

Source Where Pain RelieversWere Obtained for Most RecentNonmedical Past-Year Users

Aged 1 -17 (Percentage)2005 NATIONAL SURVey ON DRUG USe

AND HeALTH, SAMHSA. 2006

4.5% BOUGHT FROM DEALER OR OTHER STRANGER6.3% SOME OTHER WAY

10.0% BOUGHT FROM 2.6% FROM MORE THAN ONE DOCTOR

FRIEND OR RELATIVE0.1% BOUGHT ON THE INTERNET

10.2% TOOK FROM A FRIEND OR0.1% WROTE A FAKE PRESCRIPTION

RELATIVE WITHOUT ASKING0.5% STOLE FROM DOCTORS OFFICE,

CLINIC, HOSPITAL OR PHARMACY

18.3% FROM ONE DOCTOR

47.3% OBTAIN FROM FRIENDS FOR FREE

Th majorit o t ns (56% or 13.4 million)agr that pr scription drugs ar asi r to g t

than ill gal drugs. (PATS, 2006)

Mor t ns hav b n o r d pr scriptiondrugs than oth r illicit drugs, xcluding mari-

juana. Fourt n p rc nt o 12 17 ar oldshav b n o r d pr scription drugs at sompoint in th ir liv s, compar d to 10 p rc nt ot ns who hav b n o r d cocain , cstas(9%), m thamph tamin (6%) and LSD (5%).(CASA, 2006)

14 ar olds ar our tim s mor lik l than13 ar olds to b o r d pr scription drugs.(CASA, 2006)

Thirt nin p rc nt o 14 20 ar olds sa itis as to g t pr scription drugs onlin or bphon . O that total, mor girls than bo s saidit was as (48% vs. 31%). (TRU, 2006)


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GENDER DIFFERENCESGirls ar mor lik l than bo s to int ntionallabus pr scription drugs to g t high.

Among 12 17 ar olds, girls ar mor lik lthan bo s to hav abus d pr scription drugs(9.9% o girls vs. 8.2% o bo s), pain r li v rs(8.1% vs. 7.0 %), tranquiliz rs (2.6% vs. 1.9%),and stimulants (2.6% vs. 1.9%) in th past ar.(SAMHSA, 2006)

Misuse of Prescription DrugsAmong Teens Aged 1 -17Lifetime, Past-Year, Past-Month(Percentage)

2005 NATIONAL SURVey ON DRUG USe AND HeALTH, SAMHSA. 2006

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GIRLS

BOYS 12.7%

11.1%

9.2%

7.5%

3.6% 3.1%

LIFETIME PAST-YEAR PAST-MONTH

Among 12 17 ar olds, girls had high r rat so d p nd nc or abus involving pr scription

drugs (1.8% or girls and 1.1% or bo s), painr li v rs (1.4% vs. 0.8%), tranquiliz rs (0.4%vs. 0.3%) and stimulants (0.5% vs. 0.3%) in thpast ar. (SAMHSA, 2006)


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Past-Year Abuse of Oxycontin

and Vicodin among 8th

, 10th

and 1th Graders Combined(Percentage)

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2002

2003

2004

2005

2006

2.7% 3.2% 3.3% 3.4%

3.5%

6.0% 5.7%5.7%

6.6% 6.3%

OXYCONTIN VICODIN

TYPES OF PRESCRIPTION DRUGS ABUSED BY TEENSPain r li v rs such as Ox Contin and Vicodin arth most commonl abus d pr scription drugs

b t ns.

Pain r li v rs ar curr ntl th most abus dt p o pr scription drugs b 12 17 ar olds,

ollow d b stimulants, tranquiliz rs ands dativ s. (NSDUH, 2006)

Past ar us o Vicodin is high among 8th,10th and 12th grad rs, with n arl on in 10 highschool s niors using it in th past ar.(MTF, 2006)

On av rag , almost our p rc nt (3.5%) o 8th-12 th grad rs r port d using Ox Contin, and sixp rc nt r port d using Vicodin in th past ar.(MTF, 2006)

In 2006, past ar abus o Ox Contin among8th grad rs xactl doubl dincr asing 100p rc nt ov r th last our ars ( rom 1.3% in

2002 to 2.6% in 2006). In 10th grad rs, past arabus o Ox Contin incr as d b 26 p rc nt

( rom 3.0% in 2002, to 3.8% in 2006).(MTF, 2006)

Fiv o th top six drugs abus d b 12th grad-rs in th past ar w r pr scription drugs or

cough and cold m dicin s. (MTF, 2006)

Four p rc nt o 8th grad rs, v p rc nt o 10th

grad rs, and s v n p rc nt o 12th grad rsr port d taking m dicin s with d xtrom tho-rphan (DXM) during th past ar to g t high.(MTF, 2006)

Almost two out o v t ns r port d havingri nds who abus d pr scription pain r li v-rs and n arl thr out o 10 r port d havingri nds who abus d pr scription stimulants in

th past ar. (PATS, 2006)


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DEPENDENCE AND TREATMENT Adol sc nts ar mor lik l than oung adults tob com d p nd nt on pr scription m dication.

In 2004, mor than 29 p rc nt o t ns intr atm nt w r d p nd nt on tranquiliz rs,s dativ s, amph tamin s and oth r stimulants.(TeDS, 2004)

Mor 12 17 ar olds than oung adults (18-25) (15.9% vs. 12.7%) b cam d p nd nt onor abus d pr scription drugs in th past ar.(SAMHSA, 2006)

Abusing pr scription drugs or th rst timb or ag 16 l ads to a gr at r risk o d p n-d nc lat r in li . (SAMHSA, 2006)

In th past ar, n arl hal (48%) o all m r-g nc d partm nt (eD) visits r sulting romd xtrom thorphan abus w r pati nts 12 20

ars old. (DAWN, 2006)

Pr scription drug abus dramaticall incr as dduring th past d cad . In th last 10 ars, th

numb r o t ns going into tr atm nt or addic-tion to pr scription pain r li v rs has incr as db mor than 300 p rc nt. (TeDS, 2006)

B tw n 2004 and 2005, th proportion othos s king tr atm nt or pr scription painm dication incr as d nin p rc nt, to morthan 64,000 admissions. (TeDS, 2006)

em rg nc room visits involving abus o pr -scription or ov r th count r drugs incr as d21 p rc nt rom 2004 2005. (DAWN, 2007)

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APPENDIX: DEFINITIONSPrescription drugs that ar most commonl abus d includ thr class s: opioids, c ntral n rvouss st m (CNS) d pr ssants and stimulants.

Opioids ar pr scrib d to all viat pain. exampl s includ ox codon (Ox Contin), propox ph n(Darvon), h drocodon (Vicodin), h dromorphon (Dilaudid) and m p ridin (D m rol).

CNS d pr ssants slow normal brain unction and ar us d to tr at anxi t and sl p disord rs. Inhigh r dos s, som CNS d pr ssants can b com g n ral an sth tics. Tranquiliz rs and s dativ s ar

xampl s o CNS d pr ssants and includ barbiturat s (Am tal, N mbutal, S conal, Ph nobarbital),b nzodiaz pin s (Valium, Xanax) and funitraz pam (Roh pnol).

Stimulants incr as al rtn ss, att ntion and n rg , which ar accompani d b incr as s in bloodpr ssur , h art rat and r spiration. Stimulants ar pr scrib d to tr at narcol ps , att ntion d cith p ractivit disord r (ADHD) and d pr ssion that has not r spond d to oth r tr atm nts. exampl s opr scription stimulants includ amph tamin s (Biph tamin , D x drin ), cocain (Cocain H drochlorid ),m thamph tamin (D sox n) and m th lph nidat (Ritalin).

Dextromethorphan (DXM) is a cough suppr ssant ound in man ov r th count r cough and coldr m di s.

Nonmedical use, misuse and abuse o pr scription drugs ar all d n d h r as us o pr scriptionm dications without m dical sup rvision or th int ntional purpos o g tting high, or or som r asoth r than what th m dication was int nd d.

Current use r rs to us o pr scription drugs during th month prior to th surv int rvi w.

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ANNOTATED REFERENCE LISTBoyd, McCabe, Cranford, and Young. Adolescents Motivations to Abuse PrescriptionMedication, Pediatrics . 2006

A stud conduct d through th Institut or R s arch on Wom n and G nd r, Substanc Abus R s archC nt r, Univ rsit o Michigan, Ann Arbor, MI. Th 2005 sampl was d riv d rom on thnicall divschool district in south ast rn Michigan and includ d 7th through 12th grad stud nts. Th ocus o thstud was to d t rmin adol sc nts r asons or ngaging in th nonm dical (illicit) us o our classo pr scription m dications and to xamin wh th r motivations w r associat d with a high r risk orsubstanc abus probl ms.URL:http://pediatrics.aappublications.org/cgi/content/abstract/118/6/2472

Emergency Department Visits Involving Dextromethorphan, the New DAWN report, Issue 32,Substance Abuse and Mental Health Services Administration (SAMHSA). 2006This issu o Th DAWN R port xamin s th charact ristics o em rg nc D partm nt (eD) visits thainvolv DXM. Includ d ar ndings on th ag o eD pati nts who us d DXM and th r ason or thto th eD. Also provid d ar th rat s o DXM r lat d eD visits p r 100,000 population or di r ngroups and th r qu nc with which DXM products ar ound in combination with alcohol.URL:https://dawnin o.samhsa.gov/fles/TNDR10DXM.htm

Friedman, R. The Changing Face of Teenage Drug Abuse: The Trend Toward Prescription Drugs,The New England Journal of Medicine . 2006

Articl topics rang rom t n nonm dical us o pr scription drugs and illicit drugs, to how t ns acquth pills, to actuall using th m dication or its int nd d us without a pr scription. Th articl addr sth p rc ption among t ns that pr scription drugs ar sa r to us than str t drugs. Th articl isbas d on Th National C nt r on Addiction and Substanc Abus (CASA) at Columbia Univ rsit and Mtoring Th Futur 2006 studi s. Dr. Fri dman is a ps chiatrist and th dir ctor o th Ps chopharmacolog

Clinic at W ill Corn ll M dical Coll g , Ithaca, Ny.URL: http://content.nejm.org/cgi/content/extract/354/14/1448

Misuse of Prescription Drugs, National Survey on Drug Use and Health (NSDUH), Substance Abuseand Mental Health Services Administration (SAMHSA). 2006This r port pr s nts ndings rom th 2002, 2003, and 2004 National Surv s on Drug Us and H althth nonm dical us o pr scription t p ps choth rap utic drugs. NSDUH, an annual surv o th civinoninstitutionaliz d population o th Unit d Stat s ag d 12 or old r, cov rs our broad class s o pr -scription ps choth rap utic drugs: pain r li v rs, tranquiliz rs, stimulants and s dativ s. Att ntion is alsogiv n to two sp ci c drugs within th s g n ral class s: m thamph tamin (a stimulant) and Ox Contin(a pain r li v r). NSDUH is support d b th Substanc Abus and M ntal H alth S rvic s Administratio th U.S. D partm nt o H alth and Human S rvic s.

URL: http://www.oas.samhsa.gov/prescription/toc.htm

Monitoring the Future (MTF), National Institute on Drug Abuse (NIDA). 2006Monitoring th Futur is an annual surv b gun in 1976 that coll cts in ormation about b haviors,attitud s, and valu s o Am rican middl school, s condar school stud nts, coll g stud nts and oungadults. each ar, a total o approximat l 50,000 8th, 10th and 12th grad stud nts ar surv d.URL:http://www.monitoringthe uture.org/pressreleases/06drugpr.pd

http://www.monitoringthe uture.org/data/06data.html#2006data-drugs
http://content.nejm.org/cgi/content/extract/354/14/1448http://www.oas.samhsa.gov/prescription/toc.htmhttp://www.monitoringthefuture.org/data/06data.html#2006data-drugshttp://www.monitoringthefuture.org/data/06data.html#2006data-drugshttp://www.oas.samhsa.gov/prescription/toc.htmhttp://content.nejm.org/cgi/content/extract/354/14/1448


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National Survey of American Attitudes on Substance Abuse XI: Teens and Parents, an annualback-to-school survey. The National Center on Addiction and Substance Abuse at ColumbiaUniversity (CASA). 2006For th past 11 ars, CASA has b n surv ing attitud s o t ns and th ir par nts. CASAs back to-school surv prob s substanc abus risk. Th stud id nti s actors that incr as or diminish thlik lihood that t ns will smok , drink, or us ill gal drugs. Th stud surv d 1,297 t ns; ag 12 1(591 bo s, 706 girls) and 562 par nts o t ns, 84 p rc nt o whom (470) w r par nts o t ns whocompl t d th surv .URL:http://www.casacolumbia.org/absolutenm/templates/PressReleases.aspx?articleid=451&zoneid=56

Partnership for a Drug-Free America, The Partnership Attitude Tracking Study (PATS): Teens ingrades 7 through 12, 2005. 2006Th Partn rship Attitud Tracking Stud tracks th attitud s about ill gal drugs, providing r s arch aboutth thoughts and p rc ptions o th Partn rships targ t audi nc s. Th surv consists o two nationallproj ctabl sampl s; a t n sampl or stud nts in grad s s v n through 12, and a par nt sampl . Th2005 PATS t ns stud surv d 7,216 adol sc nts rom all ov r th U.S. Data w r coll ct d ro

March through Jun 2005.URL:http://www.drug ree.org/Files/Full_Teen_Report

http://www.drug ree.org/Parent/Resources/Key_Findings_o _PATS_Spanish

Research Findings: Underage Alcohol Access & Consumption, Internet, Phone and Mail. TeenageResearch Unlimited (TRU). 2006T nag R s arch Unlimit d, a t n mark ting rm, conduct d quantitativ r s arch to ass ss minorsonlin and phon alcohol ord ring practic s; awar n ss o W b sit s that s ll alcohol; assumptions abouth practicalit o using th Int rn t or phon to circumv nt und rag drinking laws; prop nsit to ordalcohol via th Int rn t, phon , or mail; and th ir alcohol consumption habits. Th onlin surv wascommission d b th Win and Spirits Whol sal rs o Am rica, Inc. Th surv was ld d rom Apri11, 2006, and was compl t d b 1,001 p opl ag s 14 20.URL:http://www.wswa.org/public/media/tru-research/TRUSurvey080206.pd

Seventeen Magazine , March Issue. 2007Seventeen Magazine was stablish d in 1944 and d sign d or oung wom n in th ir t ns and arltw nti s as a guid to th ir li st l and nt rtainm nt int r sts. It is a monthl publication with a circulao mor than two million.

Substance Abuse Treatment Admissions by Primary Substance of Abuse According to Sex, AgeGroup, Race, and Ethnicity, 2004 Treatment Episode Data Set (TEDS). 2006This r port pr s nts r sults rom th Tr atm nt episod Data S t or 2004 and tr nd data or 19942004. Th r port provid s in ormation on th d mographic and substanc abus charact ristics o th 1.9

million annual admissions to tr atm nt or abus o alcohol and drugs in aciliti s that r port to individStat administrativ data s st ms.URL:http://wwwdasis.samhsa.gov/webt/quicklink/US04.htm

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http://www.drugfree.org/Files/Full_Teen_Reporthttp://www.drugfree.org/Parent/Resources/Key_Findings_of_PATS_Spanishhttp://www.drugfree.org/Parent/Resources/Key_Findings_of_PATS_Spanishhttp://www.drugfree.org/Parent/Resources/Key_Findings_of_PATS_Spanishhttp://www.drugfree.org/Files/Full_Teen_Report


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The 2005 National Survey on Drug Use and Health, Substance Abuse and Mental Health ServicesAdministration (SAMHSA). 2006NSDUH, orm rl th National Hous hold Surv on Drug Abus , is an annual surv that provid s in ortion about alcohol, tobacco, illicit drug, and non m dical pr scription drug us among outh and adultsag 12 and old r. NSDUH is support d b th Substanc Abus and M ntal H alth S rvic s Administrationo th U.S. D partm nt o H alth and Human S rvic s.URL:http://www.oas.samhsa.gov/NSDUH/2k5NSDUH/2k5results.htm

http://www.oas.samhsa.gov/NSDUH/2k4NSDUH/2k4results/2k4results.htm http://www.oas.samhsa.gov/nhsda/2k3nsduh/2k3Results.htm

*Som o th r s arch includ d in this r port includ s surv s with small r sampl siz s. How v r thos r sults cannot bg n raliz d to th ntir population.

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http://www.oas.samhsa.gov/NSDUH/2k5NSDUH/2k5results.htmhttp://www.oas.samhsa.gov/NSDUH/2k4NSDUH/2k4results/2k4results.htmhttp://www.oas.samhsa.gov/nhsda/2k3nsduh/2k3Results.htmhttp://www.oas.samhsa.gov/nhsda/2k3nsduh/2k3Results.htmhttp://www.oas.samhsa.gov/NSDUH/2k4NSDUH/2k4results/2k4results.htmhttp://www.oas.samhsa.gov/NSDUH/2k5NSDUH/2k5results.htm

teens and prescription drugs!!!

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