Adolescent Prescription and Over-the-counter Drug Abuse: The Truth About Abusing Over-the-counter and Prescription Medications (YF1857, Aug. 2018)

Prescription and over-the-counter drug abuse and overdose are growing concerns across the nation and in North Dakota communities. In North Dakota, there has been a 59.7% increase in the number of controlled substance prescriptions dispensed between 2008 and 2015. Staying up-to-date on prescription and over-the-counter drug abuse trends is critical for today's caring adults.

Meagan Scott, Ph.D., Assistant Professor/4-H Youth Development Specialist

Chloe Krinke, M.Ed., LAPC, NDSU Center for 4-H Graduate Assistant

Availability: Web only

After marijuana and alcohol

After marijuana and alcohol, prescription and over-the-counter (OTC) drugs are the most commonly abused substances by Americans 14 and older. 1,756 teens abuse a prescription drug for the first time every day.

90% start in teenage years
Medicine Abuse Project, 2013

What is Prescription/OTC Drug Abuse?

  • Taking a prescription/OTC drug not prescribed to you
  • Taking it in a way other than prescribed (larger dose)
  • Taking it for another purpose than prescribed (to “get high”)
  • Mixing a prescription/OTC drug with other drugs (alcohol)

Myth: Taking an extra pill from my prescription or giving one to my friend is not harmful because a doctor prescribed it.

Fact: Taking drugs that are not prescribed or taking them in any way other than a doctor directs can be dangerous.

Using another person’s medication or sharing your medication is against the law. – N.D. Century Code 19-03. 1-23.

Myth: Prescription and OTC drugs are safer than illegal drugs.

Fact: Prescription and OTC drugs can be more addictive and dangerous than illegal drugs. Users are at risk for adverse health effects and overdose. Legal does not mean safe.

Why Do Youth Abuse?

  • Feel good or “get high”
  • Relieve or stop pain
  • Help with school work
  • Reduce appetite
  • Experiment
  • Relax/reduce stress
  • Escape reality
  • Fall asleep or stay awake
  • Feel accepted by others
  • Feed an addiction

Early substance abuse is associated with a greater likelihood of developing a substance use disorder later in life.

Most youth who abuse prescription drugs get them for free from a friend or relative, sometimes without the person’s knowledge.

Warning Signs of Abuse

  • Missing medications
  • Continually “losing” prescriptions
  • Negative performance at school or work
  • Changes in hobbies or interests
  • Visits to internet sites with information on how to get and abuse prescription/OTC drugs to “get high”
  • Disrupted sleeping/eating patterns
  • Changes in friends
  • Changes in appearance and hygiene
  • Withdrawal from family and friends
  • Excessive mood swings (irritability)


Widely Available: In North Dakota, the number of controlled substance prescriptions dispensed increased 59.7 percent between 2008 (935,201) and 2015 (1,493,847).

Commonly Abused Prescription/OTC Drugs



Generic Names

Commercial Names (common)

Street/Slang Names

Signs of Abuse


Relieve pain




oxycodone HCL




Tylenol with Codeine

Roxanol, Duramorph

Methadose, Dolophine

OxyContin, Percocet, Tylox

Vicodin, Norco, Lortab, Lorcet

Actiq, Duragesic, Sublimaze

Dilaudid, Demerol, Pana

Captain Cody, Lean, Sizzurp

M, Miss Emma, Monkey

Amidone, Fizzies

Oxy, Hillbilly Heroin, Percs

Vike, Vics, Watson-387

Apache, China Girl, TNT

Juice, Demmies, Biscuits

Euphoria, drowsiness, sedation, weakness, dizziness, nausea, impaired coordination, confusion, dry mouth, itching, sweating, constipation, slowed breathing. Risk of death increases when combined with alcohol or other depressants. Oxycodone is
twice as potent as morphine, and fentanyl is 80 to 100 times
as potent as morphine.


Relieve anxiety or sleep issues



sleep medications

Amytal, Nembutal, Seconal

Ativan, Valium, Xanax, Klonopin

Ambien, Sonata, Lunesta

Barbs, Reds, Phennies

Candy, Downers, Tranks

Roofies, Forget-me Pill, R2

Euphoria, excitement, fever, irritability

Drowsiness, slurred speech, poor concentration, confusion, dizziness


Treat ADHD, narcolepsy, or obesity





Adderall, Dexedrine

Concerta, Ritalin

AdipexP, Lonamine

Belviq, Contrave, Saxenda

Addys, Dexies, Uppers

JIF, MPH, Vitamin R, Skippy

Speed, Pep Pills, Zing, Diet Coke

Feelings of exhilaration, increased energy, mental alertness, weight loss, nervousness, insomnia, irregular heartbeat, seizures, psychosis, anger, paranoia, irritability


Hormone therapy





Juice, Gym Candy, Pumpers, Roids, Gear, Stackers

Acne, fluid retention, aggression, mood swings, extreme irritability, delusions, stunted growth


Relieve cough/cold

Relieve diarrhea

dextromethorphan (DXM)

loperamide hydrochloride

Brand names include “DM” (Robitussin, Mucinex, etc.)


Robotripping, Robo, Triple-C, Dex, Tussin, Purple Drank

The Poor Man’s Methadone

Euphoria, slurred speech, increased heart rate, dizziness, nausea, paranoia

Euphoria, fainting, stomach pain, constipation, pupil dilation, kidney failure, heart attack


2017 North Dakota High School Youth Risk Behavior Survey

Reported substance use one or more times in life:

 High school youth survey

Proper Disposal

Reducing Access Will Reduce Abuse

North Dakota is the only state offering two free programs to dispose of unwanted medications year-round: the Take Back program at participating law enforcement agencies and the MedSafe program at participating pharmacies. More than 11 tons of unused medications have been collected from the Take Back containers. Visit to find a location near you. Do not flush prescription drugs down the toilet or drain unless the label instructs to do so. Proper disposal is important.

North Dakota Fast Facts

  • More high school students have abused prescription and OTC medications (21.7 percent) than have used synthetic drugs, cocaine, ecstasy and heroin combined (14.6 percent).
  • 4.3 percent of middle school students and 14.4 percent of high school students reported using prescription drugs without a doctor’s prescription (OxyContin, Percocet, Vicodin, Codeine, Adderall, Ritalin or Xanax).
  • 1.8 percent of middle school students and 7.3 percent of high school students reported taking OTC drugs to “get high.”
  • Nonmedical use of pain relievers is highest among 18- to 25-year-olds.

 60% before turning 18
ND Prevention Resource & Media Center, 2017

Prevention Strategies for Caring Adults/Parents

o Take inventory of all prescriptions and secure them in a locked area.
o Talk to youth about the risks of abuse.
o Keep communication open.
o Monitor and supervise youth.
o Keep updated and informed on the latest prescription/OTC drug trends.
o Call 1-855-378-4373 (Partnership for Drug Free Kids) for confidential support for your family.
ND Prevention Resource & Media Center, 2017

Fentanyl-laced Prescriptions

Fentanyl is an extremely potent synthetic opioid 50 to 100 times stronger than heroin. Fentanyl is being found in counterfeit pills made to look like prescription pain relievers or sedatives. Those who use laced prescription drugs are at a much higher risk of overdose and death. Because of its high potency, fentanyl is deadly in very small doses; a lethal dose can be inhaled or absorbed accidentally through skin contact. Drugs obtained on the street, even if they look like a real prescription, may be fatal.

August 2018
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