Most Teens Taking Prescription Drugs Do It Right

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Most students taking prescription medications for pain, sleep, anxiety or attention deficit/hyperactivity disorder (ADHD) do not misuse the drugs, a new study finds. And proper use of these medications was not associated with a higher risk of addiction or other drug problems.

But while 78% of teens used their medications as prescribed, 22% did report misusing their prescription drugs at least once. These kids were nearly eight times more likely to receive a drug abuse diagnosis, compared with those who used their medications appropriately.

The study involved a confidential computer survey of nearly 2,600 middle and high school students in two districts in Southeast Michigan. Eighteen percent of the students had received at least one prescription for a pain medication, stimulant, anti-anxiety or sleeping medication in the past year.

More frequent use and medical use of multiple types of medications were also associated with higher risk of misuse. For example, of those who had taken painkillers on more than 10 different occasions, 36% misused them at least once, compared with 14% of teens who took painkillers once or twice.

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Misuse was defined as taking more than the prescribed dose or taking the drugs deliberately to get high, either alone or in combination with alcohol or other drugs.┬áTaking more than the prescribed dose was more common than intentional intoxication, suggesting that error or self-treatment attempts when drugs didn’t seem to be effective could account for some of the reported misuse.

The researchers did not determine the medical or psychiatric reasons for which the teens were prescribed these drugs, so the study could not tease out whether it was the students’ diagnosis or the drug use itself that raised the risk of drug misuse or abuse.

Common psychiatric disorders like ADHD and mood and anxiety disorders are themselves associated with higher risks of substance disorders, and more than half of teens who develop drug problems have a co-existing or pre-existing psychiatric diagnosis.

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Parents, meanwhile, can be reassured that short-term medical use of psychoactive prescription medications is safe and that even long-term use does not increase the risk of drug problems as long as medications are taken correctly.

To reduce the chances that teens will take too many pills, distribute their drugs to others or use them to get high, parents should ensure that medications with misuse potential are secured and let their teens know that they are regularly checking pill counts.

The study was led by Sean Esteban McCabe of the University of Michigan and published in the Archives of Pediatric & Adolescent Medicine.

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Maia Szalavitz is a health writer at Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.