Wes: One of the first Double Take columns we did back in November 2004 addressed prescription drug abuse among teenagers. In the interim, the problem hasn’t exactly gone away.

In fact, I’m now finding young adults on my caseload who played around with pharmaceuticals in high school, severely addicted by the middle of college, going up on stimulants and down on pain meds. Not a great way to keep your life under control.

The abuse of pills has a whole different dynamic than street drugs because they’re easy to conceal, very hard to detect, predictable in quality and dosage, and readily available from legal suppliers. In fact, most start off life as perfectly valid prescriptions, then get re-routed along the way. One of the biggest errors parents can make is hanging on to drugs, especially pain medications or benzodiazepines, like Valium and Xanax, after they’re no longer needed. Many kids begin their pharmaceutical habit (or sale and distribution business) not at school or from some nefarious dealer, but at home in the convenience of their own bathrooms.

Stimulants like Adderall and Ritalin are frequently re-routed via young people who carry valid diagnoses and prescriptions. In fact, it’s the rare person coming to our clinic with undiagnosed ADHD who hasn’t first borrowed someone else’s medication to see if it works. Prescribing physicians and nurse practitioners should join with parents in being vigilant for misuse and redirection. In our office, parents are required to administer stimulants and all medications, rather than leaving that to the teen, and we prefer teens not spread the news if they’re taking meds. For the most part, stimulants are misused as study aids for those who don’t actually have ADHD. However, there is still an interest in abusing them recreationally, which given their side effects always baffles me.

For teens, prescriptions drugs have one additional seduction — the appearance of medical legitimacy and safety. Ben does a nice job of discussing that next.

Ben: Very few things are inherently bad. For instance, we have an entire department in our city devoted to fighting fire because fires can destroy homes and people.

However, we also use fire to warm our homes, prepare food and even set a mood. It’s not a bad thing, but it needs to be used properly and carefully.

The same is true of prescription drugs. Countless people work to make the most effective drugs for specific problems, and many benefit from their work. Start using those same drugs to get high or lose weight, and you’re inviting in all kinds of nasty side effects.

There’s this weird mindset that because it has a doctor’s signature next to it, it’s somehow less dangerous than back alley drugs. If you’re using the drug properly, sure, but it stops being medicine when you start using someone else’s or use too much of your own. Chug a bottle of over-the-counter cough syrup, for instance. If it has dextromethorphan in it, you could start having hallucinations, along with a handful of other bad side effects.

Bottom line: Use drugs the way they’re prescribed (that’s kind of the point of prescription).