Tim’s two sons, now 19 and 22, have always had a healthy respect for over-the-counter (OTC) drugs. “Even as teens they would take cold medicine only if necessary, but their usual response to colds and the flu was vast amounts of orange juice,” says the Toronto dad. “It’s not so much anything I had done to make them drug-shy,” he says, explaining both boys have had experience with prescription medication to treat recurring conditions and have had regular appointments with doctors and specialists. “I guess you could sum up their medical awareness by saying they’re smart kids.”
Talking with your teen is a good start to helping him understand what’s in the family medicine cabinet, says Dr. Stan Kutcher, a professor of psychiatry at Dalhousie University and Sun Life Financial Chair in Adolescent Mental Health at Halifax’s IWK Health Centre. “One thing parents should be doing as part of their health literacy education for their kids is to help them understand how to use medicines properly.” If you aren’t sure how to explain it yourself, Dr. Kutcher recommends asking a pharmacist. “They are professionals who are there to help educate you about the proper use of medicines.”
“By and large, all things considered, kids can take adult doses of most OTC medicines around the time of puberty,” says Dr. Kutcher. Some parents, though, find it hard to relinquish control, even when it comes to treating run-of-the-mill aches and pains, says Dr. Miriam Kaufman, a pediatrician specializing in adolescent medicine at Toronto’s Sick Kids Hospital and author of Helping Your Teen Overcome Depression: A Guide for Parents (Key Porter).
And there are no clear instructions for teens—just pediatric or adult doses. For some medications, the adult dose is three times the pediatric amount. While child doses are, for the most part, determined by milligram per kilogram of weight, in contrast, the adult dose of most medications is one size fits all. Teens might prefer to stick to half a pill instead of a whole one, even though they are fully grown, but more often adolescents over-medicate says Dr. Kaufman. “Kids, especially those in families with an ethos that says that when something’s wrong, you take a pill, might be starting to think that the answer to everything is in a medicine bottle.” Dr. Kaufman’s advice for teens is “to take the adult dose if you’re as big as most adults, or to take the kids’ dose if you’re smaller than a lot of your friends.”
Another issue is that teens may not take the appropriate medication for what ails them. For example, adolescents might take an Aspirin (acetylsalicylic acid, an anti-inflammatory) to control vomiting. “Doctors see young people who are depressed and have been taking Aspirin or ibuprofen (also an anti-inflammatory) because they don’t know what else to take and they figure it’s going to make them feel better,” says Dr. Kaufman.
According to surveys by Ontario’s Centre for Addiction and Mental Health (CAMH), around seven percent of teens reported using certain OTC cough and cold medications to get high during the past year. One recurring fad among high school students is to dissolve an Aspirin in Coca-Cola before drinking it to get a buzz, says Dr. Kutcher. He adds that while it might have a placebo effect, it doesn’t produce an actual “high.”
Teens may also misuse cough and cold medicines that include dextromethorphan, a cough suppressant that when abused produces feelings of detachment as well as distorting a person’s perception of sight and sound. It can also produce confusion, dizziness, drowsiness, nausea, vomiting, increased heart rate, hallucinations, anxiety and overheating.
Dr. Robert Mann, senior scientist at CAMH, says the abuse of OTC medications by teens has only recently attracted attention due to new available data. “It’s happening out there, and there is the potential for problems,” says Dr. Mann, co-author of the CAMH survey. He cautions parents to be aware of what’s in their medicine cabinet and that they “should keep an eye on what’s being used and for what purpose.” If you are concerned or suspicious, make it clear to your teen that using these medications recreationally can have serious consequences. Parents can also discuss their concerns with their pharmacist or physician, he says.