Adolescent Medication Misuse: Results from the MUSC Inventory of Medication Experiences (MIME).

OBJECTIVES: To survey a diverse high school population on current prescription and over-the-counter medication misuse behaviors and attitudes. METHODS: We administered the MUSC Inventory of Medication Experiences (MIME), a newly developed self-report instrument, in demographically diverse high schools in Charleston, SC, to assess the feasibility of its administration and determine characteristics associated with medication misuse among high school students. RESULTS: A total of 3182 students completed the MIME (93% completion rate). Nearly one-third (31%) reported misuse of a medication more than once a month. Analysis was conducted to evaluate associations between misuse and age (<15=33%, 15=32%, 16=33%, 17=30%, 18=26%, >18=34%; p=.35), grade (9=29%, 10=32%, 11=33%, 12=30%; p=.22), race (White 34%, African-American 26%, others 30%; p<.001), gender (M=32%, F=28%; p=.01), parent/guardian level of education (college=30%; p=.12), if a participant was prescribed medication (yes=46%, no=21%; p<.001), if a family member was prescribed medication (yes=40%, no=26%; p<.001), and if a family member had ever offered their prescribed medication to the student (yes=91%, no=29%; p<.001). CONCLUSION: Medication misuse may be more pervasive than originally thought, with a notably high level among those most familiar with medications.

Varenicline versus bupropion XL for smoking cessation in older adolescents: a randomized, double-blind pilot trial.

INTRODUCTION: Despite tremendous potential public health impact, little work has focused on development of evidence-based smoking cessation treatments for adolescents, including pharmacotherapies. No prior studies have explored the feasibility and safety of varenicline and bupropion XL, 2 potentially promising pharmacotherapies, as smoking cessation treatments in adolescents. METHODS: Treatment-seeking older adolescent smokers (ages 15-20) were randomized (double-blind) to varenicline (n = 15) or bupropion XL (n = 14), with 1-week titration and active treatment for 7 weeks. Structured safety, tolerability, and efficacy assessments (cotinine-confirmed 7-day point prevalence abstinence) were conducted weekly. RESULTS: There were no serious adverse events. Two participants discontinued bupropion XL due to adverse effects, and none discontinued varenicline. Over the course of treatment, participants receiving varenicline reduced from 14.1 ± 6.3 (mean ± SD) to 0.9 ± 2.1 cigarettes/day (CPD, 4 achieved abstinence), while those receiving bupropion XL reduced from 15.8 ± 4.4 to 3.1 ± 4.0 CPD (2 achieved abstinence). CONCLUSIONS: These preliminary results support the feasibility and safety of conducting adequately powered, placebo-controlled efficacy studies of varenicline and bupropion XL for adolescent smoking cessation.