June 11, 2004 -- It's a new trend in drug abuse: One in five kids -- especially girls -- are excessively taking nonprescription painkillers. The result can be chronic headaches and potentially serious medical problems like gastrointestinal bleeding and kidney failure.
This startling new finding was presented at the annual scientific meeting of the American Headache Society held in Vancouver this week.
"I've been astounded by the large numbers of kids using over-the-counter medications five or six times a week -- sometimes 15 to 20 times a week," says researcher A. David Rothner, MD, director of the Pediatric/Adolescent Headache Clinic at The Children's Hospital at The Cleveland Clinic, in a news release.
"Even more frightening was that a lot of them were taking medications without telling their parents," Rothner says. "Physicians need to specifically ask children and adolescents who get [chronic] headaches how much over-the-counter medicine they are using."
Rothner's study involved 680 children and adolescents between ages 6 and 18 who had been referred to his clinic; 41% had migraine headaches, 28% had tension-type headaches; 22% had a mixture of migraine and tension-type headaches; and 19% had chronic headaches.
- 22% were taking too many over-the-counter pain relievers.
- Kids abusing pain relievers were mostly girls with chronic tension headaches or a mix of migraine and tension headaches.
- Nearly 20% of kids had reported headaches daily or nearly every day -- 80% of these were girls and 85% were A or A/B students.
- 14% of the kids missed more than 15 school days, mostly because of chronic headaches.
A few of the children had kidney failure or stomach bleeding because of the excessive amount of medication they were taking.
"If you have a child or teen with frequent headaches who is missing a lot of school, you need to be forceful in getting an accurate diagnosis," says Rothner.
Most of the kids named school as a major cause of stress, he says. "All school kids are under stress, but some children and adolescents seem to be biologically predisposed to having headaches. Stress may play a significant role in developing chronic daily headaches."
By getting them to a doctor, parents can help kids get the right diagnosis for their chronic headaches -- and the right treatment. Parents should monitor their children's use of over-the-counter medications and limit it to two doses per week, he says. If the headaches are frequent, a doctor can prescribe preventive medication.
Though no headache medications have been FDA approved for children or adolescents, most doctors will prescribe them because limited research shows some are safe. Triptan medications are the most effective for migraines and seem to be safe and effective for children, Rothner says.