Pediatricians should be aware that adolescents and young adults are abusing medication that is regarded as sufficiently benign to be available without prescription. Obtained through legitimate over-the-counter channels or the purchase of "look-alikes" and used in place of controlled substances, these drugs can cause serious problems.
A decade ago, tightening of drug laws restricted production and availability of popularly abused stimulants, setting the stage for an increased use of nonprescription, sympathomimetic drugs. Amyl nitrite was restricted to availability by prescription in 1969, and the Controlled Substance Act of 1972 may have reduced the manufacture of amphetamine 95% from the levels of the 1960s. In 1974, methaqualone, a hypnotic, was added to the list of substances covered by the 1972 Act. These changes and the upsurge of cocaine use during the 1970s fostered the production of a legion of new drugs popularly known as look-alikes. Most often, look-alikes closely resemble amphetamine tablets or capsules in size, color, numbering, and trademarking; they also exist as cunning counterfeits of well known medications. Adolescents and young adults who abuse look-alikes usually locate sources of supply in magazine advertisements that emphasize the "-amine" or "-caine" component of the drug. They receive more than a placebo, but not what they expect. Some look-alikes contain the stimulants phenylpropanolamine (deleted from some new look-alike formulations), ephedrine, and caffeine; others have lidocaine (to cover some advertising claims) or a hodge-podge of other substances—all of which are commonly found in over-the-counter preparations marketed for the treatment of allergic symptoms, upper respiratory infections, or obesity, or as "pick-me-ups."
- Copyright © 1983 by the American Academy of Pediatrics