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What Teens Are Hearing About Drugs
Some Messages Help, Others Are Troubling

By Francesca Lunzer Kritz
Special to The Washington Post
Tuesday, September 9, 2008

Here's a multiple-choice question for parents of tweens and teens.

You're monitoring your child's cellphone and come across a text message encouraging her to try a prescription drug. Could the message be coming from:

A. a drugmaker trolling for a new customer.

B. an adolescent friend urging a raid on your medicine cabinet for a "pharm" party.

C. a trusted physician, offering a reminder to the 25 percent of teenagers who take a daily prescription for conditions ranging from allergies to cancer.

D. any one of the above.

The answer? D. These days, messages aimed at drawing teens' attention to drugs are being televised, e-mailed, texted and even downloaded with music every day.

"These new media choices create a buzz and certainly a perception of a rising trend toward targeting teens," says Jim Joseph, executive vice president of Saatchi & Saatchi Consumer Health+Wellness, a Manhattan advertising agency.

The challenge for teens, and for adults who care for them, is to figure out "how to wade through the clutter of messages they're getting about drugs -- both prescription and nonprescription ones -- in order to make safe and appropriate choices," says Wayne Snodgrass, a professor of pediatrics and pharmacology at the University of Texas Medical Branch in Galveston and chair of the American Academy of Pediatrics Committee on Drugs.

"There's been a demystification of prescription medications for teenagers," says Sharon Levy, director of the adolescent substance abuse program at Children's Hospital Boston. According to a survey published last month by the National Center for Addictions and Substance Abuse, a growing number of teenagers say it's easier to illegally obtain prescription drugs than to buy beer.

Experts blame a cavalier attitude toward drugs for a growing incidence of prescription drug abuse by teens. Every day, 2,500 kids ages 12 to 17 abuse a prescription painkiller for the first time, according to John Walters, head of the White House's Office on National Drug Control Policy; the number of teen patients treated for prescription painkiller abuse grew threefold between 1995 and 2005.

"Teens are abusing prescription drugs because many believe . . . these drugs provide a 'safe' high," Walters says.

At the same time, many teens fail to stick with a prescribed drug regimen for a chronic condition such as asthma, depression or diabetes. "Parents have a crucial role to play in all this," Snodgrass says, "by making it clear that drugs are only safe and effective when they're specifically prescribed, and when taken appropriately."

Drug Ads Just for Teens

When it comes to direct-to-consumer advertising for prescription drugs, permitted by the Food and Drug Administration since 1997, there are no specific rules for marketing to kids and teens, says Robert Temple, director of the Office of Medical Policy at the FDA's Center for Drug Evaluation and Research.

"Appropriate situations for drug companies to specifically address teens include those where the teen could benefit from a medication but might not necessarily start the conversation with an adult," says Meredith Ressi, vice president of research at Manhattan Research, a health-care market research firm in New York. She cites drugs for acne or birth control as examples.

Acne, Ressi says, is a very good example because "a parent might not bring up treatment for fear of making their child feel bad but would likely be delighted to have the teen start the conversation and then be able to help."

Tazorac, an acne drug made by Allergan, is the subject of a back-to-school ad campaign featuring situations such as high school graduation and the prom in which teens might feel particularly self-conscious about their acne. Incentives to register on the site and learn more about the drug (teens 13 to 18 need a parent's permission) include a $5 Starbucks card and a chance at winning a Nintendo Wii console, a video camcorder or a laptop computer.

Ads meant to get a teen's attention typically feature cool clothes, hip music and other teen draws. Bayer Healthcare Pharmaceuticals, the maker of Yaz, a birth control pill, hired the Veronicas, a group popular with teen girls, to record a song for one of the drug's commercials. The Web site of Galderma, the maker of Differin, another acne drug, offers teens a quiz called "The Truth About Zits."

"When marketing directly to teens, you need to be able to speak to and otherwise engage them very differently from adults," says Elizabeth Izard Apelles, CEO of digital marketing agency Greater Than One, whose clients include Novartis, which makes ADHD drug Focalin XR. "Otherwise, they won't pay a lick of attention."

Other advertising execs agree.

"We use a combination of media, trying to reach" teens, says Kathy Magnuson, executive vice president of Brand Pharm, whose clients include Galderma. In June, Galderma launched a Differin ad on ABC Family and MTV and has also bought space for the ad at movie theaters and on the Internet.

Drugmaker Sanofi Aventis used a low-tech but novel approach to reach teen girls. The company placed a full-page ad (plus another page of FDA-required consumer information) for acne drug Benzaclin in the fall catalogue of Delia's, a teen-girl clothing chain.

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Merck is moving beyond TV ads for Gardasil, which protects against human papillomavirus infection and is recommended for adolescent girls. Because the vaccine is given in three doses, each months apart, Merck is sending out reminders by mail, e-mail and text message -- "REMIND" to "GARSL" -- telling those who got the first shot to come back for shots two and three.

Kathy Woodward, a pediatrician at the adolescent health clinic at Children's National Medical Center in Washington, worries that ads aimed at adolescents often create an inappropriate sense of fun, fostering the idea that there's a pill for every ill. Woodward believes taking drugs might seem hip, for example, when Antonio Banderas, whose voice is well known from the "Shrek" movies, narrates TV commercials for the allergy drug Nasonex.

Woodward says she has been overwhelmed by the number of teenage boys who come in asking for a prescription for Lamisil, an antifungal drug. TV ads that stopped airing about a year ago said dark-colored toenails might be a fungal infection that the drug can clear up.

"It's only an infection 10 percent of the time," says Woodward, "and leaving the nail as it is poses no health risk." What's more, because of a slight risk of liver damage, Woodward notes, anybody who takes the drug needs monitoring.

"When teenage boys make [a drug they've seen advertised] the focus of their yearly office visit," she explains, "it takes away time I need to talk about crucial health issues including safe driving, alcohol and prescription drug abuse."

Francesca Lunzer Kritz is a freelance writer. Comments:health@washpost.com.

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