title: High-frequency use of over-the-counter analgesics among adolescents: reflections of an emerging difficult life, a cross-sectional study.
abstract: OBJECTIVE
  To examine characteristics of 15- to 16-year-old adolescents who used over-the-counter analgesics daily to weekly (high-frequency users) as compared to those who used less or no analgesics (low-frequency users). Further to analyse the differences in pain experience, lifestyle, self-esteem, school attendance and educational ambition.
  
  
  METHODS
  An anonymous cross-sectional questionnaire-based study. The questionnaire covered the use of over-the-counter analgesics, pain experience, sociodemographics, lifestyle factors, self-esteem, school absence and future educational plans. The study took place in the 10th grade in six junior high schools in a medium-sized town in Norway. The local sales data for analgesics and antipyretics were close to the national average. We invited 626 adolescents to participate. Of the 367 adolescents (59%) who responded, 51% were girls. Associations between the frequency of use of over-the-counter analgesic and the mentioned variables were analysed using multiple logistic regression.
  
  
  RESULTS
  In total, 26% (42 boys and 48 girls) used over-the-counter analgesics daily to weekly. These high-frequency users experienced more widespread pain, slept less, had more paid spare-time work, drank more caffeinated drinks, participated more often in binge drinking, had lower self-esteem, less ambitious educational plans and more frequent school absence than did the low-frequency users. These associations remained significant when controlling for gender, cultural background and self-evaluated economic status.
  
  
  CONCLUSIONS
  Adolescent, who are high-frequency users of over-the-counter analgesics, suffer more pain and have identifiable characteristics indicative of complex problems. Their ability to handle stress appears to be discordant with the kind of situations to which they are exposed. The wear and tear associated with allostatic mechanisms counteracting stress may heighten their pain experience.
authors.affiliation: Department of Nursing, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
authors.forename: Siv
authors.initials: S
authors.lastname: Skarstein
authors.forename: Elin O
authors.initials: EO
authors.lastname: Rosvold
authors.forename: Sølvi
authors.initials: S
authors.lastname: Helseth
authors.forename: Lisbeth G
authors.initials: LG
authors.lastname: Kvarme
authors.forename: Tanja
authors.initials: T
authors.lastname: Holager
authors.forename: Milada C
authors.initials: MC
authors.lastname: Småstuen
authors.forename: Per
authors.initials: P
authors.lastname: Lagerløv
mesh_terms: D000293:Adolescent; D000700:Analgesics / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D008297:Male; D004366:Nonprescription Drugs / Q000008:administration & dosage*; D009664:Norway
chemical_list: D000700:Analgesics; D004366:Nonprescription Drugs
keywords: OTC analgesics; adolescents; allostasis; allostatic load; lifestyle; pain; self-esteem; stress