In response to Mary Powell’s letter (“Rights of Christians Infringed upon,” Open Forum, Feb. 17): no Mary, Christians and Catholics are not in fact afforded less rights than everyone else. And I say that as someone who went to (Catholic) church every Sunday and a many, many “holy days” for the first 18 years of her life. In this country, Catholics are free to make whatever choices they are comfortable with for their own lives. no one is forcing them to use contraceptives or to engage in sexual intercourse against their will. they are not, however, free to make choices for other people’s lives. You don’t hear gay people claiming that everyone must be gay, or people who advocate the right to a woman to choose whether or not to have an abortion saying that “everyone must have an abortion whether they want to or not.” no, what these groups advocate is that everyone should have the right to choose what is right for themselves and their families at whatever situation and point in life they might find themselves in. What Catholics (and many other Christians) seem to want is to force their antiquated view of morality on the rest of the world.

If you don’t want to use birth control Mary, then don’t. If you don’t want your daughters to use oral contraceptives, then explain to them why you think it is the wrong choice. And feel free to spread that message as widely and loudly as you are able (hopefully using scientifically based facts, not baseless propaganda). But don’t think that you have the right to force that point of view on anyone else. That’s the problem with the Catholic point of view on this issue.

Churches, whose main purpose is the dissemination of religion, are exempt from Obama’s ruling. It’s only when churches choose to take a wider role in society (e.g., running a university or a hospital) that they are not exempt. In that forum, they serve a vast array of people from many religious and non-religious backgrounds. In that capacity, they are ethically bound to offer all services that are scientifically and medically appropriate. It is up to the woman and her doctor to decide what’s best — not the morality of the Catholic church.

And by the way, Mary, shame on you for spreading false information about contraceptive use under the guise of a “knowing professional” (i.e., a nurse). You insinuated in your letter that PID and infertility were caused by “multiple abortions and from years of contraceptive use.” Associating OC use with PID is patently false. PID is primarily associated with sexually transmitted diseases (primarily Chlamydia and gonorrhea). the only way you could associate oral contraceptives with PID is the fact that women who are on the pill are less likely to use other forms of “barrier” birth control (i.e., condoms) that prevent these diseases. But in fact, a 1982 study published in the American Journal of Obstetrics and Gynecology found that: “Annually, an estimated 50,000 initial cases of PID are prevented and 12,500 hospitalizations are averted by OC use. consequently, protection against PID is one of the most important noncontraceptive benefits of oral contraception.”

And a number of the other negative situations you mentioned in your letter (e.g., “depression and suicidal thoughts from post-traumatic stress disorder from post-abortion trauma”) would actually be prevented by the use of oral contraceptives as the cause of the abortion would have been averted in the first place. And what on earth, Mary, does “drug and alcohol addiction in a 22-year old girl after sex with five men” have to do with a woman’s right to choose oral contraceptives (whether for the purpose of preventing unwanted pregnancy, or to regulate irregular and painful menstrual cycles, or to control PMS symptoms, or reduce the negative affects of teenage acne)?

Shame on you Mary for using your degree as a nurse to aid in the spreading of misinformation about oral contraceptives. And shame on the Catholic Church for their positively medieval stance on this issue.

Current Font Size: Adolescents are asking for contraceptives for their skin, Ritalin to cram for exams, or steroids to score at sport

Teenagers at elite schools are being exposed to a cocktail of pills and are at risk of developing a "quick-fix pill culture" to cope with problems.

This generation is likely to swallow handfuls of prescription drugs, whether or not they are medically needed, medical professionals report.

"I take a concentration of pills: Cataflam (anti-inflammatory), calming pills, Roaccutane for my skin and birth control pills for my skin. I go to a brain doctor twice a year and a physio twice a week," says a 17-year-old girl from a Johannesburg private school.

One of her friends says: "In the morning, I take a pill, a puff, a syrup, a skincare pill, I have an inhaler for the day and I go to the pulmonologist."

She is following doctor’s orders, but other students and parents think nothing of trying to give their doctors orders – demanding medicines or exaggerating symptoms to get what they want.

Joburg psychiatrist Dr Brendan Belsham says: "If a matric student and the parents have an agenda to get a script, they can come to the rooms and exaggerate the symptoms. as clinicians we need to be aware of this and the merits of each case.

"The diagnostic criteria for conditions like ADHD (attention deficit hyperactivity disorder) are subjective and you can be ticking the boxes, convinced a script is warranted when it may not be. Students may be wanting a quick fix to satisfy the social demand for better marks at the expense of doing practical things like time management and studying.

"I also have patients who tell me they sell their prescribed medicines to others for performance enhancement to study."

The pressures to perform in the classroom and on the field – and to look good – are among the reasons why adolescents are asking for contraceptives for their skin, the ADHD medicine Ritalin to cram for exams, or steroids to score at sport (and with girls). Peer pressure plays a critical role in driving up demand, which is higher among girls.

Family practitioner Dr Lorraine Becker says: "If one girl has very bad skin and it clears up (on hormonal treatment), then all her classmates want it. I often get boys saying they want Roaccutane for acne.

"I had a matric pupil who had never needed Ritalin. but when her friend got it, she wanted it, too. She said she needed it to concentrate better, but if she had never needed it in 18 years, she didn’t need it now.

"I think we are developing a pill culture and we have to guard against that."

Founder of the SA Depression and Anxiety Group, Zane Wilson, says the abuse of pills in SA happens in pockets compared to the US, where it is widespread: "there are some cases, but not a tsunami of them."

In the US, the abuse of prescription drugs and painkillers soared in the 1990s and is continuing to rise steeply. seven million Americans reported non-medical use of prescription drugs in 2009 – more than the number using cocaine, heroin, hallucinogens and inhalants combined. Non-medical use is intentionally taking the medicines in a way other than how they were prescribed.

Belsham says: "Anecdotally, we have a rising trend in this country, too. there is a social complacency towards chemicals, more in this generation than previously, though it is a problem in all age groups."

Students are also being exposed to stronger medicines and are familiar with brands. one parent says when she offered a girl a Panado, she asked for Myprodol instead. Myprodol is a stronger painkiller that requires a script.

"The number of prescriptions for some of these medicines has increased dramatically since the early 1990s: more than eight-fold for stimulants (such as Ritalin) and four-fold for opioids," the US National Institute on Drug Abuse told a congressional caucus last year. "Other contributors may be the perception that abusing prescription drugs is less harmful than illicit ones."

On top of the abuse of illegal drugs, the age-old problem of underage drinking is still widespread in South African schools.

Becker says: "The biggest problem is alcohol, but drugs are also a big problem. one boy told me that smoking dagga was a rite of passage when starting high school. this is hugely risky as it is a gateway drug."

A girl from a Catholic private school, which is strict about regulating tablets and drugs on the premises, thinks the abuse of medicines is influenced by peers, the school and parents’ attitudes. She says: "We are in a culture where people take pills from Panados to antibiotics, pills for skin and sleeping pills."

Some families are more pill-orientated than others, doctors observe. Becker says: "I treat generations of families and you see it from the grandparents and parents to the grandchildren. They are brought up in a culture where you take a pill to get better."

She says the campaign against steroid abuse by boys has made an impact and schools have clamped down on it.

Sports physician Dr Jon Patricios says that anabolic steroids are schedule 5 prescription drugs and being in possession of them is a criminal offence. "They are very rarely prescribed for teenagers," he says.

But despite awareness about steroid abuse, they are still in demand by boys. Patricios, who is president of the SA Sports Medicine Association, says: "They are used to cheat at sport, but also to build a ‘beach body’. this is one of the fastest growing drugs of abuse among teenage boys, but not as a prescription drug as much as black-market trade."

The stresses on adolescents living in an age of instant technology and image are aggravating this. but taking shortcuts, Belsham warns, erodes the character development needed to mature into adulthood.

HELP FOR KIDS

University of Cape Town psychiatrist Professor Dan Stein says South African teenagers may be abusing prescription drugs, but "disorders such as ADHD are under-treated".

"My anecdotal impression is that this (abuse) can occur in some more affluent areas, but most parents don’t want to treat kids with prescription meds, and this can lead to under-treatment of certain conditions. Overall, the data shows that, in SA, mental disorders are under-diagnosed and under-treated."

His colleague, Dr Brendan Belsham, says people must consult a professional if they need help.

"there is no substitute for proper medical advice. Don’t try a few Ritalin from a neighbour or try to twist the arm of your GP for a script. You need to be aware of the whole child."

He adds: "where medicines are indicated and, for example, an ADHD disability is treated in conjunction with lifestyle management, learners’ confidence can skyrocket."

From a family medicine perspective Becker agrees that mental health disorders are often undetected.

"Be very aware of your children," she says. "If you see any change of behaviour – being awake all the time, argumentative, withdrawn – you must investigate. Schools put pressure on students and adolescence can be a minefield. It’s hard for them."

Zane Wilson of the SA Depression and Anxiety Group says SA’s 29% of teens have attempted suicide and need treatment.

• For free counselling, call the Sadag line on 0800 567 567.