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. 2019 Jul;58(7):681-691.
doi: 10.1016/j.jaac.2018.11.018. Epub 2019 Mar 27.

Sources of Nonmedical Prescription Drug Misuse Among US High School Seniors: Differences in Motives and Substance Use Behaviors

Sean Esteban McCabe  1 , Philip Veliz  2 , Timothy E Wilens  3 , Brady T West  4 , Ty S Schepis  5 , Jason A Ford  6 , Corey Pomykacz  6 , Carol J Boyd  2
Affiliations

Sources of Nonmedical Prescription Drug Misuse Among US High School Seniors: Differences in Motives and Substance Use Behaviors

Sean Esteban McCabe et al. J Am Acad Child Adolesc Psychiatry. 2019 Jul.

Abstract

Objective: To examine whether sources of nonmedical use of prescription drugs (NMUPD) involving anxiolytics, opioids, and stimulants were associated with sociodemographic characteristics, NMUPD characteristics (eg, frequency), and other substance use.

Method: Nationally representative samples of US high school seniors (N = 18,549) were surveyed by self-administered questionnaires (2009-2016). Design-based latent class analysis and Rao-Scott χ2 tests were used to test associations among sociodemographic characteristics, NMUPD characteristics, other substance use behaviors (eg, binge drinking, cigarette smoking, marijuana use), and NMUPD sources.

Results: Approximately 11.0% of high school seniors reported past-year NMUPD (n = 1,917). A substantial proportion of nonmedical users obtained the prescription drugs from multiple sources (44.2%). Latent class analysis identified 5 subgroups of NMUPD sources (friend/relative sources, friend/purchased sources, own leftover prescription, multiple sources, and other sources). Nonmedical users who obtained prescription drugs from friend/purchased sources were more likely to be adolescent boys, whereas those who used their own leftover prescriptions were more likely to be adolescent girls. Nonmedical users who obtained prescription drugs from multiple sources were more involved in substance use. In contrast, adolescent nonmedical users who used their own leftover prescriptions were less involved in substance use.

Conclusion: Growing evidence indicates that different NMUPD sources are associated with different substance use behaviors. All NMUPD sources should be discouraged, because they place individuals, families, and communities at risk. Patients and their families should receive education on how to manage and properly dispose of controlled medications to avoid diversion into the community. Prescribers are encouraged to check prescription monitoring programs and screen adolescents for substance use/misuse when prescribing controlled medications.

Keywords: diversion; epidemiology; prescription medications; substance abuse.

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Conflict of interest statement

Disclosure: Dr. Wilens has received grant funding from the NIH/NIDA. He is or has been a consultant for Alcobra, Neurovance/Otsuka, and Ironshore. He has published the book, Straight Talk About Psychiatric Medications for Kids (Guilford Press) and has co-edited the books, ADHD in Adults and Children (Cambridge University Press), Massachusetts General Hospital Comprehensive Clinical Psychiatry (Elsevier), and Massachusetts General Hospital Psychopharmacology and Neurotherapeutics (Elsevier). He is co-owner of the Before School Functioning Questionnaire (BSFQ), a copyrighted diagnostic questionnaire. He has a licensing agreement with Ironshore (BSFQ Questionnaire). He is Chief, Division of Child and Adolescent Psychiatry and (Co) Director of the Center for Addiction Medicine at Massachusetts General Hospital. He has served as a clinical consultant to the US National Football League (ERM Associates), US Minor/Major League Baseball, Phoenix/Gavin House, and Bay Cove Human Services. Drs. McCabe, Veliz, West, Schepis, Ford, and Boyd and Ms. Pomykacz report no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Estimated Latent Class Analysis Probabilities and Prevalence of Sources Based on Five Latent Classes (n=1691)
See this image and copyright information in PMC

Comment in

  • Editorial: What Cures One Can Kill Another.
    Thurstone C. Thurstone C. J Am Acad Child Adolesc Psychiatry. 2019 Jul;58(7):661-662. doi: 10.1016/j.jaac.2018.12.014. Epub 2019 Apr 17. J Am Acad Child Adolesc Psychiatry. 2019. PMID: 31002866

References

    1. Miech RA, Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE, Patrick ME. Monitoring the Future National Survey Results on Drug Use: 1975-2017: Volume I, Secondary School Students. Ann Arbor: Institute for Social Research, The University of Michigan, 2018.
    1. Crane EH. The CBHSQ Report: Emergency Department Visits Involving Narcotic Pain Relievers. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, 2015. - PubMed
    1. McCabe SE, Veliz P, Wilens TE, Schulenberg JE. Adolescents' prescription stimulant use and adult functional outcomes: A national prospective study. J Am Acad Child Adolesc Psychiatry 2017;56:226–233 - PMC - PubMed
    1. Boyd CJ, McCabe SE, Cranford JA, Young A. Prescription drug abuse and diversion among adolescents in a southeast Michigan school district. Arch Pediatr Adolesc Med. 2007;161:276–281. - PubMed
    1. McCabe SE, Cranford JA, Boyd CJ, Teter CJ. Motives, diversion and routes of administration associated with nonmedical use of prescription opioids. Addict Behav. 2007;32:562–575. - PMC - PubMed

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