Prescription drug misuse

Misuse of prescription drugs is common among high school students; and those misusing prescription drugs frequently obtain them from multiple sources, according to two studies published in the July issue of the Journal of the American Academy of Child and Adolescent Psychiatry. However, adolescent controlled prescription drug misuse (PDM) co-occurs with significant consequences, including lower educational achievement; substance use disorder (SUD) symptoms, and psychopathology.

Nonetheless, adolescent PDM sources and the prevalence of other substance use; SUD, and mental health outcomes associated with sources remain poorly understood. However, PDM source prevalence across adolescents; and by sex and school enrollment/engagement were estimated. Adjusted odds of past-year DSM-IV substance-specific SUD, marijuana use; any SUD, major depressive disorder (MDD), anxiety diagnosis, mental health treatment, and past-month binge drinking estimated by source.

Ty S. Schepis, Ph.D., from Texas State University in San Marcos, used data from the 2009 to 2014 National Survey; on Drug Use and Health (including 103,920 adolescents aged 12 to 17 years) to assess six sources of prescription drug misuse. But the researchers found that friends/relatives; for free, was the most common source (29 to 33.2 %); followed by physician sources for opioids (23.9 %), purchases for stimulants (23.5 %), and tranquilizer/sedatives (22.7 %).

However, female adolescents were more likely to use multiple sources; and >70 %of adolescents using multiple sources had a past-year substance use disorder. But over 70% of adolescents using multiple sources had a past-year SUD. Multiple sources; purchases, and theft/fake prescription were more strongly associated with other substance use than physician source use; and multiple source use was linked with MDD.

But in a second study, Sean Esteban McCabe, Ph.D., from the University of Michigan in Ann Arbor; and colleagues analyzed data from a national sample of 18,549 high school seniors participating in the Monitoring the Future study. However, the researchers found that 11 % of high school seniors reported past-year nonmedical use of prescription drugs; of which a substantial proportion obtained the prescription drugs from multiple sources (44.2 %).

Adolescent nonmedical users

Adolescent boys were more likely to obtain prescription drugs from friend/purchased sources; while adolescent girls were more likely to use their own leftover prescriptions. Substance use was more likely among nonmedical users who obtained prescription drugs from multiple sources, while adolescent nonmedical users; who used their own leftover prescriptions were less involved in substance use.

“The implications from these two studies could not be clearer,” McCabe said in a statement. “Parents, public health experts, and clinicians must rally to address this problem. There is a critical need for clinical workforce training to support clinic and school-based education, screening, prevention, and early intervention.”