Excessive and Nonmedical Use of
Prescription Medications in Adolescents
In Session
With Cranford et al:
Excessive and Nonmedical
Use of Prescription Medications in
Adolescents
Addiction Research Center,
Department of Psychiatry, University of
Michigan
Sean Esteban McCabe,
PhD
Institute for Research on Women and Gender,
University of Michigan
Carol J. Boyd,
PhD
University of Michigan School of Nursing
First published in
Psychiatry Weekly, Volume 8, Issue
20, on October 7, 2013
Q: To what extent are
adolescents’ non-medical or overuse of prescription
drugs related to other substance use?
A: Non-medical
use of prescription medication continues to increase
among adolescents in the United States. Seven
percent of young people in the US aged 12–17
years reported non-medical use of a psychotropic
drug in a recent national study. In order to better
inform prevention efforts, our study, which is part of
a larger project by Dr. Carol Boyd, examined
adolescents’ medical and non-medical use of
prescription medications—specifically those with
addictive potential—as well as alcohol, marijuana,
and tobacco.
All 7th- to 12th-grade students
attending 5 schools in southeastern Michigan were
invited to participate in the study. We received
completed surveys from 2,744 respondents.
Respondents’ mean age was 14.8 years (SD 1.9
years); 50.4% were female, 64.1% were white, and
30.6% were African American.
We identified 4 subgroups of
adolescents based on their past 12-month use of
tobacco, alcohol, marijuana, illicit drugs, and non-
medical or excessive medical use of prescription
medications.
Q: Which of the 4 risk
classes represented the largest cohort of
respondents?
A: The majority
of respondents (76.3%) were categorized in the
“Low/No Use” group, who reported either no or very
low probabilities of using any of the substances in
the past year.
The largest high-risk subgroup
(11.5%), referred to as the “TAM” group, included
students who reported high probabilities of using
tobacco, alcohol, and marijuana at least once in the
past year. The second-largest high-risk subgroup
(8.0%), referred to as the “ANM” group, included
students who reported high probabilities of alcohol
use and non-medical or excessive prescription use
at least once in the past year.
The smallest high-risk subgroup
(4.2%) included students who reported high
probabilities of using all evaluated substances at
least once in the past year, referred to as the
“Multiple Substances” group. Low parental
monitoring, high parental substance use, low levels
of internalizing problems, and high levels of
externalizing problems were more likely among
members of the TAM, ANM, and Multiple Substances
groups than of the Low/No Use group. In addition,
females with substance-using parents were also
more likely to be in the Multiple Substances group
than in the Low/No Use group.
Alcohol use was the most
commonly reported substance in this study, with
25% of respondents reporting at least one instance
of alcohol use in the past year. Tobacco and
marijuana use both hovered around 11%. Non-
medical and excessive use of prescription
medication were reported by ~8% and ~6% of
respondents, respectively.
Our results also found that non-
medical and excessive medical use of prescription
medications are indicative of high-risk substance
use subtypes. This makes substance use prevention
messages more difficult and highlights the
importance of balancing such messages so that (a)
youth who are prescribed medications are not made
to feel like drug abusers; yet (b) their parents and
teachers are vigilant about the abuse risks.
Disclosure: This research
was supported by research grants R01DA024678
and R01DA031160 from the National Institute on
Drug Abuse, National Institutes of Health.
Reference:
Cranford JA, McCabe SE, Boyd
CJ. Adolescents’ nonmedical use and
excessive medical use of prescription medications
and the identification of substance use
subgroups. Addict Behav.
2013;38:2768-2771.