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Prescription Drug Misuse Among High School Students: A Part of the Baggage that Students Bring to the College Experience

Written by: Molly Downing, PhD, Clinical Instructor, College of Pharmacy, The Ohio State University


This fall, colleges and universities nationwide welcomed thousands of first-year students into their campus community.  Throughout these students’ lifetime, our country has experienced tremendous change in the cultural norms, access, and uses surrounding prescription medications.  How have these societal changes impacted their own personal attitudes and beliefs towards the non-medical or recreational use of these products?  In addition, how might their experiences as teens influence their choices in college regarding whether to misuse prescription medications?  Moreover, what ramification does this have for our campus communities?  In an effort to address these questions, what follows is a snapshot of the prevalence, perceived beliefs, and attitudes teens exhibit toward prescription medications.


What percent of teens misuse prescription medications?

The misuse of prescription medications continues to be the third most prevalent substance used amongst teens, behind marijuana and alcohol.  Discrepancies exist amongst prevalence estimates of past year misuse (see table below).  Despite these discrepancies, research indicates the average age of first initiation falls within the college years, suggesting that many teens choosing not to misuse during high school remain vulnerable to misuse in college.


Annual Prevalence Estimates of Teen Prescription Drug Misuse
Study All Rx Medications Rx Opioids Rx  Stimulants
NSDUH1 6.2% 4.6%
PATS2 16% 9% 8%
MTF3 14% 4.8% 6.8%


Why do teens misuse?

When asked the main reason for misusing a prescription drug, the most common answers included “to help me relax” (15%), “to experiment” (15%), “to have fun” (14%), “because being high feels good” (12%), and “to help me forget my troubles” (12%)2.  These reasons may be especially concerning to campus communities—if some teens enter college relying on prescription drugs as a form of relaxation or recreational fun, how will adjusting to the demands and freedoms of college impact their decisions surrounding prescription drug misuse?


Do teens perceive prescription drug misuse as harmful?

When asked to what extent teens risk harming themselves if they misuse prescription medications, their answer certainly varies based on the category of prescription medication and frequency to which it’s misused (see table below).  However, the same trend is observed amongst all prescription medications—as misuse becomes more regular, the perceived harmfulness increases.  In addition, it seems that health-related consequences may motivate teens to not misuse prescription drugs.  When asked for the greatest risk that would prevent a teen from misusing, the most common answers included “overdosing” (50%), “endangering your health” (30%), “becoming addicted” (30%), and “getting depressed” (27%)2.


% Teens Perceiving Great Risk in3:
  Trying 1-2X Occasional Use Regular Use
Rx Opioids 43% 59% 73%
Rx Stimulants 34% 42% 55%
Rx Sedatives 30% 51%


What attitudes do teens exhibit toward prescription drugs?

Some teens continue to exhibit relaxed attitudes toward engaging in self-medicating behaviors.  For example, as long as one does not get “high”, 31% of teens believe it is okay to misuse prescription medications to deal with injury or pain, and 29% believe it is okay to take more of a prescription medication than instructed2.  In addition, 31% of teens believe prescription medications can be used as study aids2.  This attitude may underlie a larger cohort effect—between 2009-2014, misuse of prescription stimulants increased from 6.6% to 8.1% amongst high school seniors and from 5.7% to 10.1% amongst college students4.

As teens transition from high school to college, they bring with them their preexisting experiences, attitudes, and beliefs about prescription drugs.  While statistics may tell only one side of the story, we can glean some information from them that helps campuses direct their future prevention efforts.  First, campuses should strive to cultivate environments that promote safe alternatives to misusing prescription medications.  If teens tend to misuse to relax or to have fun, do our prevention efforts include teaching healthy relaxation techniques or promoting fun recreational events around campus that do not involve misusing substances?  Similarly, if an increasing percent of high school seniors rely on prescription stimulants as study aids, are we helping incoming first-year students create a plan that includes healthy study habits?  Second, if health-related consequences motivate half of teens to not misuse, let’s take advantage of this motivating factor in our prevention efforts.  Are we educating young adults on how prescription drug misuse can affect their health?  In addition, statistics would suggest the majority of teens only perceive regular, not occasional, misuse as harmful.  As we teach the health-related consequences, perhaps we should also make the connection that due to the pharmacology of these drugs continued occasional use will lead to regular use.  Lastly, let’s not forget that even by conservative estimates, the majority of first-year college students have never misused a prescription medication in their lifetime2; however, as noted earlier, this body of students remain vulnerable to initiating misuse in college.  All students deserve a campus community that supports safe medication practices and healthy alternatives to prescription drug misuse.  Let’s do our part to cultivate it.



1Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health: Detailed Tables (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/

2Partnership for Drug-Free Kids. (2014). The Partnership Attitude Tracking Study. Retrieved from www.drugfree.org

3Johnston, L.D., O’Malley, P.M., Miech, R.A., Bachman, J.G., & Schulenberg, J.E. (2015). Monitoring the Future national survey results on drug use: 1975-2014: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan.

4Johnston, L.D., O’Malley, P.M., Bachman, J.G., Schulenberg, J.E. & Miech, R.A. (2015). Monitoring the Future national survey results on drug use, 1975-2014: Volume 2, College students and adults ages 19-55. Ann Arbor: Institute for Social Research, The University of Michigan.

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