A recent study examined the prevalence of prescription drug misuse (PDM) among U.S. adolescents and young adults and the relationships among school enrollment and type of PDM within these populations. For this study, young adults were defined as individuals aged 18 to 25 years old. The authors investigated three types of PDM: Medical misuse (e.g., use in ways the prescriber did not intend), nonmedical misuse (e.g., use without a prescription) or mixed misuse (a combination of medical and nonmedical misuse). Data from the 2015 National Survey on Drug Use and Health (NSDUH) were obtained for 14,553 young adults. The sample was approximately half male, 55% White, 14% African-American, and 21% Hispanic/Latino. PDM variables were assessed separately by medication class (i.e., opioids, stimulants) and included lifetime prescription use, past-year prescription use, past-year PDM, and type of past-year PDM. Participants who reported past-year PDM also reported whether they experienced 10 DSM-5 substance use disorder (SUD) symptoms. All participants were categorized by educational status/attainment (still in high school, full-time in college, part-time in college, college graduate, not in college); both two- and four-year institutions were considered colleges. The authors used Taylor series approximation, with adjusted degrees of freedom, to create robust variance estimates separately for each medication class. Primary analyses used design-based logistic (PDM prevalence) and multinomial regression (PDM type and SUD symptoms) to examine differences in PDM variables by educational status/attainment, controlling for age, sex, and race/ethnicity. Results indicated outcomes varied by medication class and educational subgroups in young adults. Rates of any opioid use (p ≤ 0.0001), PDM of opioids (p ≤ 0.0001), PDM of opioids type (p = 0.049 and p = 0.55), and opiate use disorder symptoms (p ≤ 0.0001) were significantly higher among young adults not enrolled in college than among full-time college students or college graduates. The same was true for sedatives/tranquilizers. In contrast, the prevalence of PDM of stimulants and SUD symptoms were highest among full-time college students and graduates. Limitations of this study include its cross-sectional design and reliance on self-report.
Take away: For young adults, the prevalence of prescription opioid and sedative/tranquilizer use, misuse, and substance use disorder (SUD) symptoms were significantly higher among those who were not enrolled in college and did not have a college degree. For prescription stimulants; however, the opposite was true: Rates of stimulant use, misuse, and stimulant use disorder symptoms were highest among full-time college students.