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Trajectories of prescription drug misuse during the transition from late adolescence into adulthood in the USA: a national longitudinal multicohort study

Prescription drug use is known to be prevalent in the young adult population. This study looks at identifying prescription drug misuse for three specific drug classes; opioids, stimulants, and sedatives. Their goal is to predict drug use trajectories to identify factors surrounding this high-risk prescription drug misuse. The sample size started as 17,000 students from US high school students (age 18). They followed up with approximately 2,450 of the participants every two years until a mean age of 30 and then once at age 35.

Each survey asked questions surrounding their opioid, stimulant, and sedative use in the past year. They asked them to scale their use with 1 being “No occasions” to 7 being “40 or more occasions.” They also asked sociodemographic questions about parental education, average grades, cigarette use, binge drinking, marijuana use, and others. The researchers used a five-class solution indicating five prescription drug misuse trajectories. They were rare prescription drug misuse, peak at 18 years, peak at 19-20 years, peak at 23-24 years, and at 27-28 years. These trajectories were the same for each of the prescription drug classes but sedatives. For sedatives, there seemed to be a peak at 35 years of age.

The researchers found that all drug misuse trajectories were correlated to higher odds of having two or more substance use disorder symptoms at age 35. These odds were increased if peak prescription drug misuse was later. Finally, risk factors for prescription drug misuse included high school drinking, cigarette smoking, marijuana use, multiple prescription drug misuse, white race, and not completing a 4-year degree. This data shows that any serious prescription drug misuse increases the risk of developing other substance use disorders throughout adulthood. Interventions should target this prescription drug misuse during young adulthood to prevent future substance abuse as individuals age.

Take Away: Young adults across the United States misuse prescription drugs. This study focuses on drug misuse trajectories for opioids, stimulants, and sedatives. The researchers surveyed 17,000 students from the age of 18-35. They found that sedatives had a later peak use at age 35. They found that any prescription drug misuse led to higher odds of having two or more substance use disorder symptoms by the age of 35. Risk factors included things like the use of other substances and not completing a 4-year degree. This information helps to determine young adults at risk and helps to create targeted interventions to provide needed resources.

Mccabe, S. E., Veliz, P. T., Dickinson, K., Schepis, T. S., & Schulenberg, J. E. (2019). Trajectories of prescription drug misuse during the transition from late adolescence into adulthood in the USA: a national longitudinal multicohort study. The Lancet Psychiatry, 6(10), 840–850. doi: 10.1016/s2215-0366(19)30299-8

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