Citation

Schepis TS, Wilens TE, McCabe SE. J. Am. Acad. Child Adolesc. Psychiatry 2019; 58(7): 670-680.e4.

Affiliation

Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, and the Institute for Research on Women and Gender, University of Michigan, Ann Arbor.

Copyright

(Copyright © 2019, American Academy of Child Adolescent Psychiatry, Publisher Lippincott Williams and Wilkins)

DOI

10.1016/j.jaac.2018.09.438

PMID

30768405

Abstract

OBJECTIVE: 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.

METHOD: Data were from the 2009-2014 National Survey on Drug Use and Health, including 103,920 adolescents (12-17 years). Six mutually exclusive sources were used: physician source only, theft/fake prescription only, friend/relative for free only, purchases only, other source only, or multiple sources. Analyses occurred separately for prescription opioids, stimulants and tranquilizer/sedatives. 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 depression (MDD), anxiety diagnosis and mental health treatment and past-month binge drinking were estimated by source.

RESULTS: Friends/relatives for free was the most common source (29.0%-33.2%), followed by physician sources for opioids (23.9%) and purchases for stimulants (23.5%) and tranquilizer/sedatives (22.7%). Few school enrollment/engagement differences existed, but females were more likely to use multiple sources. 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.

CONCLUSION: Adolescents using multiple sources, purchases and theft/fake prescriptions have elevated rates of other substance use, SUD and MDD and particularly warrant intervention. Also, adolescents with other SUD and MDD should be screened for PDM and misuse sources.

Copyright © 2018. Published by Elsevier Inc.

Language: en

Keywords

adolescent; opioid; source; stimulant; tranquilizer