Adolescents' Motivations to Abuse Prescription Medications

American Academy of Pediatrics (AAP) - Tập 118 Số 6 - Trang 2472-2480 - 2006
Carol J. Boyd1, Sean Esteban McCabe2, James A. Cranford2, Amy Young3,4
1Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
2Substance Abuse Research Center, University of Michigan, Ann Arbor, Michigan
3UNIVERSITY OF MICHIGAN
4Institute for Research on Women and Gender

Tóm tắt

OBJECTIVES. Our goals were to (1) determine adolescents' motivations (reasons) for engaging in the nonmedical (illicit) use of 4 classes of prescription medications and (2) examine whether motivations were associated with a higher risk for substance abuse problems. RESPONDENTS. The 2005 sample (N = 1086) was derived from one ethnically diverse school district in southeastern Michigan and included 7th- through 12th-grade students. METHODS. Data were collected by using a self-administered, Web-based survey that included questions about drug use and the motivations to engage in nonmedical use of prescription medication. RESULTS. Twelve percent of the respondents had engaged in nonmedical use of opioid pain medications in the past year: 3% for sleeping, 2% as a sedative and/or for anxiety, and 2% as stimulants. The reasons for engaging in the nonmedical use of prescription medications varied by drug classification. For opioid analgesics, when the number of motives increased, so too did the likelihood of a positive Drug Abuse Screening Test score. For every additional motive endorsed, the Drug Abuse Screening Test increased by a factor of 1.8. Two groups of students were compared (at-risk versus self-treatment); those who endorsed multiple motivations for nonmedical use of opioids (at-risk group) were significantly more likely to have elevated Drug Abuse Screening Test scores when compared with those who were in the self-treatment group. Those in the at-risk group also were significantly more likely to engage in marijuana and alcohol use. CONCLUSION. The findings from this exploratory study warrant additional research because several motivations for the nonmedical use of prescription medications seem associated with a greater likelihood of substance abuse problems.

Từ khóa


Tài liệu tham khảo

Substance Abuse and Mental Health Services Administration. Results From the 2002 National Survey on Drug Use and Health: National Findings. Rockville, MD: Office of Applied Studies; 2004. DHHS publication No. SMA 03-3836, National Survey on Drug Use and Health series H-22

Daniel KL, Honein MA, Moore CA. Sharing prescription medication among teenage girls: potential danger to unplanned/undiagnosed pregnancies. Pediatrics. 2003;111(5 pt 2):1167–1170

Boyd CJ, McCabe SE, Teter CJ. Medical and nonmedical use of prescription pain medication by youth in a Detroit-area public school district. Drug Alcohol Depend. 2005;81:37–45

Boyd CJ, Teter CJ, McCabe SE. Asthma inhaler misuse and substance abuse: a random survey of secondary school students. Addict Behav. 2006;31:278–287

Teter CJ, McCabe SE, Cranford JA, Boyd CJ, Guthrie SK. Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample. J Am Coll Health. 2005;53:253–262

University of Michigan Substance Abuse Research Center. 2001 University of Michigan Student Life Survey Summary. Available at: http://sitemaker.umich.edu/umsarc/student_life_survey. Accessed September 21, 2006

Hall K, Irwin M, Bowman K, Frankenberger W, Jewett D. Illicit use of prescribed stimulant medication among college students. J Am Coll Health. 2005;53:167–174

Califano JA. Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the US. New York, NY: National Center on Addiction and Substance Abuse at Columbia University; 2005. Available at: www.casacolumbia.org/absolutenm/articlefiles/380-under_the_counter_-_diversion.pdf. Accessed September 21, 2006

Zito JM, Safer DJ, dosReis S, et al. Psychotropic practice patterns for youth: a 10-year perspective. Arch Pediatr Adolesc Med. 2003;157:17–25

Cox ER, Motheral BR, Henderson RR, Henderson RR, Mager D. Geographic variation in the prevalence of stimulant medication use among children 5 to 14 years old: results from a commercially insured US sample. Pediatrics. 2003;111:237–243

Olfson M, Gameroff MJ, Marcus SC, Jensen PS. National trends in the treatment of attention deficit hyperactivity disorder. Am J Psychiatry. 2003;160:1071–1077

Robison LM, Sclar DA, Skaer TL, Galin RS. National trends in the prevalence of attention-deficit/hyperactivity disorder and the prescribing of methylphenidate among school-age children: 1990–1995. Clin Pediatr (Phila). 1999;38:209–217

Robison LM, Skaer TL, Sclar DA, Galin RS. Is attention deficit hyperactivity disorder increasing among girls in the US? Trends in diagnosis and the prescribing of stimulants. CNS Drugs. 2002;16:129–137

Joranson DE, Ryan KM, Gilson AM, Dahl JL. Trends in medical use and abuse of opioid analgesics. JAMA. 2003;283:1710–1714

Dasgupta N, Kramer ED, Zalman M, et al. Association between nonmedical and prescriptive usage of opioids. Drug Alcohol Depend. 2006;82:135–142

Zacny J, Bigelow G, Compton P, Foley K, Iguchi M, Sannerud C. College on Problems of Drug Dependence taskforce on prescription opioid nonmedical use and abuse: position statement. Drug Alcohol Depend. 2003;69:215–232

Poulin C. Medical and nonmedical stimulant use among adolescents: from sanctioned to unsanctioned use. CMAJ. 2001;165:1039–1044

American Association for Public Opinion Research. Standard definitions: final dispositions of case codes and outcome rates for surveys, 2004. Available at: www.aapor.org/pdfs/standarddefs_ver3.pdf. Accessed March 20, 2006

Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future National Survey Results on Drug Use, 1975–2004. Vol 1, Secondary School Students. Bethesda, MD: National Institute on Drug Abuse, 2005. NIH publication 05-5727

Skinner H. The Drug Abuse Screening Test. Addict Behav. 1982;7:363–371

Cocco KM, Carey KB. Psychometric properties of the Drug Abuse Screening Test in psychiatric outpatients. Psychol Assess. 1998;10:408–414

Fendrich M, Johnson TP. Examining prevalence differences in three national surveys of youth: impact of consent procedures, mode, and editing rules. J Drug Issues. 2001;31:615–642

Botvin GJ, Griffin KW, Diaz T, Scheier LM, Williams C, Epstein JA. Preventing illicit drug use in adolescents: long-term follow-up data from a randomized control trial of a school population. Addict Behav. 2000;25:769–774

Compton W, Volkow N. Major increases in opioid analgesic abuse in the United States: Concerns and strategies. Drug Alcohol Depend. 2005;81:103–107

McCabe SE, Teter CJ, Boyd CJ. The use, misuse and diversion of prescription stimulants among middle and high school students. Subst Use Misuse. 2004;39:1095–1117

McCabe SE, Teter CJ, Boyd CJ, Guthrie SK. Prevalence and correlates of illicit methylphenidate use among 8th, 10th, and 12th grade students in the United States, 2001. J Adolesc Health. 2004;35:501–504

Sung HE, Richter L, Vaughan R, Johnson P, Thom B. Nonmedical use of prescription opioid among teenagers in the United States: trends and correlates. J Adolesc Health. 2005;27:44–51