Adolescent Nonmedical Use of Sedatives/Anxiolytics Is Associated with Substance Use Disorder Later in Life

An increasing number of individuals are prescribed sedatives/anxiolytics. There is a concern that exposure through prescriptions may lead to substance use disorder (SUD), particularly when they are prescribed to adolescents. This study used data from a cohort of 8373 individuals in the Monitoring the Future study to examine the association between medical and nonmedical prescription sedative/anxiolytic use at age 18 and subsequent SUD symptoms at age 35.

• At age 18, 20% of the cohort reported lifetime use of sedatives or anxiolytics; 7.6% reported only medical use, 6.2% reported medical and nonmedical use, and 6.3% reported only nonmedical use.
• At age 35, compared with participants who reported no medical or nonmedical use, those who reported medical and nonmedical use were more likely to have alcohol use disorder symptoms (adjusted odds ratio [aOR], 1.5) and other drug use disorder symptoms (aOR, 3.0). Participants who reported nonmedical use only also had increased odds of alcohol (aOR, 2.1) and other drug use disorder symptoms (aOR, 3.0).
• Those who reported only medical use did not have significantly higher odds of SUD symptoms at age 35, compared with adolescents with no medical or nonmedical use.

Comments:

This study shows that many adolescents are exposed to sedative/anxiolytics. Almost half of those who are prescribed these medications also take them nonmedically and these individuals are at risk for SUD later in life. Although this does not establish a cause and effect relationship, it does reinforce the need to administer these agents judiciously and to monitor closely when they are prescribed.

Darius A. Rastegar, MD

Reference:

McCabe SE, Veliz P, Boyd CJ, Schulenberg JE. Medical and nonmedical use of prescription sedatives and anxiolytics: adolescents’ use and substance use disorder symptoms in adulthood. Addict Behav. 2017;65:296–301.