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Research Summary

Prescription Drug Misuse Is Prevalent and Associated with Youth, Psychiatric Problems, and Other Substance Use

Nonmedical use of prescription drugs is a growing problem among adolescents and young adults. Three recent articles examine this problem using cross-sectional data from the National Survey on Drug Use and Health (NSDUH), a representative US sample survey assessing the prevalence, patterns, and consequences of alcohol, tobacco, and illegal drug use.

  • Analyzing data from 91,804 persons over age 18 who participated in the survey between 2002–2004, Becker and colleagues found past-year nonmedical use of prescription opioids in 4.5% of subjects, 12.9% of whom met criteria for abuse or dependence. Correlates of nonmedical use included younger age, depressive and anxiety symptoms, cigarette smoking, alcohol misuse, Latino ethnicity, unemployment, and low education attainment.
  • Wu and colleagues examined data from 18,678 adolescents aged 12–17 who participated in the 2005 survey and found that 10% reported lifetime nonmedical use of prescription opioids. Of these, 61% had used prescription opioids nonmedically before age 15, and 18% had used them weekly or more in the previous year. Risk factors for lifetime use included age 16–17 (compared with age 12–13), younger age at first drug use, fair or poor health, and 3 or more emergency department visits in the past year. Mental-health service use was a significant correlate for girls.
  • In an analysis of the 2003 survey, Simoni-Wastila and colleagues found a 9.3% prevalence of nonmedical prescription drug use by adolescents. They similarly detected a relationship between past-year nonmedical use of prescription drugs with age 16–17, cigarette smoking, and alcohol use.


Nonmedical use of prescription drugs, especially opioids, is highly prevalent among adolescents and adults. In an ideal world, all physicians would ask all patients about nonmedical use of prescription drugs as a routine part of the medical and psychiatric history. In reality, this ideal often proves challenging in a busy clinic or office. These studies, although they cannot determine causal direction, do provide clues that can guide clinical prevention and case finding. Clinicians should be especially careful to address the possibility of prescription and other drug problems among persons in middle to late adolescence or early adulthood; in those who smoke, drink, or use other substances; and in those with depressive or anxiety symptoms.

Peter D. Friedmann, MD, MPH


Becker WC, Sullivan LE, Tetrault JM, et al. Non-medical use, abuse and dependence on prescription opioids among U.S. adults: psychiatric, medical and substance use correlates. Drug Alcohol Depend. 2008; 94(1–3):38–47.


Wu LT, Pilowsky DJ, Patkar AA. Non-prescribed use of pain relievers among adolescents in the United States. Drug Alcohol Depend. 2008;94(1–3):1–11.


Simoni-Wastila L, Yang HWK, Lawler J. Correlates of prescription drug nonmedical use and problem use by adolescents. J Addict Med. 2008;2(1):31–39.