November 1, 2013
High school seniors who misuse prescription pain medications risk abusing other controlled substances as young adults, a new University of Michigan study indicates.
The study found that about a third of 18-year-olds who took prescription opioids, such as Vicodin and OxyContin, for nonmedical purposes reported continued misuse of these substances into their early-to-mid-20s.
In the first national study of its kind, U-M researchers used data from the national Monitoring the Future study to examine 16 longitudinal patterns of nonmedical use of prescription opioids during the transition from adolescence to adulthood. Nationally representative samples of 27,268 high school seniors in the U.S. were followed from age 18 across three subsequent time periods at ages 19-20, 21-22 and 23-24.
At each time period, respondents were asked about how often they used prescription opioids on their own (without a doctor's orders) during the past 12 months. They also answered questions about other substance use behaviors, such as binge drinking, marijuana use and other controlled substance use.
Nearly 12 percent of the sample reported past-year nonmedical use of prescription opioids in at least one of the four waves between ages 18 and 24. Among those who reported past-year nonmedical use in at least one of the four waves, approximately 69 percent reported at one wave only, 20.5 percent at two waves, 7.8 percent at three waves and 2.7 percent at all four waves.
"This research suggests that most nonmedical use of prescription opioids during adolescence is experimental, but that repeated nonmedical use sets the stage for later substance abuse," said the study's lead author Sean Esteban McCabe, a research associate professor at the U-M Substance Abuse Research Center and the Institute for Research on Women and Gender.
Most high school seniors who reported nonmedical use of prescription opioids during their senior year (wave 1) did not continue this behavior again in the subsequent years (waves 2-4), the study showed.
However, if these students reported nonmedical use of prescription opioids at multiple waves, the odds of other substance use were significantly greater in later waves. Indeed, although only 3 percent of nonmedical users reported nonmedical use of prescription opioids at all four waves, nearly all of them used other substances at ages 23-24.
The study also indicated that white adolescents and those who engaged in multiple problem behaviors while in high school were at increased risk for more chronic patterns of nonmedical use of prescription opioids during the transition to adulthood.
The study's co-authors included John Schulenberg, Patrick O'Malley, Megan Patrick, and Deborah Kloska, all researchers at the Institute for Social Research. Research grants from the National Institute on Drug Abuse and the National Institutes of Health supported this study.
The article is available online and will appear in an upcoming issue of Addiction.