MedicalResearch: What is the background for this study? What are the main findings?
Dr. Martins: While a large proportion of young adults, ages 18 to 22, are prescribed opiates, non-medical use of opioids is second only to marijuana as the most prevalent form of illegal drug use among young adults.
Until this study, little was known about nonmedical use of prescription drugs among non-college-attending young adults in the United States. Approximately 70 percent of all U.S. young adults enroll in some form of college education, but around 30% do not.
We analyzed public data for 36,781 young adults between the ages of 18 and 22 over a 12-month period in 2008 through 2010 from the National Survey on Drug Use and Health, an annual cross-sectional survey of the Substance Abuse and Mental Health Administration. Using the Kessler 6 screening instrument, we also measured past-year serious psychological distress as self-reported by the respondents.
Among non-college-attending young adults with at least a high school degree, 13.1 percent reported using prescription opioids for non-medical reasons. The figure rose slightly to 13.2 percent for those who did not graduate from high school, and declined to 11.3 percent among college attendees.
Non-Hispanic Blacks and Asians were less likely to use prescription opioids non-medically in the past-year compared to non-Hispanic Whites. Those who reported experiencing psychological distress most recently were more likely than those without distress to be non-medical users of the drugs.
The relationship between educational attainment and prescription drug use disorder was seen to a greater extent in women: young women who completed high school but were not enrolled in college were at a significantly greater risk of opioid disorder than their college-attending counterparts, while the difference between male college students and males with a high school diploma/GED for past-year opioid disorder was negligible.
We also looked at non-medical use of prescription stimulants. The result was the opposite of what we found with opioids: Those without a high school degree and those who completed high school or equivalency were less likely to have used nonmedical stimulants compared to their college-attending peers. Asian users of the stimulants for non-medical purposes were more likely than whites to develop a stimulant use disorder. Living in a large metropolitan area was associated with a greater use of stimulants that were not prescribed compared to those living in less urban areas. Hometown size also had a bearing on whether this led to a stimulant-use disorder.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Martins: Our findings clearly show there is a need for young adult prevention and intervention programs to target nonmedical prescription drug use beyond college campuses, since this study illustrates that young adults who do not attend college are at particularly high risk for nonmedical prescription opioid use and disorder.There are few NMUPO prevention programs tailored for young adults with less years of formal education—most prescription drug use prevention messages are targeted towards college students. As such, prevention programs are also needed for non-college attending young adults, not only at the media level, but also in workplaces.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Martins: Future research should examine in greater detail drug use patterns among young adults who are nonmedical prescription opioid users and do not attend college as well as further examine nonmedical prescription drug use patterns among those who attend 2-year versus 4-year colleges and those who drop-out of college.
Nonmedical prescription drug use among US young adults by educational attainment
Silvia S. Martins, June H. Kim, Lian-Yu Chen, Deysia Levin, Katherine M. Keyes, Magdalena Cerdá, Carla L. Storr
Social Psychiatry and Psychiatric Epidemiology, 12/01/2014