Prior Physician Medication and Subsequent Patterns of Drug Misuse in Young Adults

Introduction: The purpose of this study was to examine the relationship between prior physician-prescribed medication and initiation and subsequent patterns of misuse of prescription, licit, and illicit drugs among young adults.

Methods: A cross-sectional survey design sampled a total of 562 high-risk youth aged 18 to 25 reporting recent prescription drug misuse in LA and NY in 2009-2010. The sample was stratified into four mutually-exclusive groups based on type of medication ever prescribed: pain pills only (group 1); pain pills and tranquilizers or stimulants (group 2); tranquilizers or stimulants only (group 3); and no history of prescription medications (group 4). Groups were analyzed to compare trajectories of drug use and health indicators.

Results: Young adults who were prescribed pain pills and tranquilizers or stimulants (group 2) initiated misuse of tranquilizers significantly earlier, had higher rates of recent misuse of pain pills and tranquilizers, and had higher prevalence of lifetime injection of all prescription drugs. In contrast, differences in most patterns of recent and lifetime illicit drug use, e.g., marijuana, heroin, cocaine, between groups were not significant. Group 2 reported significantly higher ADHD symptoms, stress, and emotional and physical abuse.

Conclusion: Findings indicate that being prescribed a pain medication and one additional drug was associated with increased rates of prescription drug misuse and declines in general well-being during young adulthood compared to being prescribed fewer or no prescription drugs. These findings may have important implications for prescription drug policy and prevention programming.