Measuring prescription drug misuse in the National Survey on Drug Use and Health

The National Survey on Drug Use and Health (NSDUH) provides national, state, and substate data on substance use and mental health in the civilian, non-institutionalized population aged 12 or older. According to NSDUH, the misuse of prescription drugs, particularly pain relievers, ranks second only to marijuana use among the Nation's most prevalent illicit drug use behaviors. However, the definition of prescription drug misuse is complex, involving multiple criteria. Large, national surveys currently do not characterize the subtypes of prescription drug misusers based on these criteria (e.g., nonprescription users, persons who overuse prescribed medication, recreational users). For national surveys to produce accurate measures of prescription drug misuse, respondents face the cognitive task of first determining whether they used the medications included in the survey questions. If so, they must then determine whether their use constituted misuse. Survey items to measure prescription drug misuse and identify subtypes of misusers also need to consider the burden for respondents in terms of survey length. This presentation will discuss findings from a focus group, usability testing, and cognitive interviews as part of an effort to redesign the prescription drug questions in NSDUH. Findings will be presented on respondents' ability to identify prescription drugs they have used, to differentiate between legitimate use and misuse based on the revised questions, and (where applicable) to identify specific behaviors they engaged in that constitute misuse.