Prescription Drug Abuse

In reading the articles ‘Nonmedical Prescription Drug Use Among US Young Adults by Educational Attainment,’ ‘Ethnic/Racial Differences in Peer and Parent Influence on Adolescent Prescription Drug Misuse,’ and ‘Influences of Motivational Contexts on Prescription Drug Misuse and Related Drug Problems’, they all highlight the misuse of prescription drug use by young adults. Each article provides its unique interpretation of studies concerning how and why youth misuse prescription drugs on an ethnic level. The articles also discuss the risks of prescription drug misuse, treatments for affected youth, and preventative measures.

Data from 36,781 youth and college-enrolled young adults (independent variable) with at least a high school degree showed a higher ratio of past-year non-medical usage of pharmaceutical opioids (dependent variable) independently, as opposed to 11.3%, adjusted use extents, and yet a decrease in the use of pharmaceutical stimulant (Martins, Kim, Chen, Levin, Keyes, Cerda’, & Storr, 2014). Are there complexities in rates of NMUPD among ethnic/racial social groups? Does apparent peer and parental substance use influence teenagers’ NMUPD? If so, what are the observed differences in peer and parental influence patterns across ethnic groups (Conn & Marks, 2014)? Using data from 400 young adults (independent variable) recruited using time-space sampling, we examined the role of motivational contexts in the frequency of misuse of three types of prescription drugs, drug-related problems, and symptoms of dependency. Addressing positive and negative motivational contexts of prescription drug misuse may not only serve as a means to reduce misuse and execute harm reduction measures but also inform the content of treatment plans for young adults struggling with prescription drug misuse (Kelly, Rendina, Vuolo, Wells, & Parson, 2014).

Each article employed different methods for testing its hypothesis. The article ‘Ethnic/Racial Differences in Peer and Parent Influence on Adolescent Prescription Drug Misuse’ aimed to explore one aspect of cultural socialization, specifically parent and peer attitudes towards adolescent NMUPD. A secondary data analysis was conducted on the public use of the 2010 National Survey of Drug Use and Health using records of 12 to 17 year-old African American, Hispanic, and white participants. A reliability study assessed the reliability of the questionnaire responses. For racial/ethnic grouping, adolescents were asked to select a monoracial or a multiracial category, and non-Hispanic more than one race. The sample contained enough participants in each ethnic group to conduct analyses (Conn & Marks, 2014).

The article ‘Prescription Drug Use Among US Young Adults by Educational Attainment’ exhibited that young adults aged 18 to 22 who do not attend college are particularly at high risk for non-medical prescription opioid use and disorder. This varies by education and race/ethnic groups and there are notable differences within the male and female subgroups. The National Survey of Drug Use and Health utilized a screening question to assess whether the respondent had ever used a non-prescription stimulant or taken one for the experience or feeling it caused (Martins, Kim, Chen, Levin, Keyes, Cerda’, & Storr, 2014).

The last article, ‘Influences of Motivational Contexts on Prescription Drug Misuse and Related Drug Problems’, recruited 400 young adults via time-space sampling to examine the role of motivational contents in the frequency of misuse of three prescription drug types as well as drug-related problems and symptoms of dependency. Participants were asked questions like ‘In the past three months, I have used prescription drugs when I felt overwhelmed and wanted to escape’ (Kelly, Rendina, Vuolo, Wells, & Parson, 2014).

The results showed significant ethnic group differences in rates of prescription drug misuse, with white adolescents reporting the highest rates and African American adolescents the lowest. African American adolescents who perceived stronger parental disapproval of daily alcohol consumption were 285% less likely to misuse prescription drugs non-medically than those perceiving lesser parental disapproval or that parents neither approved nor disapproved. Despite having the highest rate of non-medical prescription drug misuse, white adolescents who reported the highest levels of parental substance disapproval demonstrated significantly less risk compared to both African American and Hispanic adolescents. Hispanic adolescents perceiving stronger parental disapproval of drinking alcohol daily were 200% less likely to misuse prescription drugs non-medically compared to those who did not. The study confirmed the presence of these ethnic group differences and provided novel findings suggesting perceived parental substance use disapproval uniquely influences adolescent non-medical prescription drug misuse (Conn & Marks, 2014).

Compared to being enrolled in college, those not enrolled with at least a high school diploma had a higher prevalence of past-year non-medical use of prescription opioids [NMUPO 13.1 and 13.2%, respectively, vs. 11.3%, adjusted odds ratios (aOR’s) 1.21 (1.11-1.33) and 1.25(1.12-1.40)], indicating lower prevalence of prescription drug use. The study did not distinguish whether these non-medical prescription opioid users first started using these drugs when legitimately prescribed or obtained illegally (Martins, Kim, Chen, Levin, Keyes, Cerda, & Storr, 2014).

Although the results provided much-needed insight into the motivational contexts of prescription drug misuse and its links to substance abuse problems among young adults, some limitations should be considered. The study also showed a negative situation subscale was significantly and directly associated with both outcomes, increasing CIDI severity by 1.28 and SIP-AD severity by 5.33 per unit increase. Positive reinforcement of drug use was not associated with clinically significant outcomes (Kelly, Rendina, Vuolo, Wells, & Parson, 2014).

Conclusion

Taking everything into account, this examination reveals that young adults who don’t attend college are at a particularly high risk for non-medical prescription opioid use and disorder. Interestingly, the non-medical utilization of prescription stimulants is higher among college-educated young adults. The impact of gender and race on these associations is important to consider. Higher education may be a protective factor for some race/ethnic groups, but not for all. There is a need for young adult prevention and intervention programs to target non-medical prescription drug use beyond college campuses. Despite these limitations, our study provides valuable new information about ethnic group differences in adolescent NMUPD. The results also highlight a significant distinction in understanding the influence of parents vs. peers during the formative period of adolescence. If parents exert a greater influence among adolescents, particularly regarding NMUPD, an essential next step would include in-depth inquiry to further explore the elements of parental socialization that shape substance use behavior. Furthermore, it will be vital to identify possible mediators, such as specific cultural beliefs or practices, which may positively impact prescription drug use/abuse among ethnic minority adolescents.

In summary, our results provide support for prevention and treatment initiatives aimed at educating parents to a greater extent about the use of prescription drugs and how their messages about various substances may influence teenagers’ drug-related behaviors. Taking such measures may significantly contribute to efforts to address this growing health concern among our nation’s youth. Overall, our findings show that being driven to misuse prescription drugs due to negative situations is a key factor contributing to drug problems and symptoms of dependency among young adults. Prescription pain killer misuse is an important pathway to these issues. Addressing the experience of negative situations as a motivation for prescription drug misuse may provide an effective means to reduce substance abuse problems among young adults who misuse prescription drugs. Clinicians should consider this a key intervention point for young adults at risk of reverting to prescription drug misuse. A focus on both positive and negative motivations to use drugs could also be a strategy to promote the adoption of harm reduction methods among these individuals.

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