Rates of prescription drug misuse in the United States have risen significantly during recent years, with one study reporting an increase of 2.5 million prescription drug users between 2002 and 2007 (SAMHSA, 2007; McCabe, West, & Wechsler, 2007). Prescription drug misuse is of particular concern among adolescents and young adults who have shown higher rates of misuse than other age groups (Kroutil et al., 2006; McCabe, Cranford, & Boyd, 2006). For example, a study by Kroutil et al. found that 18-25 year olds were 4 times as likely to misuse prescription stimulants than those 26 years old and older (2006). This week, STASH reviews a study by McCabe, Boyd, & Teter (2009) that attempts to identify subtypes of prescription drug misusers as a step toward selecting more appropriate and, hopefully, more successful, interventions.
Table 1: Substance use and substance related problems based on lifetime nonmedical prescription drug misuse subtypes (adapted from McCabe et al., 2009).
- Study participants were all students from one large university in the Midwest so results might not generalize to a young adult population.
- The study relies on self-report data.
- It is possible that self-selection bias was a factor in this study because the response rate of those approached to participate in the study was 68%.
- Researchers classified misuse subtypes based on life-time prescription drug use while other high risk behaviors were assessed more recently (i.e., past two weeks, past year). It is possible that this time frame discrepancy could lead to different results and conclusions if the time frame affected the way study participants reported the behaviors under investigation.
This study indicates that there is heterogeneity among prescription drug misusers and that members of the recreational subtype are more likely to engage in high risk alcohol and drug use behavior than those in the self-medication subtype. Identifying relationships between prescription misuser subtype and other drug and/or alcohol use and abuse illuminates potential pathways for prevention and intervention. This study also found significant racial and gender differences in motivation for drug misuse. Males, White and Hispanic participants were more likely to be in the recreational misuse subtype. Further research is needed to understand the role of these subtypes in prescription drug misuse, and to fully understand the interplay of subtype and other risky drug and alcohol use behaviors.
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Substance Abuse & Mental Health Services Administration (SAMHSA). (2007). Results from the 2006 National Survey on Drug Use and Health. Rockville, MD: Office of Applied Studies.
Kroutil, L. A., Van Brunt, D. L., Herman-Stahl, M. A., Heller, D. C., Bray, R. M., & Penne, M. A. (2006). Nonmedical use of prescription stimulants in the United States. Drug and Alcohol Dependence, 84(2), 135-143.
McCabe, S. E., Boyd, C. J., & Teter, C. J. (2009). Subtypes of nonmedical prescription drug misuse. Drug Alcohol Depend, 102(1-3), 63-70.
McCabe, S. E., Cranford, J. A., & Boyd, C. J. (2006). The relationship between past-year drinking behaviors and nonmedical use of prescription drugs: prevalence of co-occurrence in a national sample. Drug and Alcohol Dependence, 84(3), 281-288.
McCabe, S. E., West, B. T., & Wechsler, H. (2007). Trends and college-level characteristics associated with the non-medical use of prescription drugs among US college students from 1993 to 2001. Addiction, 102(3), 455-465.