Prescription Drug Abuse and Diversion Among Adolescents in a Southeast Michigan School District

Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, United States
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 5.73). 04/2007; 161(3):276-81. DOI: 10.1001/archpedi.161.3.276
Source: PubMed


To determine the prevalence of medical use of 4 classes of prescription medications relative to nonmedical use (illicit use), to examine the relative rates among the 4 drug classes, and to assess whether gender differences exist in the trading, selling, loaning, or giving away of medications.
A Web-based survey was administered to 7th- to 12th-grade students residing in 1 ethnically diverse school district; a 68% response rate was achieved.
During a 3-week period in May 2005, teachers brought students to their schools' computing center where students took the survey using a unique personal identification number to sign on to the survey.
There were 1086 secondary students, including 586 girls, 498 boys, 484 black students, and 565 white students.
Students were asked about their medical and nonmedical use of sleeping, sedative or anxiety, stimulant, and pain medications. Diversion of prescription medication was assessed by determining who asked the student to divert his or her prescription and who received it.
Thirty-six percent of students reported having a recent prescription for 1 of the 4 drug classes. A higher percentage of girls reported giving away their medications than boys (27.5% vs 17.4%, respectively; chi(2)(1) = 6.7; P = .01); girls were significantly more likely than boys to divert to female friends (64.0% vs 21.2%, respectively; chi(2)(1) = 17.5; P<.001) whereas boys were more likely than girls to divert to male friends (45.5% vs 25.6%, respectively; chi(2)(1) = 4.4; P = .04). Ten percent diverted their drugs to parents.
Physicians should discuss the proper use of prescription medications with their patients and their patients' families.

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    • "It has generally been reported that nonprescribed drug use is more common among females compared to males, especially with regard to tranquilizers and sedatives [22]. The higher prevalence of nonprescribed use of tranquilizers or sedatives among females found in our study corroborates studies in this aspect [3,23]. "
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    ABSTRACT: Background Although the nonprescribed use of tranquilizers or sedatives by adolescents is a cause for concern in many countries, there is a shortage of data from low and middle income countries (LAMIC). The present study aims to estimate the prevalence of nonprescribed use of tranquilizers/sedatives by adolescents in Brazil, and to assess how socioeconomic and demographic circumstances, as well as indicators of access to these substances are associated with their use and with risk perception. Methods A cross-sectional study was conducted using a multi-stage probability sample of 18131 high school students from public and private schools from all 27 Brazilian state capitals. A self-reporting questionnaire was used to obtain information on social and economic circumstances, nonprescribed use of tranquilizers or sedatives and risk perception of their use. Results Lifetime nonprescribed use of tranquilizers or sedatives was reported by 5% of respondents, more commonly among females (OR: 2.19, 95% CI: 1.75-2.75) and those attending private schools (OR: 1.47, 95% CI: 1.17-1.84). The use of tranquilizers/sedatives by relatives or friends was associated with nonprescribed use by the participant (OR: 4.26, 95% CI: 3.46-5.23) and a majority of lifetime users obtained these substances from a family environment (82%). Previous medical prescription was independently associated with nonprescribed use (OR: 6.61, 95% CI: 4.87-8.98) and with low risk perception (OR: 2.42, 95% CI: 1.12-5.24). Conclusions A substantial proportion of Brazilian adolescents use nonprescribed tranquilizers/sedatives. Easy access to these substances seems to play an important role in this use and should be tackled by preventive and treatment interventions.
    BMC Public Health 05/2013; 13(1):499. DOI:10.1186/1471-2458-13-499 · 2.26 Impact Factor
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    • "These results suggest diversion sources may provide insights regarding the risk for SUDs and studies that assess diversion should separate family from peer diversion sources. Finally, the finding that there were no reports of nonmedical users buying prescription opioids on the Internet, regardless of the SUD screening result, adds to a growing literature indicating adolescents and young adults are not currently purchasing prescription opioids via the Internet (Johnston et al., 2010; McCabe & Boyd, 2005; McCabe et al., 2007; Schepis & Krishnan, 2009). However, future research should continue to monitor the role of the Internet as a potential diversion source based on the feasibility of purchasing controlled medications online without a prescription (Califano, 2004; Forman, 2003). "
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    ABSTRACT: The objectives of this study are to examine the associations among a positive score on the CRAFFT (a substance use brief screening test for adolescents) and demographic characteristics, diversion sources, routes of administration, substance use behaviors and motivations associated with the use of prescription opioids without a legal prescription. In 2009-2010, a sample of 2744 middle and high school students from two Midwestern school districts in the United States self-administered a Web-based survey. Approximately 5.6% (n=148) of respondents reported past-year nonmedical use of prescription opioids (NMUPO). Of those reporting NMUPO, approximately 35.1% (n=52) screened positive for substance use disorders based on the CRAFFT. Multiple logistic regression analyses indicated that the odds of buying prescription opioids, obtaining opioids from multiple diversion sources, administering opioids intranasally, and using opioids to get high were greater for nonmedical users with a positive CRAFFT screen as compared to NMUPO with a negative CRAFFT screen. NMUPO with a positive screen was motivated primarily for recreational purposes, while NMUPO with a negative screen was motivated almost exclusively by pain relief. The CRAFFT brief screening test for adolescents can be used to identify a subgroup of NMUPO at the highest risk for a substance use disorder as well as a subgroup of NMUPO who would benefit from appropriate pain management.
    Addictive behaviors 02/2012; 37(5):651-6. DOI:10.1016/j.addbeh.2012.01.021 · 2.76 Impact Factor
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    • "Past year alcohol use and DSM-IV defined abuse, as well as the lifetime and past year use of various illegal substances was also assessed. Questions on the medical and nonmedical use of the four most commonly abused classes of psychoactive drugs (i.e., pain, sleeping, anxiety, stimulants) were abstracted from the Student Life Survey questionnaire developed by University of Michigan (McCabe et al., 2005; Boyd et al., 2006; McCabe et al., 2007). Market available trade names were used to increase identification and reduce information errors. "
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    ABSTRACT: Concerns about psychoactive prescription drug abuse among youth are growing worldwide, but the majority of published studies remain from the US and Canada impeding cross-cultural comparisons. This study examines the prevalence, sources, motivations and substance-use correlates of commonly abused medications among youth from Lebanon. An IRB-approved cross-sectional study was conducted (May 2010) at the American University of Beirut. Proportionate cluster sampling was used to generate a representative sample of AUB students (n=570). A self-filled anonymous questionnaire was administered. Lifetime medical and nonmedical prevalence of medications were (respectively): pain (36.9%, 15.1%), anxiety (8.3%, 4.6%), sleeping (6.5%, 5.8%) and stimulants (2.6%, 3.5%). Gender differences were not observed. Lebanese were least likely to report non-medical use. Nonmedical users mostly used the drugs for their intended purpose (e.g., sleeping to help in sleep, stimulants to increase alertness). Parents and pharmacists (without a doctor's prescription) were the top two sources of all medications, except for stimulants (friends predominated). Diversion was observed in about 20% of the medical users. Lifetime marijuana users and past year alcohol abusers were three times as likely to use any prescription drug nonmedically. In Lebanon, as in Western cultures, a considerable proportion of youth may be self-medicating. The absence of medical supervision coupled with motivations such as "to get high" renders this issue a high priority on the national youth agenda. Besides larger more comprehensive surveys, the findings signal the immediate need to reinforce relevant policies, and raise awareness among youth, parents, health professionals and other stakeholders.
    Drug and alcohol dependence 09/2011; 121(1-2):110-7. DOI:10.1016/j.drugalcdep.2011.08.021 · 3.42 Impact Factor
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