Article

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: 4.25). 04/2007; 161(3):276-81. DOI: 10.1001/archpedi.161.3.276
Source: PubMed

ABSTRACT 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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    • "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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    • "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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    • "Physicians should instruct all patients who require controlled medications about the abuse potential of these medications, and the need to store their prescriptions in a secure location. Given that many individuals obtain diverted prescription medications for nonmedical use from friends, peers, and family members (Boyd et al., 2007; McCabe and Boyd, 2005), clinicians prescribing these medications should exercise caution, and periodically monitor their patients' behavior over the course of treatment. They should also consider limiting both the quantity of medication prescribed, as well as the number of refills, which in turn requires more frequent clinician–patient interactions and therapeutic monitoring. "
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