Nearly third of US young people prescribed psychoactive drugs admit misusing them

Stimulants and tranquillisers were more likely to be misused than opioids, the findings indicate.

Drug overdose is a leading cause of unintentional death in the US, most cases of which involve opioid painkillers, but not all.

Data on the misuse of other prescription psychoactive drugs are few and far between. And every year more than 1 in 3 teens and young adults in the US is prescribed one of these drugs.

To plug this knowledge gap, the researchers drew on the responses of 110,556 US 12-25 year olds who took part in the 2015-2018 National Survey of Drug Use and Health Sampling.

Overall, around a third (35%) said they had taken a prescribed psychoactive drug in the past year, and a similar proportion (31%) said they had misused that drug.

While opioids were the most commonly prescribed drug, misuse of stimulants and tranquillisers was higher, with nearly 45% of users admitting to this.

One in 10 respondents said they took at least two prescribed psychoactive drugs, with nearly 6 in 10 (58%) confessing to misusing one of these. And 87% admitted to misusing another substance, such as alcohol, cigarettes, cigars, marijuana, cocaine, heroin, inhalants, or hallucinogens.

Use and misuse of a prescribed psychoactive drug increased with age. While one in four teens (12-17 year olds) reported taking any psychoactive prescribed drug over the past year, and around 6% reported taking at least two such drugs, this increased to 41% and 13.5%, respectively, among 18-25 year olds.

Among the teen users of psychoactive prescription drugs, opioids were the most frequently used (19%) followed by stimulants (7%), tranquillisers (4%) and sedatives (2%).

Around 1 in 5 users of prescribed psychoactive drugs said they misused them, with tranquillisers most often misused (40%), followed by stimulants (24%), opioids (nearly 18%), and sedatives (14%).

Among 18-25-year-olds prescribed psychoactive drugs in the past year, 35% reported misuse of at least one drug. And among those prescribed at least two of these drugs, 61% reported misuse and just under 94% reported concurrent use of another substance.

Analyses of the responses from the 18-25-year-olds revealed that, compared with those who had never touched other substances, misuse of psychoactive prescription drugs increased in tandem with more recent use of these substances and number used.

Among 18-25 year-olds, opioids were again the most commonly prescribed psychoactive drug (30%), followed by stimulants (14%), tranquillisers (11.5%) and sedatives (3.5%).

The estimated proportion of misuse in this age group was highest for tranquillisers (45%) followed by stimulants (51%), opioids (23%) and sedatives (19%).

This is an observational study, and therefore can't establish cause, added to which the researchers acknowledge that the study was based on self report; the time frames over which some variables were measured weren't consistent; and misuse was very broadly defined.

Nevertheless, they conclude that the overlap in the profiles of those who use for medical reasons and those who misuse is a strong indicator of how likely they are to abuse psychoactive drugs.

"It is important to monitor the diversity of medication misuse behaviours among youth and young adults, given their potential for abuse liability," they write.

"Modifiable risk factors for prescription substance misuse, such as tobacco and other non-prescription substance use, underscore the need for comprehensive approaches towards health promotion among youth and young adults," they add.

They note that 11.5% of the 18-25 year olds reported serious psychological distress, which was consistently associated with misuse of every psychoactive prescription drug assessed.

"Mental health and medical providers would benefit from using a team approach and having open communication with other healthcare providers to ensure evidence-based guidelines are used when assessing for, and treating, mental health and substance use difficulties," they conclude.