Nonmedical prescription drug misuse (NPDM) involving scheduled (controlled) medications (i.e., opioid analgesics, stimulants, tranquilizers) has significantly increased over the past two decades in the United States and is most prevalent among individuals 18 years of age. While there have been advances in understanding NPDM, considerable gaps in knowledge remain due to limitations in measurement and study designs and no national studies have examined longitudinal trajectories of NPDM among adolescents and most existing studies fail to account for important characteristics of NPDM such as motives, route of administration, and co- ingestion with other drugs. Findings from our two small exploratory cross-sectional projects (R03DA018239 and R03DA0187272) indicate that there are at least two behavioral subtypes of NPDM (self-treatment and recreational) subsumed under current measures used to assess NPDM, and these behavioral subtypes appear to differ in terms of adverse consequences. However, there is little published information regarding the long- term patterns of misuse and adverse outcomes associated with NPDM among adolescents in the United States. Existing cross-sectional and longitudinal panel data from the Monitoring the Future (MTF) study provide an unprecedented opportunity to address research questions that will lead to a more comprehensive understanding of NPDM and its consequences among adolescents. The objective of the proposed study is to advance our knowledge regarding longitudinal trajectories of NPDM using twelve independent, nationally representative cohorts of approximately 180,000 high school seniors between 1997 and 2008 from the MTF study. The MTF panel sample features twelve separate cohorts of approximately 28,800 high school seniors (modal age 18) who were followed 1-2 years (modal ages 19-20) and 3-4 years (modal ages 21-22) later, resulting in three waves of data. The proposed study aims to 1) assess NPDM and characteristics of NPDM (e.g., motives, route of administration, co-ingestion with other drugs) associated with three prescription drug classes (opioid analgesics, stimulants, tranquilizers), and determine the associations among NPDM, characteristics of NPDM, psychosocial risk factors, and adverse outcomes (e.g., health, legal and social) using cross-sectional and panel data;2) identify longitudinal trajectories of NPDM of three prescription drug classes (opioid analgesics, stimulants, tranquilizers) across the developmental transition of greatest risk for NPDM- related adverse outcomes using panel data (i.e., ages 18-22), and examine variations in these trajectories by demographic factors, psychosocial risk and protective factors, and NPDM characteristics;and 3) examine the associations among longitudinal trajectories of NPDM of three prescription drug classes (opioid analgesics, stimulants, tranquilizers), important developmental transitions (e.g., college attendance, employment) and adverse outcomes (e.g., health, legal and social) during emerging adulthood using panel data. Findings from this project will substantially advance the current understanding of NPDM among adolescents in the United States, and provide information that will improve the screening, assessment, prevention, and treatment of prescription drug abuse.

Public Health Relevance

Despite a recent increase in nonmedical prescription drug misuse (NPDM) in the United States, relatively little is known about the longitudinal patterns of NPDM among adolescents. The proposed study will inform the development of prevention efforts to reduce NPDM by examining trajectories of NPDM using a nationally representative sample. Findings will help guide clinical practice and future research by examining new research questions related to the developmental course of NPDM. This study has important implications for the identification of individuals at greatest risk for adverse consequences associated with NPDM and those in greatest need of treatment services.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA031160-03
Application #
8445325
Study Section
Special Emphasis Panel (ZRG1-PSE-J (50))
Program Officer
Obrien, Moira
Project Start
2011-04-01
Project End
2015-03-31
Budget Start
2013-04-01
Budget End
2015-03-31
Support Year
3
Fiscal Year
2013
Total Cost
$211,356
Indirect Cost
$74,556
Name
University of Michigan Ann Arbor
Department
None
Type
Organized Research Units
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Veliz, Philip; Epstein-Ngo, Quyen; Austic, Elizabeth et al. (2015) Opioid use among interscholastic sports participants: an exploratory study from a sample of college students. Res Q Exerc Sport 86:205-11
Boyd, Carol J; Austic, Elizabeth; Epstein-Ngo, Quyen et al. (2015) A prospective study of adolescents' nonmedical use of anxiolytic and sleep medication. Psychol Addict Behav 29:184-91
McCabe, Sean Esteban; West, Brady T; Teter, Christian J et al. (2014) Trends in medical use, diversion, and nonmedical use of prescription medications among college students from 2003 to 2013: Connecting the dots. Addict Behav 39:1176-82
McCabe, Sean Esteban; Schulenberg, John E; O'Malley, Patrick M et al. (2014) Non-medical use of prescription opioids during the transition to adulthood: a multi-cohort national longitudinal study. Addiction 109:102-10
Boyd, Carol J; Young, Amy; McCabe, Sean E (2014) Psychological and drug abuse symptoms associated with nonmedical use of opioid analgesics among adolescents. Subst Abus 35:284-9
Veliz, Philip; Epstein-Ngo, Quyen M; Meier, Elizabeth et al. (2014) Painfully obvious: a longitudinal examination of medical use and misuse of opioid medication among adolescent sports participants. J Adolesc Health 54:333-40
McCabe, Sean Esteban; West, Brady T (2014) Medical and nonmedical use of prescription benzodiazepine anxiolytics among U.S. high school seniors. Addict Behav 39:959-64
McCabe, Sean Esteban; West, Brady T (2013) Medical and nonmedical use of prescription stimulants: results from a national multicohort study. J Am Acad Child Adolesc Psychiatry 52:1272-80
Patrick, Megan E; Singer, Eleanor; Boyd, Carol J et al. (2013) Incentives for college student participation in web-based substance use surveys. Addict Behav 38:1710-4
Veliz, Philip; Boyd, Carol; McCabe, Sean Esteban (2013) Adolescent athletic participation and nonmedical Adderall use: an exploratory analysis of a performance-enhancing drug. J Stud Alcohol Drugs 74:714-9

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