Nonmedical prescription drug use is an increasing public health problem with the rates of prescription drug abuse highest among young adults. This application proposes a 36-month qualitative study of nonmedical prescription drug use in San Francisco. Using ethnographic sampling methods, 120 participants will be recruited (60 men and 60 women) and interviewed who are between the ages of 18 and 25 and have used one or more drugs from three drug groups (opiates, stimulants and CNS depressants) for nonmedical purposes at least 12 times in the six months prior to interview. Nonmedical use is defined as the use of prescription drugs, prescribed or not, to get high, for the experience(s) they cause, to enhance school/work performance or to modify the effects of other drug or alcohol use. The relationship between the indication for which the medication was prescribed (e.g., pain, sleep disorder, anxiety disorder, obesity) and the role of individual factors and social settings that contribute to abuse will be examined. The following seven research questions are areas to be explored: 1) What are the beliefs, motivations and perceived attractions for initiation and continuation of nonmedical prescription drug use? 2) Do nonmedical prescription drug users combine prescribed drugs with alcohol, illegal drugs or other not prescribed drugs? 3) What are the adverse health, behavioral and social consequences of nonmedical prescription drug use? 4) What are nonmedical prescription drug users'sources for prescription and other drugs? 5) What is the relationship between the individual, the prescription drug, and the setting in which the drug is used or misused? 6) Are there gender differences in the types of prescription drugs misused and the way they are acquired and combined with other drugs? 7) What is the role of the Internet as both a source of prescription drugs and a source of information about those drugs? By limiting the scope of our investigation to young nonmedical prescription drug users, we will address a current gap in the extant literature regarding factors underlying the association between nonmedical prescription drug use and adverse health, behavioral and social consequences. This qualitative research project will provide much needed information about the nature of nonmedical prescription drug use among young adults. Specifically, this project would provide information regarding the health and social consequences of nonmedical prescription drug use and in particular, the impact of use on relationships and lifestyles. Findings from this proposed study would aid in the development of effective prevention and treatment interventions for nonmedical prescription drug abusers and contribute to the improvement of integrated health care and drug treatment services.
