TOPLINE

Youths with a past-year major depressive episode (MDE) had more than double the odds of misusing prescription psychotherapeutic drugs and four times the odds of having prescription drug use disorder than those without depression, a study showed. Youths with a past-year MDE who misused opioid analgesics and tranquilizers were more likely to do so to help with feelings and emotions than those without a past-year MDE.

METHODOLOGY

• In a cross-sectional study, researchers analyzed data from the 2023 and 2024 National Survey on Drug Use and Health, a nationally representative survey of noninstitutionalized individuals in the US.
• 50,629 participants (49.1% male; 26.2% Hispanic; 45.6% non-Hispanic White; 13.7% non-Hispanic Black individuals) were included, of whom 22,906 were adolescents (aged 12-17 years) and 27,723 were young adults (aged 18-25 years).
• Researchers assessed past-year misuse of prescription psychotherapeutic drugs (opioid analgesics, tranquilizers, stimulants, sedatives) and use disorder, comparing youths with and without past-year MDE.
• The analysis was adjusted for sex, race and ethnicity, and insurance status.
• The investigators also examined self-reported motivations for prescription drug misuse among participants.

TAKEAWAY

• Past-year MDE was reported by 16.3% of respondents, equating to an estimated 9.8 million individuals nationally.
• A larger proportion of youths with vs without a past-year MDE reported the misuse of prescription psychotherapeutic drugs (6.6% vs 3.2%; P < .001) and having a use disorder (6% vs 1.5%; P < .001).
• After adjustment, youths with a past-year MDE were more likely to misuse prescription drugs (odds ratio [OR], 2.09; 95% CI, 1.75-2.50) and have prescription drug use disorder (OR, 4.02; 95% CI, 3.37-4.80) than those without.
• Those with a past-year MDE had a higher likelihood of reporting the misuse of opioid analgesics (10.2% vs 3.7%; P = .01) and tranquilizers (29.8% vs 13.2%; P = .003) to "help with feelings and emotions" than those without.

IN PRACTICE

"These findings suggest the need to identify barriers to integrated mental health and substance use treatment for at-risk youths before patterns of self-medication progress to substance use disorders," the authors wrote.

SOURCE

The study was led by Michael S. Toce, MD, MS, Boston Children's Hospital, Boston. It was published online on October 16 in JAMA Network Open.

LIMITATIONS

Survey responses were subject to reporting bias. The cross-sectional design prevented the establishment of causal inferences. Mental health conditions other than depression were not assessed. Drugs could not be directly compared owing to different motivations for misuse. Lastly, individuals experiencing homelessness were excluded.

DISCLOSURES

One author was funded by the Boston Children's Hospital Pediatric Emergency Medicine Faculty Development Award through the Eleanor and Miles Shore Faculty Development Awards Program and the Office for Culture and Community Engagement HMS Faculty Fellowship Program. Disclosure information for the study investigators is available in the original study publication.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.