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TOPLINE:

Medical and nonmedical use of prescription drugs, as well as peer-to-peer diversion, decreased significantly among adolescents in the United States between 2009 and 2022, a new study showed, with leftover medication becoming the primary source for nonmedical use of stimulants and opioids.

METHODOLOGY:

• Researchers analyzed data from 14 cohorts (2009-2022) from the nationally representative, cross-sectional Monitoring the Future study, in which surveys were self-administered by 12th-grade students during regular classes.
• The assessment focused on past-year nonmedical use, defined as “used without a prescription or other than as prescribed;” lifetime medical use of prescription stimulants, opioids, and benzodiazepines; and diversion sources.
• The analysis was controlled for sex, race or ethnicity, parental education, metropolitan status, and US region of residence.

TAKEAWAY:

• The lifetime medical use of prescription opioids declined from 17.7% in 2009-2010 to 7.4% in 2021-2022 (adjusted odds ratio [aOR], 0.88), while the medical use of prescription benzodiazepines and stimulants did not change significantly.
• Past-year nonmedical use of prescription opioids decreased significantly from 8% in 2009-2010 to 0.7% in 2021-2022 (aOR, 0.74).
• Free distribution of prescription stimulants by friends decreased significantly, from 55%-58% in 2009-2014 to 21.1% in 2021-2022 (aOR, 0.86), while buying benzodiazepines from friends decreased from 48.9% in 2009-2010 to 3.9% in 2021-2022 (aOR, 0.88).
• In 2021-2022, an individual’s leftover personal medications became the top source for nonmedical opioid (26.7%) and stimulant use (40%).

IN PRACTICE:

“Practitioners should discuss the amount of leftover medication with their patients and consider reducing the number of dispensed units. Further research is needed to identify effective strategies to reduce diversion and [nonmedical use] of one’s own leftover medication, while also monitoring for potential unintended consequences of supply reduction,” the investigators wrote.

SOURCE:

This study was led by Sean Esteban McCabe, PhD, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor, Michigan. It was published online on April 09 in The American Journal of Psychiatry.

LIMITATIONS:

Study limitations included the cross-sectional design, exclusion of certain subpopulations, such as homeschooled adolescents and school dropouts, smaller recent sample sizes because of COVID-related disruptions, and reduced reports of nonmedical use in later years. Comparisons with other national studies were also restricted, owing to methodological and measurement differences.

DISCLOSURES:

This study was funded by the US Food and Drug Administration and the National Institute on Drug Abuse. One investigator reported ties with various organizations, with full details provided in the original article.

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