Stimulants and tranquilizers are more frequently misused than opioids

Nearly a third of American teens and young adults have been prescribed psychoactive drug abuse, with the likelihood of abuse increasing with age, suggests an analysis of responses to the national survey published in the online journal Family medicine and community health.

Stimulants and tranquilizers were more likely to be misused than opioids, the results indicate.

Drug overdose is a leading cause of unintentional death in the United States, with most cases involving opioid painkillers, but not all.

Data on the abuse of other psychoactive prescription drugs are scarce. And each year, more than 1 in 3 teenagers and young adults in the United States are prescribed one of these drugs.

To fill this knowledge gap, the researchers relied on responses from 110,556 Americans between the ages of 12 and 25 who participated in the 2015-2018 National Survey of Drug Use and Health Sampling.

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

While opioids were the most commonly prescribed drug, the abuse of stimulants and tranquilizers was higher, with almost 45% of users admitting it.

One in 10 respondents said they had taken at least two prescribed psychoactive medications, with almost 6 in 10 (58%) admitting to having abused one of them. And 87% admitted to having abused another substance, such as alcohol, cigarettes, cigars, marijuana, cocaine, heroin, inhalants or hallucinogens.

The use and abuse of a prescribed psychoactive medication increased with age. While one in four adolescents (12-17 years old) said they had taken a prescribed psychoactive medication in the past year, and around 6% said they had taken at least two of these medications, this figure rose to 41 % and 13.5%, respectively, among 18-25 year olds. year.

Among adolescents using prescription psychoactive drugs, opioids were used the most (19%), followed by stimulants (7%), tranquilizers (4%) and sedatives (2%).

About 1 in 5 users of prescribed psychoactive drugs reported misusing them, with tranquilizers most often misused (40%), followed by stimulants (24%), opioids (nearly 18%) and sedatives (14%).

Among the 18-25 year olds to whom psychotropic drugs have been prescribed during the past year, 35% declared having abused at least one drug. And among those who were prescribed at least two of these drugs, 61% reported misuse and just under 94% reported having used another substance simultaneously.

Analyzes of responses from 18-25 year olds revealed that, compared to those who had never touched other substances, the abuse of prescription psychoactive drugs increased with more recent use of these substances and number of uses.

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

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

This is an observational study, and therefore cannot establish causation, in addition to which the researchers acknowledge that the study was based on self-reporting; the time frames over which certain variables were measured were not consistent; and abuse was defined very broadly.

Nevertheless, they conclude that the overlapping profiles of those who use for medical purposes and those who abuse them is a strong indicator of their likelihood of abusing psychoactive drugs.

“It is important to monitor the diversity of drug abuse behaviors among youth and young adults, given their potential for abuse,” they write.

“Modifiable risk factors for the abuse of prescription substances, such as tobacco and other non-prescription substances, underscore the need for comprehensive health promotion approaches in youth and young adults,” they add. .

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

“Mental and medical health care providers would benefit from using a team approach and open communication with other health care providers to ensure that evidence-based guidelines are used. when assessing and treating mental health and substance use problems,” they conclude.

Alvin J. Chase