Social Aspects of Adolescent Non-Medical Use of Prescription Drugs

Non-medical use of prescription drugs (NMUPD) is an person’s use of a medication prescribed to someone else or use of a personal prescription in a way or dosage outside the original purpose (NIDA, 2012). In 2005 2.1 million teens abused prescription drugs, with an estimated 850,000 12-17 year old adolescents initiating NMUPD (Office of National Drug Control Policy (ONDCP), 2007). As a result, prescription drugs are now the second most abused illegal drug among adolescents (ONDCP, 2007), exceeded only by marijuana. A comprehensive understanding of current research associated with adolescent NMUPD is critical in developing research-based interventions. Thus we reviewed the empirical research on adolescent NMUPD within the context of the ecological model (Bronfenbrenner, 1988, 1989); examining NMPD factors at the individual, family, peer, and community levels.

We searched numerous social science and medical databases (e.g., Academic Search Premier, CINAHL, MEDLINE, Psychology and Behavioral Sciences Collection, PsycINFO, and Sociological Collection) using consistent keyword searches (e.g., "prescription drug abuse"). The inclusion criteria led to the incorporation of qualitative or quantitative studies published in English between January 1998 to March 2013, and reflected adolescents (8 to 22 years) in the United States. This systematic review identified 35 peer-reviewed published manuscripts that used quantitative and/or qualitative methods. The variables or phenomenon included in the studies were then analyzed in relation to the ecological model (Bronfenbrenner, 1988, 1989). Specifically we identified risk and protective factors (n=97) related to adolescent NMUPD and categorized these into individual (n=61), family (n=13), peer (n=10), or community (n=13) levels.

Preliminary findings reveal an emphasis on the individual level factors in the current research —59 of the 95 measures (62%) reflected individual factors. The remaining factors were evenly distributed across family (12 measures), peer (10 measures), and community (14 measures) levels. The vast majority of the measures (n = 61; 64%) were included in only one of the 35 articles reviewed so replication of the findings is quite low. Nevertheless, the proportion of significant factors related to NMUPD was high:  79% at the individual level; 58% at the family level; 90% at the peer level; and 57% at the community level. Significant risk factors at the various levels included:  other substance use, sexual assault, peer delinquency, foster care, and rurality.

Findings will be discussed in relation to future research and the findings’ contribution to the development, implementation, and evaluation of multi-level prevention program to reduce the risk of adolescent nonmedical use of prescription drugs.