Original article
Leftover Prescription Opioids and Nonmedical Use Among High School Seniors: A Multi-Cohort National Study

https://doi.org/10.1016/j.jadohealth.2012.08.007Get rights and content

Abstract

Purpose

To (1) estimate the proportion of nonmedical users of prescription opioids (i.e., used prescription opioids in the past year without a doctor's orders) who used leftover medications from their own previous prescriptions; (2) assess substance use behaviors as a function of diversion source; and (3) identify the sources for these prescribed opioids.

Methods

We analyzed data collected via self-administered questionnaires from nationally representative samples of high school seniors (modal age, 18 years) as a part of the Monitoring the Future (MTF) study. The sample consisted of four cohorts (senior years of 2007–2010, n = 8,888), including 647 high school seniors who reported past-year nonmedical use of prescription opioids, of whom 53% were estimated to be women.

Results

An estimated 36.9% of past-year nonmedical users of prescription opioids obtained these opioid medications from their own previous prescriptions. Logistic regression analyses indicated that nonmedical users who used leftover medications from their previous prescriptions were primarily motivated to relieve physical pain, whereas nonmedical users who obtained medications from other sources had significantly higher odds of prescription opioid abuse and other substance use behaviors. Based on a subanalysis of nonmedical users who obtained prescription opioids from their previous prescriptions in 2010 (n = 51), approximately 27.1% obtained them from a dentist, 45.0% obtained them from an emergency room physician, and 38.3% obtained them from another physician.

Conclusions

Leftover prescription opioids from previous prescriptions represent a major source of nonmedical use of prescription opioids among high school seniors. These findings indicate that enhanced vigilance is needed when prescribing and monitoring prescription opioids among adolescents, to reduce leftover medications and nonmedical use.

Section snippets

Participants and procedures

The MTF study annually surveys a cross-sectional, nationally representative sample of high school seniors in approximately 135 public and private schools in the coterminous U.S., using self-administered paper–pencil questionnaires in classrooms. The MTF study uses a multistage sampling procedure. In Stage 1, geographic areas or primary sampling units are selected; in Stage 2, schools within primary sampling units are selected (with probability proportionate to school size); and in Stage 3,

Prevalence of diversion sources associated with NMUPO

An estimated 36.9% of past-year nonmedical users of prescription opioids obtained these opioid medications from their own leftover medication. The estimated prevalence of other diversion sources included: bought on the Internet (1.4%), took from friend or relative without asking (22.2%), given for free from friend or relative (55.0%), bought from a friend or relative (37.9%), bought from a drug dealer (19.4%), and other method (9.5%). Among past-year nonmedical users of prescription opioids,

Discussion

The present study found that leftover prescription opioids from previous prescriptions account for a substantial source of NMUPO among high school seniors in the U.S. We found that more than a third of past-year nonmedical users of prescription opioids obtained these medications from their own previous prescription(s). The findings of the present study are consistent with previous work among adolescents, which has shown that using one's previous prescription serves as a major source of NMUPO [1]

Acknowledgments

The development of this article was supported by Research Grants R01DA024678 and R01DA031160 from the National Institute on Drug Abuse, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. The Monitoring the Future data were collected by Research Grant R01DA01411 from the National Institute on Drug Abuse, National Institutes of

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