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Non-medical use of prescription medications linked to other types of drug abuse among college students, U-M study finds

ANN ARBOR, Mich.—College students who take frequently abused medications without a prescription appear to have a higher risk for other types of drug abuse than those who use such therapies for medical reasons, a University of Michigan researcher has concluded.

"Several studies have reported recent increases in the prescription rates of abusable medications in the United States, including stimulants, opioids and benzodiazepines," said Sean McCabe, author of a report to appear in the March issue of Archives of Pediatrics & Adolescent Medicine.

"The increases in prescription rates have raised public health concerns because of the abuse potential of these medications and high prevalence rates of non-medical use, abuse and dependence, especially among young adults 18 to 24 years of age," said McCabe, a research associate professor at the U-M Substance Abuse Research Center.

McCabe assessed prescription drug use and potential drug abuse in a survey of 3,639 college students (average age 19.9 years). The survey asked whether the students had been prescribed, or had used without a prescription, four classes of prescription drugs—opioids, stimulants, sleeping aids and sedative or anxiety medications.

Questions about whether the students had experienced drug-related problems (for instance, performing illegal activities to obtain drugs, having withdrawal symptoms or developing medical problems as a result of drug use) were used to screen them for drug abuse. In the screening test, the word "drug" referred to the use of prescription drugs not prescribed to you, as well as the use of drugs such as marijuana, cocaine, LSD and Ecstasy.

Those who had reported that they used drugs without a prescription—whether or not they had also used them for medical reasons—were more likely to screen positive for drug abuse than those who had used the drugs only for medical reasons or had never used them at all. There was no difference in the rate of positive screening between those who had reported using the drugs by prescription and those who reported never having taken them.

Most of the students (59.9 percent) reported having used at least one of the prescription drugs with a prescription for medical reasons, while approximately one in five reportedly took them without a prescription for non-medical reasons. A total of 1,412 (39.7 percent) reported that they had used the drugs only by prescription; 156 (4.4 percent) were never prescribed any of the medications but had used them anyway; and 563 (15.8 percent) had used some of the medications both with and without a prescription.

The findings have important implications for prescribing frequently abused drugs to college students, McCabe noted.

"Clearly, appropriate diagnosis, treatment and therapeutic monitoring of college students who are receiving abusable prescription medications is crucial, not only to improve clinical outcomes but also to help prevent the abuse of these medications within a population that is largely responsible for its own medication management," he said.

The study was supported by research grants from the National Institute on Drug Abuse.


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