Sources of prescription opioids and tranquilizers for misuse among U.S. young adults: differences between high school dropouts and graduates and associations with adverse outcomes

Abstract

Background and Objectives: Prior research has identified that sources of prescription drugs for misuse vary based on educational attainment, which is important as certain sources are associated with adverse outcomes. The current research addressed limitations of the extant literature by creating distinct categories of push factors for high school dropout (e.g., negative school performance/experiences), pull factors for high school dropout (e.g., starting a family or getting a job), and high school graduates who did not attend college.

Methods: Using data from the 2009–2014 National Survey on Drug Use and Health, prevalence of sources were estimated and design-based multivariable logistic regression investigated the association between sources and educational attainment. Additionally, multivariable logistic regression assessed the associations between sources and adverse outcomes (i.e., substance use, substance use disorders, and mental health) separately for each educational category.

Results: College respondents were more likely to report “physician” and free from “friend/relative” and less likely to report “purchased” as sources. For most educational categories, “purchasing” prescription drugs was associated with adverse outcomes. Additionally, “theft/fake” prescription emerged as a source associated with adverse outcomes for college respondents, while “friend/relative” was associated with adverse outcomes for high school graduates that did not go on to college.

Conclusions: This research has important clinical implications as it identified young adults with a college education as being less likely to obtain prescription drugs from sources known to be associated with adverse outcomes. It also highlighted how associations between sources and adverse outcomes vary based on educational attainment.

Keywords:

• Sources of prescription drugs for misuse
• opioids
• tranquilizers
• educational attainment
• dropout

Additional information

Funding

The National Survey on Drug Use and Health is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). The authors were supported by grants from the National Institute on Drug Abuse of the National Institutes of Health (NIH) under Award Numbers R01DA043691 and R01DA031160. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH. Neither NIH nor SAMHSA had any further role in study design, the collection, analysis or interpretation of data, the writing of the manuscript, or the decision to submit the manuscript for publication.