A recent article published in journal Archives of Pediatrics & Adolescent Medicine reports that compared to college students taking prescription drugs for medical reasons, those who use medications without a prescription are more likely to abuse drugs.

Motivation for the study comes from recent research that shows an increase in prescription rates of medications – such as stimulants, opioids, and benzodiazepines – that are likely to be abused in the United States. Author Sean Esteban McCabe, Ph.D., M.S.W. (University of Michigan, Ann Arbor) adds, “These increases are likely the result of many factors, including improved awareness regarding the signs and symptoms of several disorders, increased duration of treatment, availability of new medications and increased marketing. 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.”

McCabe used a Web survey of 3,639 college students to acquire information about prescription drug use and potential drug abuse. The average age of the sample was 19.9 years. Key survey questions included whether the students had been prescribed or had used without a prescription opioids, stimulants, sleeping aids (sedatives), or anxiety medicines. To determine if students abused drugs, the researcher relied on questions that asked whether the students had experienced drug-related problems like engaging in illegal activities to obtain drugs, having withdrawal symptoms, or developing medical problems due to drug use.

Results of the survey are summarized below:

  • 59.9% reported medically using at least one of the four drugs with a prescription
  • About 20% reported taking them without a prescription for non-medical reasons
  • 39.7% reported that they had used the drugs only by prescription
  • 4.4% used medications, but were not prescribed them
  • 15.8% reported using some medications, both with and without prescriptions

The researcher also found that students who reported using drugs without prescriptions were more likely to screen positive for drug abuse compared to students who never used them or who had only used them for medical reasons. These results were consistent for students who reported using drugs without prescriptions for medical reasons or not. Students who did not take any drugs did not have a different likelihood of testing positive for drugs abuse than those who had reported using the drugs by prescription.

Dr. McCabe believes that doctors should be careful when prescribing commonly abused drugs to college students. “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 writes. “Finally, any efforts aimed at reducing non-medical use of prescription drugs will have to take into consideration that these drugs are highly effective and safe medications for most patients who use them as prescribed.”

Screening for Drug Abuse Among Medical and Nonmedical Users of Prescription Drugs in a Probability Sample of College Students
Sean Esteban McCabe, PhD, MSW
Archives of Pediatrics & Adolescent Medicine. (2008). 162(3):225-231.
Click Here to View Abstract

Written by: Peter M Crosta