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Self-treatment and Beyond

Sean Esteban McCabe, PhD; Carol J. Boyd, PhD; James A. Cranford, PhD; Christian J. Teter, PharmD

Arch Pediatr Adolesc Med. 2009;163(8):739-744.

Objectives  To assess motives for nonmedical use of prescription opioids among US high school seniors and examine associations between motives for nonmedical use and other substance use behaviors.

Design  Nationally representative samples of US high school seniors (modal age 18 years) were surveyed during the spring of their senior year via self-administered questionnaires.

Setting  Data were collected in public and private high schools.

Participants  The sample consisted of 5 cohorts (2002-2006) of 12 441 high school seniors.

Main Outcome Measures  Self-reports of motives for nonmedical use of prescription opioids and substance use behaviors.

Results  More than 1 in every 10 high school seniors reported nonmedical use of prescription opioids and 45% of past-year nonmedical users reported "to relieve physical pain" as an important motivation. The odds of heavy drinking and other drug use were lower among nonmedical users of prescription opioids motivated only by pain relief compared with nonmedical users who reported pain relief and other motives and those who reported non–pain relief motives only. The odds of medical use of prescription opioids were lower among nonmedical users who reported only non–pain relief motives compared with other types of nonmedical users.

Conclusions  The findings indicate motives should be considered when working with adolescents who report nonmedical use of prescription opioids. Future efforts are needed to identify adolescents who may need appropriate pain management and those at increased risk for prescription opioid abuse.

Author Affiliations: Substance Abuse Research Center (Drs McCabe, Boyd, Cranford, and Teter), Institute for Research on Women and Gender (Drs McCabe and Boyd), and Addiction Research Center, Department of Psychiatry (Dr Cranford), University of Michigan, Ann Arbor; and School of Pharmacy, Northeastern University, Boston (Dr Teter), and Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont (Dr Teter), Massachusetts.

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