PROJECT SUMMARY/ABSTRACT
Emerging data indicate that the prevalence of prescription drug misuse (PDM) in adolescents and young adults
is heavily influenced by school status, with higher rates of opioid and tranquilizer/sedative (i.e., largely
benzodiazepine) misuse in those not in school and higher rates of stimulant use among students. Other research
indicates that younger individuals not in school have more concerning substance use profiles and related
consequences, with adolescent school dropouts particuarly vulnerable. That said, no research has evaluated
PDM characteristics, like motives or diversion sources, by school status in adolescent and young adult
prescription misusers. The long-term goal of the research team is to understand prescription misusers and PDM
processes across the lifespan, aiding intervention developers by identifying treatment targets and vulnerable
subgroups of misusers. In this project, using data from multiple years of the National Survey on Drug Use and
Health (NSDUH), the overall objectives are to: one, evaluate differences by student status in adolescents and
young adults (separately) in PDM correlates, motives, sources, types, SUD symptoms and patterns of concurrent
PDM-other drug use (polydrug use); two, establish latent classes of nonmedical users, separately for the
following groups: adolescent students, adolescents not in school, young adult students and young adults not in
school; and three, compare latent classes on PDM characteristics (e.g., motives), polydrug use and SUD
symptoms. Variable selection was guided by Problem Behavior Theory, allowing for examination of risk and
protective factors for PDM across a variety of domains. The rationale for the proposed project is that better
characterization of adolescent and young adult prescription misusers and PDM processes in those groups will
provide clearer targets for interventions focused on PDM. The contribution of this project will be significant
because it will identify especially vulnerable adolescents and young adults engaged in PDM, allowing
intervention developers to better craft robust prevention and treatment programs to limit and/or treat PDM in the
two age groups with the highest prevalence of PDM. Furthermore, the research proposed here is innovative
because it represents a significant departure from the current state of the field focused largely on school-based
samples by applying accepted techniques and analyses, all previously utilized by the research team, to
considerably expand the knowledge base about PDM in a more diverse population of younger individuals. Other
sources of innovation include the investigation of a nationally representative and large sample using a
comprehensive set of PDM measures, dimensional examination of substance use disorder symptoms (including
those from PDM) and use of a well-studied theory to study the influence of a wide variety of risk and protective
factors. Rapid dissemination of the knowledge derived from this project has the potential to inform the
development of maximally valid intervention options to prevent or reduce PDM and its consequences in
adolescents and young adults, all of which is consistent with the mission of NIDA.