Prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders in the United States: Results of the National Epidemiologic Survey on Alcohol and Related Conditions.
OBJECTIVE
To present national data on the prevalence, correlates, and comorbidity of nonmedical prescription drug use and drug use disorders for sedatives, tranquilizers, opioids, and amphetamines.


METHODS
Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a face-to-face nationally representative survey of 43,093 adults conducted during 2001 and 2002.


RESULTS
Lifetime prevalences of nonmedical use of sedatives, tranquilizers, opioids, and amphetamines were 4.1%, 3.4%, 4.7%, and 4.7%, respectively. Corresponding rates of abuse and/or dependence on these substances were 1.1%, 1.0%, 1.4%, and 2.0%. The odds of nonmedical prescription drug use and drug use disorders were generally greater among men, Native Americans, young and middle-aged, those who were widowed/ separated/divorced or never married, and those residing in the West. Abuse/dependence liability was greatest for amphetamines, and nonmedical prescription drug use disorders were highly comorbid with other Axis I and II disorders. The majority of individuals with non-medical prescription drug use disorders never received treatment.


CONCLUSIONS
Nonmedical prescription drug use and disorders are pervasive in the U.S. population and highly comorbid with other psychiatric disorders. Native Americans had significantly greater rates of nonmedical prescription drug use and drug use disorders, highlighting the need for culturally-sensitive prevention and intervention programs. Unprecedented comorbidity between nonmedical prescription drug use disorders and between nonmedical prescription drug use disorders and illicit drug use disorders suggests that the typical individual abusing or dependent on these drugs obtained them illegally, rather than through a physician. Amphetamines had the greatest abuse/dependence liability, and recent increases in the potency of illegally manufactured amphetamines may portend an epidemic in the youngest NESARC cohort.
Huang
Boji
B
Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-9304, USA.
Dawson
Deborah A
DA
Stinson
Frederick S
FS
Hasin
Deborah S
DS
Ruan
W June
WJ
Saha
Tulshi D
TD
Smith
Sharon M
SM
Goldstein
Risë B
RB
Grant
Bridget F
BF
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D019969:Amphetamine-Related Disorders / Q000453:epidemiology; D015897:Comorbidity; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D013287:Illicit Drugs / Q000009:adverse effects; D009293:Opioid-Related Disorders / Q000453:epidemiology; D015995:Prevalence; D011619:Psychotropic Drugs / Q000009:adverse effects; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014149:Tranquilizing Agents / Q000009:adverse effects; D014481:United States / Q000453:epidemiology
D006993:Hypnotics and Sedatives; D013287:Illicit Drugs; D011619:Psychotropic Drugs; D014149:Tranquilizing Agents