The role of traumatic event history in non-medical use of prescription drugs among a nationally representative sample of US adolescents.
BACKGROUND
Building on previous research with adolescents that examined demographic variables and other forms of substance abuse in relation to non-medical use of prescription drugs (NMUPD), the current study examined potentially traumatic events, depression, posttraumatic stress disorder (PTSD), other substance use, and delinquent behavior as potential correlates of past-year non-medical use of prescription drugs.


METHODS
A nationally representative sample of 3,614 non-institutionalized, civilian, English-speaking adolescents (aged 12-17 years) residing in households with a telephone was selected. Demographic characteristics, traumatic event history, mental health, and substance abuse variables were assessed. NMUPD was assessed by asking if, in the past year, participants had used a prescription drug in a non-medical manner. Multivariable logistic regressions were conducted for each theoretically derived predictor set. Significant predictors from each set were then entered into a final multivariable logistic regression to determine significant predictors of past-year NMUPD.


RESULTS
NMUPD was endorsed by 6.7% of the sample (n = 242). The final multivariable model showed that lifetime history of delinquent behavior, other forms of substance use/abuse, history of witnessed violence, and lifetime history of PTSD were significantly associated with increased likelihood of NMUPD.


CONCLUSIONS
Risk reduction efforts targeting NMUPD among adolescents who have witnessed significant violence, endorsed abuse of other substances and delinquent behavior, and/or endorsed PTSD are warranted. Interventions for adolescents with history of violence exposure or PTSD, or those adjudicated for delinquent behavior, should include treatment or prevention modules that specifically address NMUPD.
McCauley
Jenna L
JL
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, 29425 USA. mccaule@musc.edu
Danielson
Carla Kmett
CK
Amstadter
Ananda B
AB
Ruggiero
Kenneth J
KJ
Resnick
Heidi S
HS
Hanson
Rochelle F
RF
Smith
Daniel W
DW
Saunders
Benjamin E
BE
Kilpatrick
Dean G
DG
D000293:Adolescent; D002648:Child; D015897:Comorbidity; D003710:Demography; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency / Q000706:statistics & numerical data; D008297:Male; D055553:Prescription Drugs; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D055553:Prescription Drugs
J Consult Clin Psychol. 2000 Feb;68(1):19-30
10710837
Hum Psychopharmacol. 2004 Oct;19 Suppl 1:S3-7
15378670
Arch Gen Psychiatry. 1998 Oct;55(10):913-7
9783562
J Trauma Stress. 2005 Apr;18(2):97-105
16281201
J Clin Psychiatry. 2006 Jul;67(7):1062-73
16889449
J Consult Clin Psychol. 1997 Oct;65(5):834-47
9337502
Drug Alcohol Depend. 2003 Apr 1;69(3):215-32
12633908
J Consult Clin Psychol. 2003 Aug;71(4):692-700
12924674
Child Maltreat. 2004 Feb;9(1):62-77
14870998
Arch Gen Psychiatry. 2007 Dec;64(12):1435-42
18056552
Drug Alcohol Depend. 2006 Jun;83 Suppl 1:S4-7
16563663
J Adolesc Health. 2007 Jan;40(1):76-83
17185209
J Trauma Stress. 2006 Oct;19(5):699-707
17075907
Drug Alcohol Depend. 2008 Apr 1;94(1-3):1-11
18054444
Addict Behav. 1992;17(4):379-86
1502971
Psychol Rev. 2004 Jan;111(1):33-51
14756584
Am J Prev Med. 1998 May;14(4):259-72
9635070
Child Maltreat. 2003 Nov;8(4):261-72
14604174
JAMA. 2008 Jan 2;299(1):70-8
18167408
CMAJ. 2001 Oct 16;165(8):1039-44
11699699
J Am Acad Child Adolesc Psychiatry. 2008 Sep;47(9):1020-9
18664996
Drug Alcohol Depend. 2007 Oct 8;90(2-3):252-60
17513069
Subst Use Misuse. 2004 Jun;39(7):1095-116
15387205
J Consult Clin Psychol. 1993 Dec;61(6):984-91
8113499
Psychiatr Serv. 2004 Mar;55(3):274-83
15001728
J Adolesc Health. 2005 Jul;37(1):44-51
15963906