title: Predictors and consequences of prescription drug misuse during middle school.
abstract: OBJECTIVE
  Non-medical prescription drug use (NMPDU) is a growing public health problem among adolescents. This is the first study to examine the correlates of early NMPDU initiation during middle school, and how early initiation is associated with four domains of functioning in high school (mental health, social, academic, and delinquency).
  
  
  METHODS
  Students initially in 6th-8th grades from 16 middle schools completed in-school surveys between 2008 and 2011 (Waves 1-5), and a web-based survey in 2013-2014 (Wave 6). We used discrete time survival analysis to assess predictors of initiation from Waves 1 to 5 based on students who provided NMPDU information at any of these waves (n=12,904), and regression analysis to examine high school outcomes associated with initiation based on a sample that was followed into high school, Wave 6 (n=2539).
  
  
  RESULTS
  Low resistance self-efficacy, family substance use, low parental respect, and offers of other substances from peers were consistently associated with NMPDU initiation throughout middle school. Further, perceiving that more of one's peers engaged in other substance use was associated with initiation at Wave 1 only. By high school, those students who initiated NMPDU during middle school reported lower social functioning, and more suspensions and fighting, compared to students who did not initiate NMPDU during middle school.
  
  
  CONCLUSIONS
  NMPDU initiation during middle school is associated with poorer social functioning and greater delinquency in high school. It is important for middle school prevention programs to address NMPDU. Such programs should focus on both family and peer influences, as well as strengthening resistance self-efficacy.
authors.affiliation: RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407, United States. Electronic address: jtucker@rand.org.
authors.forename: Joan S
authors.initials: JS
authors.lastname: Tucker
authors.affiliation: RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407, United States.
authors.forename: Brett A
authors.initials: BA
authors.lastname: Ewing
authors.affiliation: RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407, United States.
authors.forename: Jeremy N V
authors.initials: JNV
authors.lastname: Miles
authors.affiliation: RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407, United States.
authors.forename: Regina A
authors.initials: RA
authors.lastname: Shih
authors.affiliation: RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407, United States.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Pedersen
authors.affiliation: RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407, United States.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: D'Amico
mesh_terms: D000293:Adolescent; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008137:Longitudinal Studies; D008297:Male; D000067074:Peer Influence; D063487:Prescription Drug Misuse / Q000009:adverse effects* / Q000523:psychology / Q000706:statistics & numerical data; D012307:Risk Factors; D020377:Self Efficacy; D012932:Social Facilitation; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D013287:Illicit Drugs
keywords: Adolescents; Initiation; Longitudinal; Non-medical prescription drug use