title: Medical and nonmedical use of prescription sedatives and anxiolytics: Adolescents' use and substance use disorder symptoms in adulthood.
abstract: This study assessed the longitudinal associations between medical and nonmedical use of prescription sedatives/anxiolytics (NMPSA) during adolescence (age 18) and substance use disorder (SUD) symptoms during adulthood (age 35).
  
  
  
  Multiple cohorts of nationally representative samples of U.S. high school seniors (n=8373) were surveyed via self-administered questionnaires and followed longitudinally from adolescence (age 18, 1976-1996) to adulthood (age 35, 1993-2013).
  
  
  
  An estimated 20.1% of adolescents reported lifetime medical or nonmedical use of prescription sedatives/anxiolytics. Among adolescents who reported medical use of prescription sedatives/anxiolytics, 44.9% also reported NMPSA by age 18. Based on multivariate analyses that included age 18 sociodemographic and other substance use controls, medical use of prescription sedatives/anxiolytics without any history of NMPSA during adolescence was not associated with SUD symptoms in adulthood relative to adolescents with no prescription sedative/anxiolytic use. In contrast, adolescents with a history of both medical and nonmedical use of prescription sedatives/anxiolytics and adolescents who reported only NMPSA had between two to three times greater odds of SUD symptoms in adulthood relative to adolescents with no prescription sedative/anxiolytic use and those who reported only medical use of prescription sedatives/anxiolytics.
  
  
  
  One in every five U.S. high school seniors reported ever using prescription sedatives/anxiolytics either medically or nonmedically. This study provides compelling evidence that the medical use of prescription sedatives/anxiolytics (without any NMPSA) during adolescence is not associated with increased risk of SUD symptoms in adulthood while any NMPSA during adolescence serves as a signal for SUDs in adulthood.
authors: University of Michigan, Institute for Research on Women and Gender, Substance Abuse Research Center, Ann Arbor 48109, MI, USA. Electronic address: plius@umich.edu.
authors: Sean Esteban
authors: SE
authors: McCabe
authors: University of Michigan, Institute for Research on Women and Gender, Ann Arbor 48109, MI, USA.
authors: Philip
authors: P
authors: Veliz
authors: University of Michigan, School of Nursing, Department of Psychiatry, Institute for Research on Women and Gender, Ann Arbor 48109, MI, USA.
authors: Carol J
authors: CJ
authors: Boyd
authors: University of Michigan, Institute for Social Research, Department of Psychology, Ann Arbor 48106, MI, USA.
authors: John E
authors: JE
authors: Schulenberg
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D014151:Anti-Anxiety Agents; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D008137:Longitudinal Studies; D008297:Male; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D055553:Prescription Drugs; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D055553:Prescription Drugs
keywords: Anxiolytic; Longitudinal; Medical use; Nonmedical use; Sedative; Substance use disorders