Prevalence and correlates of co-ingestion of prescription tranquilizers and other psychoactive substances by U.S. high school seniors: Results from a national survey

Abstract

Introduction Nonmedical tranquilizer use (NMTU) is a concerning and understudied phenomenon in adolescents, despite being the second most prevalent form of nonmedical use in this population. Thus, this work aimed to examine the sociodemographic and substance use correlates of past-year co-ingestion of a prescription tranquilizer and another substance among adolescents. Methods Data were from the Monitoring the Future study, a nationally representative survey of US high school students. Data from 11,444 seniors (12th graders) completing form 1 of the survey were used. The participants represented a population that was 52.7% female, 61.8% White, and had a modal age of 18. Weighted frequencies and Rao-Scott chi-square analyses were computed to describe the target population and examine associations of interest. Results An estimated 5.3% of the population engaged in past-year NMTU during this time period, with an estimated 72.6% of those users engaged in past-year co-ingestion of a tranquilizer and another substance. Marijuana and alcohol were the most commonly co-ingested substances. Those engaged in co-ingestion were more likely than past-year nonmedical users without co-ingestion to be engaged in other substance or nonmedical use (including past year nonmedical Xanax® (alprazolam) use), have an earlier onset of NMTU, and endorse recreational motives. Conclusions Adolescent nonmedical tranquilizer users engaged in co-ingestion may be a particularly vulnerable population, with higher rates of other substance use, other nonmedical use and problematic NMTU characteristics than nonmedical users without co-ingestion. Identification of and intervention with adolescent co-ingestion users is an important avenue for future research and clinical practice.

Medical and nonmedical use of prescription sedatives and anxiolytics: Adolescents' use and substance use disorder symptoms in adulthood

“…This study found that more than nine in every ten adolescents who reported NMPSA engaged in polysubstance use during the past-year which is similar to prior studies examining nonmedical use of prescription opioids, sedatives, stimulants and anxiolytics (McCabe et al, 2006; Catalano et al, 2011; Schepis et al, 2016). In fact, recent work has shown that the majority of past-year nonmedical users of prescription opioids, anxiolytics and sedatives engage in simultaneous co-ingestion with at least one other substance placing such individuals at increased risk of consequences such as overdose (McCabe et al, 2006; McCabe and Boyd, 2005; SAMHSA, 2012, 2013; Schepis et al, 2016).…”

“…The majority of adolescents who report NMPSA engage in concurrent or simultaneous polysubstance use (McCabe et al, 2006, 2007; Schepis et al, 2016), creating major challenges to isolating drug-specific-related problems resulting from NMPSA. For instance, nearly 73% of adolescent past-year nonmedical users of prescription anxiolytics simultaneously co-ingested these medications with at least one other substance, primarily cannabis and alcohol (Schepis et al, 2016).…”

“…For instance, nearly 73% of adolescent past-year nonmedical users of prescription anxiolytics simultaneously co-ingested these medications with at least one other substance, primarily cannabis and alcohol (Schepis et al, 2016). As a result, attempts to examine substance-related problems associated with NMPSA must control for a wide range of substances for assessing the risk of developing SUDs.…”

Adolescents, alcohol, and marijuana: Context characteristics and problems associated with simultaneous use

“…Studying simultaneous substance use is important because such use represents the experiences of many young substance users (Schepis et al, 2016; Subbaraman and Kerr, 2015). We identified situational and social characteristics associated with simultaneous use of alcohol and marijuana.…”

“…Although simultaneous use (i.e., use of more than one substance within a few hours) is common among young substance users (Pape et al, 2009; Schepis et al, 2016; Subbaraman and Kerr, 2015), we know very little about contexts and risks associated with simultaneous use of alcohol and marijuana. We know that risks for underage drinking vary from one context to another and that drinking contexts, independently of how much a person drinks, are related to specific problems (Bersamin et al, 2016; Lipperman-Kreda et al, 2015; Mair et al, 2015), but we do not know if contexts of simultaneous alcohol and marijuana use are unique or whether simultaneous use leads to greater problems.…”