Sources of Prescriptions for Misuse by Adolescents: Differences in Sex, Ethnicity, and Severity of Misuse in a Population-Based Study

Objective: Epidemiological data indicate that adolescent prescription misuse rates have risen over the past decade. Despite this, little work has examined sources for opioids, tranquilizers, and stimulants or evaluated sex or ethnic differences or whether different sources correspond to differences in other risk behaviors. Method: Data from the 2005 and 2006 National Survey on Drug Use and Health (adolescent n = 36,992) were used to address these questions. Frequencies and percentages for source categories were calculated, and potential sex and ethnic differences in medication source were evaluated using chi(2) analyses; logistic regression analyses evaluated whether the use of specific sources corresponded to a greater likelihood of concurrent substance use or depressive episodes. Results: The most common source of medication was from friends or family, for free; other common sources included obtaining medication from a physician, purchasing medication, or theft (usually from friends or relatives). Sex differences were found, predominately for opioids: female patients were more likely to steal medication or obtain it for free; male patients were more likely to purchase medication or acquire it from a physician. White adolescents were more likely to purchase opioids, whereas African American adolescents were more likely to misuse opioids obtained from a physician. Conclusions: Across medication classes, adolescents who most recently acquired medication by purchasing it had the worst risk profile in terms of concurrent substance use and severity of prescription misuse. These results may help identify subgroups of adolescent prescription misusers who are most vulnerable to consequences from misuse or other substance use. J. Am. Acad. Child Adolesc. Psychiatry, 2009;48(8):828-836.