Adolescent nonmedical prescription drug use is associated with sexual risk behaviors

1. One in 5 high school students reported use of a prescription drug for nonmedical use, though younger students and black students were less likely to do so.

2. Nonmedical use of prescription drugs was associated with risky sexual behaviors such as not using a condom prior to sexual intercourse, or the use of substances, such as alcohol or drugs, prior to last sexual encounter.

Study Rundown: Nearly 20% of high school students report lifetime prevalence of nonmedical use of prescription drugs (NMUPD). Previous studies have associated substance use in adolescents with sexual risk behaviors, but there has been little investigation into the potential connection between NMUPD and these behaviors. This study sought to investigate this association. NMUPD was defined as “using a prescription drug such as OxyContin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax,” without a physician’s prescription. One in 5 students reported NMUPD. Black students and younger students reported less NMUPD. NMUPD was associated with sexual risk behaviors including having more than 4 partners and not using a condom at last reported episode of sexual intercourse. This study was limited by potential over/underreporting due to survey format. Additionally, nonmedical use of prescription drugs can also include use of these medications outside of the scope of their intended use, which the survey does not account for. Despite these limitations, this study highlights the value of screening for NMUPD as it is linked with sexual behaviors that could contribute to teenage pregnancy and sexually-transmitted diseases.

Click to read the study, published today in Pediatrics

Relevant Reading: Characterizing adolescent prescription missusers: a population-based study

In-Depth [survey]: A total of 29 008 high school students across the United States (49% female, 56.3% white, 14.2% black, 20.5% Hispanic) took the Youth Risk Behavior Survey (YRBS) administered by the Centers for Disease Control (CDC) in 2011 and 2013. There was equal representation of each high school grade. Black students were found to be less likely to report NMUPD (PR 0.67, 95%CI 0.59- 0.77), as were students compared in the 9^th grade when compared to 12^th grade (PR 1.62, 1.43-1.82). NMUPD was associated with non-prescription substance use, most strongly with alcohol (PR 8.30, 95%CI 6.95-9.92) and marijuana (6.82, 95%CI 6.12-7.59). Logistic regression modeling was adjusted for sex, race/ethnicity, grade, ever injection drug use, and use of alcohol, marijuana heroin, cocaine, methamphetamines, ecstasy and inhalants. NMUPD was associated with reported history of sexual intercourse ever (aPR 1.16; 95% CI 1.11-1.22), being currently sexually active (1.26; 95% CI 1.20-1.33), history of 4 or more lifetime sexual partners (1.45; 95% CI 1.34-1.57). It was also associated with other risky sexual behaviors such as the use of substances (alcohol or drugs) before last sexual activity (1.32; 95% CI 1.17-1.48) and refraining from condom use (1.14; 95% CI 1.05-1.23).

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