Predicting adolescents' persistence, non-persistence, and recent onset of nonmedical use of opioids and stimulants

This study sought to distinguish among adolescents who were persistent, non-persistent, or recent onset nonmedical users of prescription opioids and stimulants (respondents' ages ranged from 12–17 years, N = 126,764). The multinomial logistic regression analyses of combined data from the 2003 through 2009 National Survey of Drug Use and Health were used to investigate the association of respondents' sex, age, family income, race, parental status, population density, and user status (persistent, non-persistent, recent onset) on common illicit substances (cigarettes, alcohol, marijuana, and inhalants) with opioid and stimulant use. The odds of nonmedical opioid and stimulant use were significantly greater for females than males, and increased with age. Results were mixed for income, race, and parental status. Population density was largely unrelated to nonmedical use. Persistent nonmedical users of common illicit substances, especially marijuana and inhalants, were at greatest risk for nonmedical opioid and stimulant use. Non-persistent use of common illicit substances was a strong predictor of both non-persistent opioid and stimulant use. Recent onset of common substance use predicted recent onset of prescription opioid and stimulant use. Results indicate that persistence may be related to polysubstance use involving prescription opioids and stimulants, supporting efforts to investigate the underlying causes of polysubstance use.

► We examined adolescent nonmedical use of prescription opioids and stimulants (NMUOS).
► Results were based on NSDUH data pooled over 7 years, producing a stable analysis.
► Tobacco, alcohol, marijuana, and inhalant use predicted adolescent NMUOS.
► Persistent use of these substances predicted greatest odds of adolescent NMUOS.