Nonmedical Use of Rx Drugs among Teens Linked to Substance Use Disorder in Adulthood

One in five high school seniors report having taken a prescription sedative or anxiolytic for medical or nonmedical reasons. For teens, using such drugs nonmedically leads to much worse odds of having a substance use disorder by age 35. Anxiolytics are medications that inhibit anxiety. Prescription of sedatives and anxiolytics to adolescents has increased significantly over the last two decades, likely in response to public awareness of anxiety and insomnia among teens.


These findings come from a recent study by Sean McCabe and colleagues examining 20 longitudinal years of Monitoring the Future data. US high school seniors were surveyed from 1976 to 1996 (n=8,373) and followed from adolescence into adulthood. Their age 35 surveys occurred from 1993 to 2013.


Interestingly, no increased risk for adult substance use disorder was found for the teens who had used a sedative or anxiolytic prescription under a doctor’s supervision and had not strayed from appropriate use. However, 45% of the appropriate users also reported nonmedical use. Teens who used sedatives or anxiolytics nonmedically were two to three times more likely to show substance use disorder symptoms by age 35. This group of teens included those who did and did not ever use such a prescription medically.


Substance use disorder symptoms at age 35 were assessed based on DSM criteria for alcohol, cannabis, and other drug disorders. Following recommended practice, the study looked for two or more of the DSM-based criteria present at age 35.


Other findings in this study:

-There were no differences in the results for women and men.

-Over 90% of teens who used sedatives or anxiolytics nonmedically had also used other substances in the past year.

-Teens who used sedatives or anxiolytics nonmedically were much more likely to report alcohol use rather than other drug use disorder symptoms in adulthood.


The study’s researchers say there is some cause for reassurance that appropriate teen use of prescription sedatives and anxiolytics is not associated with increased risk for substance use disorder in adulthood. However, there is also cause for concern since 45% of teens who used the prescription appropriately also reported nonmedical use.


Related studies:

Medical and nonmedical use of prescription benzodiazepine anxiolytics U.S. high school seniors

Nonmedical use of prescription opioids during the transition to adulthood: A multi-cohort national longitudinal study

Adolescent context of exposure to prescription opioids and substance use disorder symptoms at age 35: a national longitudinal study

Substance use disorder in early midlife: A national prospective study on health and well-being correlates and long-term predictors