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Why Do Adults Misuse Prescription Drugs? (2017)

Prescription drug misuse is second only to marijuana use as the nation's most commonly used illicit drug.1,2 Although prescription drug misuse is common in the United States, the majority of people (87.2 percent) who take prescription pain relievers do not misuse them.2 Understanding the prevalence of and reasons for prescription drug misuse has major public health implications. Policymakers can use this type of information to help inform their assessments of substance use prevention and treatment needs in their communities.

The 2015 National Survey on Drug Use and Health (NSDUH) collects information on the reasons people misuse prescription psychotherapeutic drugs. NSDUH is an annual survey of the U.S. civilian, noninstitutionalized population aged 12 years or older and is the primary source for statistical information on illicit drug use, alcohol use, substance use disorders, and mental health issues for this population. One of NSDUH's strengths is its large sample size, which allows for examinations of prescription drug misuse and the reason for that misuse.

This issue of The CBHSQ Report presents 2015 NSDUH estimates of past year misuse of prescription drugs among adults aged 18 or older and the primary reason for misusing these drugs among adults who misused them. As defined in NSDUH, misuse of prescription drugs includes use in any way that a doctor did not direct the respondent to use them, including (1) use without a prescription of the respondent's own; (2) use in greater amounts, more often, or longer than the respondent was told to take them; or (3) use in any other way a doctor did not direct the respondent to use them. Misuse does not include use of over-the-counter drugs or legitimate use of prescription drugs. NSDUH respondents were asked to provide information about their use and misuse of four categories of prescription drugs: pain relievers, tranquilizers, stimulants, and sedatives. The specific prescription drugs asked about on NSDUH are identified as controlled substances by the Drug Enforcement Administration based on (1) a substance's potential for abuse, (2) the current state of scientific knowledge regarding a drug, (3) risks to public health, or (4) the potential for physiological or psychological dependence.3 NSDUH respondents who reported misuse of any of the four categories of prescription drugs at least once in the past year were asked to indicate their reasons for their most recent misuse of the prescription drug. Respondents who identified more than one reason for their most recent prescription drug misuse were asked to indicate the main reason for misuse. The reasons for misusing prescription drugs are listed in Table S1. Findings in this report are based on 2015 NSDUH data from approximately 51,200 adults aged 18 or older.