Demographic characteristics and usage patterns of any psychoactive prescription medications among US young adults aged 18–25 years, National Survey of Drug Use and Health, 2015–2018
| Past-year use of any psychoactive prescription medications* | Past-year misuse †(among any users | Past-year substance use disorder ‡ (among any users) | Past-year use of 2 or more psychoactive prescription medications | ||
| N (%) | Prevalence (%) | Proportion (%) | Proportion (%) | Prevalence (%) | |
| Overall | 55 690 (100) | 41.0 (40.4–41.5) | 34.7 (33.9–35.5) | 4.2 (3.9–4.5) | 13.4 (13.0–13.8) |
| Sex | |||||
| Female | 28 994 (49.8) | 44.4 (43.7–45.1) | 30.4 (29.4–31.4) | 3.5 (3.1–3.9) | 14.2 (13.7–14.7) |
| Male | 26 696 (50.2) | 37.6 (36.8–38.3) | 39.6 (38.4–40.9) | 5.0 (4.5–5.6) | 12.6 (12.1–13.1) |
| Age, years | |||||
| 18–20 | 20 335 (37.4) | 38.2 (37.3–39.0) | 34.7 (33.4–36.1) | 4.5 (4.0–5.1) | 12.1 (11.6–12.7) |
| 21–25 | 35 355 (62.6) | 42.6 (42.0–43.3) | 34.6 (33.6–35.6) | 4.0 (3.6–4.4) | 14.2 (13.7–14.6) |
| Race/ethnicity | |||||
| White (non-Hispanic) | 29 846 (54.3) | 46.2 (45.5–46.9) | 37.3 (36.3–38.3) | 4.7 (4.2–5.1) | 17.1 (16.6–17.7) |
| Black (non-Hispanic) | 7812 (14.1) | 36.1 (34.9–37.4) | 26.0 (24.1–28.0) | 3.0 (2.2–3.8) | 8.1 (7.4–8.9) |
| Asian (non-Hispanic) | 2741 (6.2) | 23.7 (21.7–25.7) | 29.2 (24.8–33.7) | 2.7 (1.2–4.2) | 5.4 (4.3–6.4) |
| Hispanic | 11 667 (21.9) | 35.4 (34.2–36.6) | 32.5 (30.5–34.4) | 3.6 (2.9–4.4) | 9.6 (8.9–10.3) |
| Other (non-Hispanic) | 3624 (3.5) | 45.6 (43.2–48.0) | 36.8 (33.2–40.3) | 5.3 (3.6–6.9) | 15.1 (13.4–16.9) |
| Education | |||||
| Middle school or less | 11 471 (21.7) | 41.0 (39.9–42.2) | 35.4 (33.7–37.2) | 2.7 (2.1–3.3) | 13.2 (12.4–14.0) |
| <High school | 1043 (1.6) | 37.0 (33.3–40.7) | 34.8 (28.7–40.8) | 7.1 (4.1–10.1) | 13.9 (11.2–16.6) |
| High school | 1196 (2) | 43.7 (40.0–47.3) | 33.9 (28.8–39.1) | 6.1 (3.6–8.6) | 14.6 (12.1–17.2) |
| Some college | 23 660 (40.5) | 38.0 (37.2–38.8) | 32.0 (30.8–33.3) | 4.8 (4.3–5.4) | 11.6 (11.1–12.2) |
| College+ | 18 320 (34.2) | 44.5 (43.5–45.4) | 36.9 (35.5–38.3) | 4.2 (3.7–4.8) | 15.5 (14.8–16.2) |
| Poverty level § | |||||
| Poverty | 14 841 (26.2) | 40.7 (39.7–41.8) | 34.7 (33.1–36.2) | 4.0 (3.4–4.6) | 13.0 (12.3–13.7) |
| up to 2 x threshold | 13 617 (24.2) | 39.8 (38.8–40.9) | 32.4 (30.8–34.0) | 4.2 (3.5–4.8) | 12.3 (11.6–12.9) |
| >2 x threshold | 25 569 (49.6) | 41.7 (40.9–42.4) | 35.6 (34.4–36.8) | 4.4 (3.9–4.9) | 14.3 (13.7–14.8) |
| Health insurance | |||||
| No insurance | 7589 (14.3) | 35.8 (34.4–37.2) | 36.2 (33.9–38.5) | 4.8 (3.8–5.8) | 11.4 (10.5–12.3) |
| Private | 32 454 (59.7) | 42.5 (41.8–43.2) | 36.4 (35.4–37.4) | 4.0 (3.6–4.5) | 14.5 (14.0–15.0) |
| Medicaid | 11 557 (19.2) | 40.7 (39.5–41.9) | 29.0 (27.3–30.7) | 4.7 (4.0–5.5) | 12.2 (11.4–13.0) |
| Medicare only | 137 (0.2) | 47.3 (37.2–57.4) | 39.3 (24.5–54.0) | – | 14.2 (7.5–20.9) |
| Other (non-Hispanic) | 3953 (6.5) | 39.0 (37.0–41.0) | 31.3 (28.3–34.4) | 3.1 (2.1–4.1) | 11.0 (9.8–12.3) |
| Metro status¶ | |||||
| Metro | 45 231 (87.3) | 40.7 (40.1–41.3) | 35.0 (34.2–35.9) | 4.2 (3.8–4.5) | 13.4 (13.0–13.8) |
| Non-metro | 10 459 (12.7) | 42.9 (41.6–44.1) | 32.3 (30.4–34.1) | 4.4 (3.6–5.2) | 13.7 (12.8–14.6) |
| Serious psychological distress** | |||||
| No | 42 949 (77.4) | 36.8 (36.2–37.4) | 31.5 (30.6–32.5) | 2.4 (2.1–2.7) | 10.4 (10.0–10.8) |
| Yes | 12 741 (22.6) | 55.2 (54.1–56.3) | 41.8 (40.3–43.3) | 8.3 (7.5–9.1) | 23.7 (22.7–24.6) |
| Recency of non-prescription substance†† use | |||||
| Never used any substance | 7816 (14.5) | 21.1 (19.9–22.2) | 7.5 (6.0–9.0) | 0.5 (0.1–0.9) | 3.2 (2.8–3.7) |
| Used within past 30 days | 36 494 (65.4) | 48.0 (47.3–48.6) | 41.4 (40.5–42.4) | 5.0 (4.6–5.4) | 17.7 (17.2–18.2) |
| Used during past 31 days to 12 months | 7768 (13.9) | 33.3 (31.9–34.6) | 16.3 (14.5–18.0) | 2.2 (1.5–2.9) | 6.9 (6.2–7.6) |
| Used more than 12 months ago | 3612 (6.2) | 31.1 (29.2–33.1) | 11.6 (9.3–13.9) | 1.6 (0.7–2.4) | 6.2 (5.1–7.3) |
| Number of non-prescription substances†† used (past 30 days) | |||||
| 0 | 19 195 (34.6) | 27.8 (27.0–28.6) | 12.5 (11.4–13.6) | 1.5 (1.1–1.9) | 5.2 (4.8–5.6) |
| 1 | 19 270 (34.6) | 38.7 (37.8–39.6) | 25.0 (23.7–26.2) | 2.2 (1.8–2.6) | 9.9 (9.3–10.4) |
| 2 | 10 178 (18.1) | 51.9 (50.7–53.2) | 43.7 (42.0–45.5) | 4.3 (3.6–5.0) | 19.5 (18.5–20.4) |
| 3 | 4981 (9) | 63.3 (61.5–65.0) | 58.2 (56.0–60.4) | 7.7 (6.5–8.8) | 31.8 (30.1–33.5) |
| 4 | 1636 (3) | 75.0 (72.3–77.7) | 73.9 (70.7–77.0) | 12.0 (9.8–14.2) | 44.3 (41.2–47.4) |
| 5+ | 430 (0.8) | 87.3 (83.5–91.2) | 88.0 (83.6–92.5) | 26.3 (20.2–32.4) | 63.3 (57.4–69.1) |
| Number of non-prescription substances†† used (past year) | |||||
| 0 | 11 427 (20.7) | 24.1 (23.1–25.1) | 9.1 (7.8–10.4) | 0.9 (0.5–1.3) | 4.1 (3.7–4.6) |
| 1 | 17 705 (31.7) | 33.3 (32.4–34.2) | 14.7 (13.5–15.8) | 1.3 (1.0–1.7) | 6.4 (6.0–6.8) |
| 2 | 11 940 (21.1) | 43.3 (42.2–44.5) | 29.4 (27.8–31.0) | 2.4 (1.9–2.9) | 12.7 (11.9–13.4) |
| 3 | 7900 (14.1) | 52.5 (51.1–54.0) | 45.2 (43.3–47.2) | 4.1 (3.3–4.8) | 20.4 (19.3–21.6) |
| 4 | 4209 (7.5) | 64.8 (62.9–66.8) | 59.7 (57.4–62.1) | 7.4 (6.2–8.6) | 31.3 (29.5–33.1) |
| 5+ | 2509 (4.8) | 82.6 (80.7–84.6) | 81.4 (79.3–83.6) | 16.6 (14.5–18.6) | 54.0 (51.5–56.6) |
Psychoactive prescription medications assessed in NSDUH include opioids, stimulants, tranquillisers and sedatives. Estimates in bold type indicate statistically significant differences within the demographic subgroup. Estimates with relative standard errors ≥40% were suppressed (−).
*Any use was use of any of the four psychoactive prescription medications assessed.
†Misuse was defined as a report by the respondent that they had used the psychoactive prescription medication in the past year in any way not directed or prescribed, including use without a prescription of individual’s own, or deviations in the dose (greater amounts), frequency (more often) or duration (longer).
‡Substance use disorder was defined as having indications of dependence or abuse using the DSM-IV definition.
§Poverty status was defined using the Federal Poverty Threshold of each survey year.
¶Metro status assessed whether the respondent lived in a metropolitan statistical area or not delineated by the Office of Management and Budget.
**Presence of serious psychological distress was defined as Kessler-6 Psychological Distress Scale Score ≥13.
††Non-prescription substances include alcohol, cigarettes, cigars, marijuana, cocaine, heroin, inhalants and hallucinogens.