Table 5

Correlates of medical use and misuse of psychoactive prescription medications among US young adults aged 18–25 years, National Survey of Drug Use and Health, 2015–2018

	Opioids		Stimulants		Tranquilizers		Sedatives		Use of 2 or more PMs
	Medical use*	Misuse*	Medical use*	Misuse*	Medical use*	Misuse*	Medical use*	Misuse*
	APR (95%CI)	APR (95%CI)	APR (95%CI)	APR (95%CI)	APR (95%CI)	APR (95%CI)	APR (95%CI)	APR (95%CI)	APR (95%CI)
Sex
Female	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Male	0.70 (0.67 to 0.73)	1.22 (1.13 to 1.32)	1.23 (1.13 to 1.33)	1.30 (1.20 to 1.41)	0.66 (0.60 to 0.72)	1.15 (1.05 to 1.26)	0.84 (0.73 to 0.96)	1.01 (0.78 to 1.31)	0.95 (0.90 to 0.99)
Race/ethnicity
White (non to Hispanic)	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Black (non to Hispanic)	1.05 (0.99 to 1.11)	0.82 (0.73 to 0.93)	0.45 (0.39 to 0.53)	0.37 (0.31 to 0.44)	0.51 (0.44 to 0.59)	0.65 (0.55 to 0.76)	0.55 (0.44 to 0.69)	0.39 (0.23 to 0.68)	0.56 (0.51 to 0.62)
Asian (non to Hispanic)	0.69 (0.61 to 0.77)	0.52 (0.39 to 0.69)	0.41 (0.32 to 0.53)	0.57 (0.45 to 0.72)	0.31 (0.23 to 0.42)	0.39 (0.27 to 0.57)	0.35 (0.23 to 0.54)	0.48 (0.19 to 1.20)	0.42 (0.34 to 0.51)
Hispanic	0.90 (0.85 to 0.95)	0.87 (0.77 to 0.97)	0.54 (0.47 to 0.62)	0.67 (0.59 to 0.75)	0.68 (0.60 to 0.76)	0.75 (0.66 to 0.86)	0.61 (0.50 to 0.74)	0.63 (0.40 to 0.98)	0.65 (0.59 to 0.70)
Other (non to Hispanic)	1.02 (0.94 to 1.12)	1.12 (0.95 to 1.31)	0.79 (0.66 to 0.94)	0.85 (0.71 to 1.02)	0.70 (0.58 to 0.85)	0.92 (0.75 to 1.12)	0.90 (0.69 to 1.17)	1.29 (0.79 to 2.11)	0.88 (0.78 to 0.99)
Education
Middle school or less	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
<High school	1.05 (0.90 to 1.22)	1.71 (1.32 to 2.21)	1.06 (0.77 to 1.46)	0.52 (0.35 to 0.78)	1.05 (0.78 to 1.40)	1.90 (1.38 to 2.61)	1.24 (0.77 to 2.02)	1.02 (0.38 to 2.70)	1.26 (1.03 to 1.53)
High school	1.17 (1.03 to 1.34)	1.98 (1.58 to 2.48)	1.03 (0.74 to 1.44)	0.51 (0.35 to 0.73)	1.25 (0.95 to 1.65)	1.86 (1.39 to 2.49)	1.09 (0.70 to 1.70)	0.64 (0.19 to 2.16)	1.31 (1.09 to 1.56)
Some college	1.10 (1.04 to 1.16)	1.50 (1.33 to 1.69)	0.94 (0.84 to 1.05)	0.76 (0.68 to 0.84)	0.92 (0.82 to 1.04)	1.52 (1.33 to 1.74)	0.90 (0.75 to 1.08)	1.10 (0.76 to 1.59)	1.10 (1.02 to 1.19)
College+	1.12 (1.06 to 1.19)	1.40 (1.24 to 1.58)	1.1 (0.99 to 1.22)	1.11 (1.01 to 1.22)	1.03 (0.93 to 1.15)	1.56 (1.37 to 1.79)	1.10 (0.93 to 1.30)	1.12 (0.79 to 1.59)	1.25 (1.17 to 1.35)
Poverty level†
Poverty	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Up to 2xThreshold	1.03 (0.98 to 1.09)	1.04 (0.93 to 1.15)	0.96 (0.86 to 1.08)	0.71 (0.63 to 0.79)	1.05 (0.93 to 1.18)	0.94 (0.83 to 1.07)	0.91 (0.77 to 1.08)	0.92 (0.64 to 1.33)	0.95 (0.88 to 1.02)
>2xThreshold	1.02 (0.97 to 1.07)	1.04 (0.95 to 1.15)	0.95 (0.86 to 1.05)	0.78 (0.71 to 0.87)	1.11 (0.99 to 1.24)	1.00 (0.89 to 1.13)	0.91 (0.78 to 1.08)	1.30 (0.94 to 1.79)	1.00 (0.93 to 1.07)
Health insurance
No insurance	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Private	1.09 (1.02 to 1.16)	0.87 (0.78 to 0.98)	1.37 (1.18 to 1.58)	1.44 (1.25 to 1.67)	0.96 (0.84 to 1.11)	0.94 (0.82 to 1.08)	0.99 (0.79 to 1.25)	1.08 (0.72 to 1.64)	1.08 (0.99 to 1.18)
Medicaid	1.24 (1.15 to 1.32)	1.09 (0.96 to 1.23)	1.12 (0.95 to 1.32)	0.94 (0.79 to 1.13)	1.10 (0.95 to 1.28)	0.98 (0.83 to 1.15)	1.30 (1.02 to 1.64)	0.99 (0.61 to 1.61)	1.15 (1.04 to 1.27)
Medicare	1.45 (1.03 to 2.04)	1.17 (0.63 to 2.18)	1.45 (0.70 to 3.02)	1.46 (0.63 to 3.36)	1.40 (0.75 to 2.64)	1.15 (0.55 to 2.42)	0.60 (0.14 to 2.51)	-	1.25 (0.76 to 2.04)
Other	1.06 (0.97 to 1.17)	0.83 (0.69 to 1.00)	1.11 (0.90 to 1.37)	1.15 (0.94 to 1.42)	1.01 (0.83 to 1.23)	0.71 (0.57 to 0.89)	1.09 (0.81 to 1.48)	0.91 (0.48 to 1.73)	0.89 (0.78 to 1.01)
Metro status‡
Metro	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Non to metro	1.07 (1.01 to 1.12)	1.11 (1.01 to 1.22)	0.88 (0.79 to 0.99)	0.80 (0.71 to 0.90)	0.91 (0.81 to 1.01)	0.87 (0.76 to 0.99)	0.80 (0.68 to 0.95)	0.99 (0.71 to 1.39)	0.93 (0.86 to 0.99)
Serious psychological distress§
No	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Yes	1.12 (1.07 to 1.17)	2.14 (1.98 to 2.32)	1.61 (1.48 to 1.75)	1.60 (1.48 to 1.74)	2.16 (1.98 to 2.34)	2.39 (2.18 to 2.62)	2.89 (2.54 to 3.29)	3.06 (2.37 to 3.94)	2.01 (1.90 to 2.12)
Recency of any nonprescription substance¶ use
Never used	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Used in the past 30 days	1.54 (1.44 to 1.66)	8.26 (6.37 to 10.71)	2.06 (1.75 to 2.41)	34.42 (18.79 to 63.06)	2.21 (1.85 to 2.64)	27.42 (16.2 to 46.41)	2.03 (1.59 to 2.60)	5.79 (2.42 to 13.84)	4.55 (3.91 to 5.30)
Used in the past 31 days to 12 months	1.42 (1.30 to 1.54)	2.75 (2.04 to 3.72)	1.41 (1.16 to 1.72)	6.11 (3.22 to 11.62)	1.53 (1.25 to 1.88)	5.66 (3.18 to 10.07)	1.71 (1.28 to 2.28)	1.62 (0.59 to 4.41)	1.92 (1.61 to 2.30)
Used in the >12 months	1.46 (1.32 to 1.62)	2.41 (1.69 to 3.42)	1.34 (1.05 to 1.72)	1.86 (0.81 to 4.28)	1.52 (1.18 to 1.96)	2.93 (1.41 to 6.08)	1.19 (0.82 to 1.71)	1.52 (0.33 to 7.05)	1.76 (1.41 to 2.21)

Estimates in bold type indicate statistically significant differences within the demographic subgroup. Results are adjusted for all covariates shown in table.
*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). Medical use was defined as having used the psychoactive prescription medication in the past year with no accompanying report of misuse.
†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.
§Serious Psychological Distress was assessed with the Kessler Psychological Distress Scale among respondents aged 18–25 years.
¶Non-prescription substances include alcohol, cigarettes, cigars, marijuana, cocaine, heroin, inhalants and hallucinogens.