Epidemiology of prescription drug abuse in Illinois high school students

Prescription drug abuse has reached epidemic proportions and trends indicate that the number of adolescents who abuse these drugs will continue to increase. Every adolescent appear to be at risk and this epidemic does not appear to be defined by known risk profiles for substance abuse. Nearly one in every five 12th grade students used prescription drugs for non-medical reasons at least once in lifetime according to the Monitoring the Future study. This is a significant public health problem as prescription drug abuse in the adolescence can continue into the adult life and puts adolescents at risk of substance abuse and other comorbidities. The purpose of this study was to identify individual, family, school and community level factors responsible for the initiation and maintenance of prescription drug abuse behaviors in Illinois 12th grade students. A cross-sectional study design was used with the secondary data on the 12th graders’ prescription drug use from the 2010 Illinois Youth Survey. Multilevel logistic regression was performed to account for the multistage sampling and hierarchical structure of the data, using software such as HLM, STATA, and SPSS. Abuse of any prescription drug and of subclasses such as uppers, downers, steroids and other drugs were the dependent variables. Individual level variables such as age, gender, race, socioeconomic status, having clear college/future plans, other substance/over the counter (OTC) drug abuse, depression, gambling, family rules about alcohol and drug use, perceived peer drug use; school level variables such as the percent of -White students, students in the low socioeconomic status category, students reporting bullying, students reporting unsafe at school; and school district level variables such as community norms towards substance abuse, community activities, safety, location and availability of alcohol, tobacco and other drugs (ATOD) were examined for their influence on prescription drug abuse in Illinois 12th graders. Results indicate that Illinois 12th graders (11.4%) had a lower prevalence than the US prevalence (15.4%) in the year 2009. After adjusting for all the other variables in the multilevel logistic regression model, Illinois 12th graders with past year ATOD use (Odds ratio (OR): 6.095, 95% CI: 2.708,13.717), past year OTC drug use (OR: 6.081, 95% CI: 3.952,9.358), past year depression (OR: 2.381, 95% CI: 1.475, 3.844), and past year gambling (OR: 1.684, 95% CI: 1.069, 2.655) were found to have significantly higher odds of prescription drug abuse in 12th graders. Other individual level variables and all school/ school district level variables were found to be not significantly associated with prescription drug abuse in 12th graders. Prescription drug abuse in Illinois 12th graders was significantly different from prevalence in US 12th graders and was found to be significantly associated with gender, past year ATOD use, OTC use, gambling, depression, and perceived peer drug use. Most of the variation in prescription drug abuse appears to be within the schools and school districts and only a little variation exists between schools / school districts. Despite some limitations, this study is significant as there aren't many studies done to recognize the frequent drug abuse epidemics in the subpopulations. This study contributes to the existing literature on prescription drug abuse by reporting the risk and protective factors operating at individual, school and community levels in Illinois 12th grade students. Multilevel study design and statistical analyses also provide a framework for evaluation of prescription drug abuse prevention programs