Researchers describe link between prescription and illicit drug misuse in high-risk groups

A new report from researchers at the Drexel University School of Public Health identifies patterns in the misuse of illicit drugs among young adults who also misuse prescription drugs. The report, "Misuse of Prescription and Illicit Drugs among High-Risk Adults" in Los Angeles and New York, was recently published in the first issue of the Journal of Public Health Research.

This is the first report to compare patterns of prescription and illicit drug misuse among high-risk young adults who are already misusing prescription drugs. Dr. Stephen Lankenau, associate professor at Drexel and principal investigator, and colleagues, suggest that drug treatment providers should be aware of this pattern of drug use to treat their clients more effectively.

Between 2009 and 2011, Lankenau and colleagues interviewed 596 young adults between the ages of 16 and 25 in Los Angeles and New York who had misused prescription drugs within the previous 90 days. The study included interviews with three high-risk groups of young adults: injection drug users (IDUs), homeless persons and polydrug users (users who combine drugs during a drug-using event).

Results showed that participants commonly received prescriptions for opioids, tranquilizers and stimulants, prior to misusing these drugs. In addition, using prescription drugs and illicit drugs at the same time was common in both cities. Drug users tended to use an illicit drug that provided a similar effect as the prescription drug they were already misusing.

The two cities also provided contrasting drug markets, which influenced the types of drugs misused. New York participants more frequently misused oxycodone, heroin and cocaine, while Los Angeles participants more frequently misused codeine, marijuana and methamphetamine.

Last year, Lankenau and colleagues published findings about the pathway to drug misuse among a subset of this study population, which indicated that misuse of prescription opioids often preceded the use of injected drugs.

Lankenau is a sociologist who combines public health concerns and mixed-method research designs to the study of high-risk youth, out-of-treatment drug users, homelessness, and HIV/AIDS. In addition to this recent study, he is leading evaluation studies of overdose prevention programs in Los Angeles and Philadelphia to determine programs that effectively reduce the risks of fatal drug overdoses. He teaches graduate courses that apply qualitative methods to the study of public health issues. Lankenau received a Ph.D. from the University of Maryland and a postdoctoral fellowship funded by NIDA.