ANN ARBOR—Many high school seniors who take pain medications without a prescription do so for reasons besides relieving pain, according to a newly released University of Michigan study.

From a list of 17 motives for nonmedical use of prescription opioids, the leading motives were “to relax or relieve tension” (56.4 percent), “to feel good or get high” (53.5 percent), “to experiment, see what it’s like” (52.4 percent) and “to relieve physical pain” (44.8 percent).

The study sought to assess motives for nonmedical use of prescription opioids among high school seniors, as well as examine motives for nonmedical use and other substance use behaviors. Examples of prescription opioids—medications prescribed to manage pain—include hydrocodone, oxycodone, hydromorphone, meperidine, morphine, opium or codeine.

“The results of this study provide compelling evidence that adolescents have a wide range of motives for using prescription opioids nonmedically and these motives should be carefully considered in efforts to reduce this behavior,” said Sean Esteban McCabe, the study’s lead author and a research associate professor at the U-M Substance Abuse Research Center and the Institute for Research on Women and Gender.

Data were collected from 12,441 seniors in public and private high schools in the United States between 2002 and 2006.

More than one in 10 students—or 12.3 percent—reported lifetime nonmedical use, including 8 percent who used during the past year.

Only two differences were found based on gender: women reported higher prevalence rates than men for the motives “to get to sleep” (31.8 percent vs. 21.3 percent) and “because of anger and frustration” (14.8 percent vs. 8.1 percent).

Students who said they used the drugs only for pain relief were less likely to report heavy drinking or other drug use than were those who took them for other reasons or who reported multiple motivations that included pain relief.

According to the authors of the study, “future clinical and research efforts should attempt to differentiate between motives for nonmedical use of prescription opioids because the present study identified subtypes that were significantly associated with medical use of prescription opioids and substance use behaviors. Notably, we found that more than seven in every 10 nonmedical users of prescription opioids motivated by pain relief reported a lifetime history of medical use of prescription opioids.”

Other studies indicate that many adolescents obtain opioids from their own previous prescriptions.

“It is important to keep in mind that prescription opioids are the foundation for the treatment of acute and chronic pain and these medications are highly efficacious when used properly,” McCabe said. “These results suggest that appropriate pain management and careful therapeutic monitoring could contribute to reductions in the nonmedical use of prescription opioids among adolescents.”

Screening efforts should be used to differentiate between adolescents who need help with pain management and those who need a more comprehensive assessment for substance use disorders, the researchers conclude.

The findings appear in the August issue of the Archives of Pediatrics & Adolescent Medicine.

McCabe collaborated on the study with Carol Boyd, director, U-M Institute for Research on Women and Gender; James Cranford, research assistant professor, Addiction Research Center; and Christian Teter, assistant professor, Northeastern University and the Alcohol and Drug Abuse Treatment Program at McLean Hospital in Massachusetts.

Substance Abuse Research Center: http://sitemaker.umich.edu/umsarc/home

IRWG: http://irwg.research.umich.edu

Archives of Pediatrics & Adolescent Medicine: http://archpedi.ama-assn.org

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