Motives for nonmedical use of prescription opioids among high school seniors in the United States: self-treatment and beyond

Arch Pediatr Adolesc Med. 2009 Aug;163(8):739-44. doi: 10.1001/archpediatrics.2009.120.


Objectives: To assess motives for nonmedical use of prescription opioids among US high school seniors and examine associations between motives for nonmedical use and other substance use behaviors.

Design: Nationally representative samples of US high school seniors (modal age 18 years) were surveyed during the spring of their senior year via self-administered questionnaires.

Setting: Data were collected in public and private high schools.

Participants: The sample consisted of 5 cohorts (2002-2006) of 12 441 high school seniors.

Main outcome measures: Self-reports of motives for nonmedical use of prescription opioids and substance use behaviors.

Results: More than 1 in every 10 high school seniors reported nonmedical use of prescription opioids and 45% of past-year nonmedical users reported "to relieve physical pain" as an important motivation. The odds of heavy drinking and other drug use were lower among nonmedical users of prescription opioids motivated only by pain relief compared with nonmedical users who reported pain relief and other motives and those who reported non-pain relief motives only. The odds of medical use of prescription opioids were lower among nonmedical users who reported only non-pain relief motives compared with other types of nonmedical users.

Conclusions: The findings indicate motives should be considered when working with adolescents who report nonmedical use of prescription opioids. Future efforts are needed to identify adolescents who may need appropriate pain management and those at increased risk for prescription opioid abuse.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Alcohol Drinking
  • Analgesics, Opioid / administration & dosage*
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Drug Prescriptions
  • Female
  • Humans
  • Logistic Models
  • Male
  • Motivation*
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / psychology*
  • Pain / drug therapy*
  • Psychology, Adolescent
  • Smoking / epidemiology
  • Students / psychology*
  • Surveys and Questionnaires
  • United States / epidemiology


  • Analgesics, Opioid