Parent and peer disapproval were examined as potential predictors of recreational use of over-the-counter (OTC) and prescription pain medication. Risk perception was studied as a potential mediator of the effects of parent and peer disapproval. Four hundred and sixty-five college students ( , ) were recruited between September 2009 and September 2010. Participants completed an online survey about their recreational medication use, other substance use, and correlates of use. Path analyses showed that predictors of OTC and prescription pain medication recreational use are largely similar to predictors of marijuana use in college students such that risk perception mediated both the effect of parent and peer disapproval on dichotomous misuse, and peer disapproval had a significant direct effect on dichotomous misuse. Prevention interventions for recreational use of pain medication should target risk perception and peer disapproval. 1. Introduction Over-the-counter (OTC) and prescription drug misuse are the nonmedical use of medication, which is used without a prescription or for the feeling caused by the drug [1]. Motivations for misuse include alertness and concentration effects and getting high [2–4]. OTC and prescription drugs are fast becoming the drugs of choice for adolescents, with the National Center on Addiction and Substance Abuse [5] reporting a 212% increase in prescription drug misuse among adolescents between the 1992 and 2003 period. The National Survey on Drug Use and Health [6] and the Drug Abuse Warning Network [7] have also documented an increase in OTC drug misuse since 1992. Prescription drug misuse has increased independent of and relative to illicit drug use. Compton and Volkow [8] have reported that pain medication is second only to marijuana in being the most popular drug of choice for adolescents. Given that parent and peer influence have been highlighted as major predictors of substance use in adolescents [9] and that pain medications are the most widely abused prescription drugs [10], we hypothesize that parent and peer influence will affect pain medication misuse, specifically misuse to get high (recreational use), in the same way these influences affect marijuana use. Very little is known about what is responsible for the increase in prevalence and incidence rates of prescription drug misuse. It has been suggested that adolescents’ and young adults’ OTC and prescription drug misuse could be explained by their perception that such drugs are safer than illicit drugs, by the ease of access to drugs and by lower societal stigma
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