Because measures of nonmedical use of prescription pain relievers (NMUPPR) have been absent from the Youth Risk Behavior Survey (YRBS), which assesses health risk behaviors, little is known about whether NMUPPR is associated with other problem behaviors connected to the leading causes of morbidity and mortality among adolescents. This investigation examined associations between NMUPPR and risk behaviors related to injury, violence, tobacco, alcohol, illicit drug use, risky sexual behaviors, and physical activity. Self-report data were collected from 4,178 9th-12th grade students enrolled in 5 schools in 5 States using a modified version of the 2011 YRBS. Logistic regression (controlling for sex, race/ethnicity, and grade covariates) was used to assess independent associations with lifetime and 30-day NMUPPR and the other risk behaviors. Prevalence of lifetime and past 30 day NMUPPR was 19% and 10%, respectively. Students reporting NMUPPR during the past 30 days were 7 times more likely to report cigarette use (AOR=7.41), 6 times more likely to report marijuana use (AOR=6.62), driving after drinking (AOR=5.81), binge drinking (AOR=5.79), and ∼4 times more likely to report carrying a weapon (AOR=3.69) in the 30 days preceding the survey. Moreover, students reporting 30 day-NMUPPR were 9 times more likely to report using cocaine (AOR=8.95), 12 times more likely to report using methamphetamine (AOR=11.71), and 18 times more likely to report using heroin (AOR=17.64) during their lifetime. Findings suggest that NMUPPR is a salient drug-use behavior among adolescents. Furthermore, it clusters with other activities, suggesting that NMUPPR may be part of a syndrome of risk behaviors. To better inform policy, prevention, and treatment activities, NMUPPR items should become part of the YRBS. This project was supported by a grant from Purdue Pharma L.P.
© 2013 Published by Elsevier Inc.