Recreational use of prescription medications among Canadian young people: Identifying demographic and geographic disparities
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BACKGROUND: The nonmedical use of prescription medications among young people has escalated substantially in recent years. Certain subgroups of adolescents are at greater risk than others, including rural youth, however this has yet to be adequately quantified in Canada, and risk and protective factors in rural communities remain understudied. OBJECTIVES: The first objective of this thesis was to characterize the nonmedical use of prescription drugs in Canadian youth by age, gender, socioeconomic, immigrant and geographic statuses. The second objective was to examine time-use patterns among rural young people as they may relate to their risk of using prescription drugs recreationally. METHODS: Data were obtained from 10,429 youth in grades 9 and 10 across Canada who participated in the 2009/2010 Cycle of the Health Behaviour in School-aged Children survey. Participants documented information about their nonmedical use of opioid pain relievers, stimulants and sedative or tranquilizer medications in the past year. Cross-tabulations and multi-level regression analyses were used to determine proportions and estimate risk by demographic subgroups, and among 2393 rural youth, to examine associations with time-use patterns RESULTS: Females were 1.25 times more likely to report recreational use of pain relievers (95% CI: 1.04-1.51). Lower SES students were 2.41 times more likely to report recreational use of any type of medication (95% CI: 1.94-2.99). Pain reliever use was highest among rural youth living in close proximity to urban centres. Frequent peer time after school and in the evenings was associated with a 1.73 (95% CI: 1.10-2.73) and 2.16 times (95% CI: 1.30-3.60) increased risk of using prescription drugs recreationally, however associations were attenuated when adjusted for other risk factors. Non-participation in extracurricular activities was associated with a 50% increase in risk for nonmedical use of prescription drugs, even when adjusted for other risk factors. CONCLUSIONS: Females, those of low SES and some rural youth, especially those who do not participate in extracurricular activities, are at increased risk for using prescription drugs recreationally. Results from this thesis point to priority areas for public health and education in reducing harms associated with nonmedical use of prescription drugs.