Prescription Drug and Alcohol Simultaneous Co-Ingestion in US Young Adults: Prevalence and Correlates

Simultaneous co-ingestion of prescription medication (e.g., opioid, tranquilizer/sedative, stimulant) and alcohol is associated with overdose and elevated substance use, but no studies have examined prescription drug misuse (PDM) and alcohol co-ingestion in U.S. young adults (18-25 years), despite the high rates of PDM in this age group. We used the 2015-19 National Survey on Drug Use and Health (young adult N = 69,916) to examine prevalence of past-month PDM-alcohol co-ingestion, PDM characteristics, and sociodemographic, physical health, mental health, and substance use correlates. Logistic regression examined correlates, comparing those without past-year PDM, those with past-year but not past-month PDM, those with past-month PDM without alcohol co-ingestion, and those with past-month PDM and alcohol co-ingestion. An estimated 585,000 young adults engaged in any past-month PDM-alcohol co-ingestion, or between 32.7% (opioids) and 44.6% (tranquilizer/sedatives) of those who were engaged in past-month PDM. Co-ingestion varied by educational status and was more common in males and white or multiracial young adults. All PDM-involved groups had elevated odds of suicidal ideation and other psychopathology, but substance use and substance use disorder (SUD) odds were significantly higher in young adults with co-ingestion, versus all other groups. To illustrate, 41.1% with opioid-alcohol co-ingestion had multiple past-year SUDs, versus 2.0% in those without past-year PDM. Young adults with co-ingestion are particularly likely to have problematic alcohol use and higher rates of SUD. Counseling about the risks of PDM-alcohol co-ingestion and screening for co-ingestion among those at risk are warranted to limit poor outcomes. Public Health Significance Young adults who engage in prescription medication and alcohol simultaneous co-ingestion have significantly greater alcohol consumption and significantly higher rates of substance use disorders (SUDs), including multiple concurrent SUDs, than those engaged in prescription drug misuse (PDM) without co-ingestion. The estimated 585,000 U.S. young adults engaged in past-month PDM-alcohol co-ingestion need comprehensive and multidisciplinary treatment to reduce their risk for poor outcomes.

Automated summary

In U.S. young adults (18-25 years), simultaneous co-ingestion of prescription medication and alcohol is associated with elevated risks of substance use disorders. Around 585,000 young adults engaged in past-month PDM-alcohol co-ingestion, with higher rates of problematic alcohol consumption and substance use disorders observed in this group. Counseling and screening for co-ingestion are recommended to prevent negative outcomes.