Non-medical prescription use increases the risk for the onset and recurrence of psychopathology: results from the National Epidemiological Survey on Alcohol and Related Conditions

Aims Given the rising rates of the non-medical use of prescription medications (NUPM) and strong cross-sectional associations between psychopathology and NUPM, we examined whether a history of NUPM increased the risk for onset and recurrence of psychopathology. Design Longitudinal data are from waves 1 and 2 of the National Epidemiological Survey on Alcoholism and Related Conditions (NESARC). Setting The NESARC is a nation-wide, household-based survey. Participants A total of 34 653 US resident participants who completed both NESARC waves were included in analyses. Measurements Primary measures were history of NUPM and Axis I psychopathology at wave 1. Wave 1 personality disorder diagnosis and sociodemographic characteristics were used as control variables. Findings Design-based logistic regression analyses indicated that life-time and past year NUPM at wave 1 increased risk for onset of psychopathology among those with no history of psychopathology at baseline, with particular risk for non-NUPM substance use and bipolar disorders. Life-time and past year NUPM were associated with recurrence of alcohol and non-NUPM substance use disorders among those with these diagnoses at baseline. In contrast, life-time and past year NUPM was associated with the onset of all examined disorders among those with a different diagnosis at baseline. Conclusions Non-medical use of prescription medications is a consistent risk factor for the onset and recurrence of psychopathology.