Depression Linked to Higher Prescription Drug Misuse Among Youths: JAMA
USA: A cross-sectional analysis of the 2023 and 2024 National Survey on Drug Use and Health (NSDUH) found that youths with depression were more likely to misuse prescription drugs and develop prescription drug use disorders than those without depression. For certain medications, misuse was more frequently driven by attempts to cope with emotional distress. The findings highlight the need to address barriers to integrated mental health and substance use treatment to prevent self-medication from progressing to substance use disorders.
The study was conducted by Michael S. Toce, Division of Emergency Medicine, Boston Children’s Hospital, Massachusetts, and colleagues. The researchers examined the prevalence of prescription psychotherapeutic drug misuse and the reasons behind it among adolescents and young adults with and without depression.
Depression among young people has become an important public health concern. Individuals experiencing depressive symptoms may turn to prescription medications to manage difficult emotions, potentially increasing their risk of developing substance use disorders. Understanding these patterns could help clinicians identify vulnerable individuals and improve access to appropriate mental health and addiction services.
Published in JAMA Network Open, the study analysed data from 22,906 adolescents aged 12–17 years and 27,723 young adults aged 18–25 years included in the 2023 and 2024 NSDUH. The researchers assessed whether participants had experienced a major depressive episode (MDE) during the previous year and examined their reported misuse of prescription psychotherapeutic drugs, the presence of prescription drug use disorders, and motivations for misuse. Statistical models were used to compare outcomes between participants with and without depression.
The analysis revealed the following findings:
- Depression was common among young people: Approximately 16.3% of respondents reported a major depressive episode in the previous year, representing an estimated 9.8 million individuals nationally.
- Higher prevalence of prescription drug misuse: Among youths with a past-year depressive episode, 6.6% reported prescription psychotherapeutic drug misuse, while 6.0% met the criteria for a prescription drug use disorder.
- Increased odds of misuse and addiction-related disorders: Young people with depression had approximately twice the odds of reporting prescription drug misuse (odds ratio [OR], 2.09) and four times the odds of prescription drug use disorder (OR, 4.02) compared with those without depression.
- Emotional distress influenced misuse: Among respondents reporting misuse, those with depression were more likely to cite managing feelings and emotions as their primary motivation for using opioid analgesics (10.2% versus 3.7%) and tranquilizers (29.8% versus 13.2%) than their counterparts without depression.
The researchers noted that emotional distress may drive prescription drug misuse among youths with unmet mental health needs. However, self-reported data, the cross-sectional design, and exclusion of individuals experiencing homelessness limit the findings.
The authors concluded that youths with depression are more likely to misuse prescription drugs and develop related disorders, highlighting the need for integrated mental health and substance use treatment to prevent self-medication from progressing to persistent substance use disorders.
Reference:
Toce MS, Porter JJ, Lim JK, Bourgeois FT. Substance Misuse Prevalence and Risk Factors in Adolescents and Young Adults With Depression. JAMA Netw Open. 2026;9(10):e2639343. doi:10.1001/jamanetworkopen.2026.39343
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