Few studies have examined the relationship between alcohol consumption and nonmedical use of prescription drugs (NMUPD). To characterize this relationship, researchers analyzed data from 43,093 adults who had participated in a national survey on alcohol and related conditions.

• Of the overall sample, 65% drank and 3% took a prescription drug (opioid, sedative, tranquilizer, or stimulant) for a nonmedical reason in the past year. Approximately 8% had an alcohol use disorder (AUD).
• NMUPD was most common in subjects with past-year alcohol dependence (22%), followed by subjects with alcohol abuse only (8%), a heavy drinking episode* but no AUD (4%), neither a heavy drinking episode nor an AUD (2%), and abstinence (1%).
• In adjusted analyses, the odds of NMUPD were significantly greater among drinkers than abstainers (e.g., odds ratios 1.7 for subjects with neither a heavy drinking episode nor an AUD and 18.2 for subjects with alcohol dependence).
• The co-occurrence of AUDs and NMUPD was more prevalent among adults aged 18–24 years (42%) than among older subjects (24%).

Comments by R. Curtis Ellison, MD:
This study showed that drinkers, particularly those with an AUD, were more likely than abstainers to use a prescription drug for a nonmedical purpose.  As stated by the authors, these findings underscore the importance of thoroughly assessing prescription drug misuse while treating AUDs, especially among young adults.

*>=5 drinks in a single day for men, >=4 drinks for women

Reprinted with permission from Alcohol and Health: Current Evidence.