The effects of alcohol, cannabis, and cigarette use on the initiation, reinitiation and persistence of non-medical use of opioids, sedatives, and tranquilizers in adults.

Background: Non-medical prescription drug use (NMPDU) has been a growing concern due to increased prevalence and severity of consequences. Epidemiological research has identified alcohol, cannabis, and cigarette use to be associated with NMPDU and initiation. However, studies have not examined stages of NMPDU in relation to other substances, which can highlight salient factors associated with high risk stages of NMPDU, such as reinitiation and persistence.

Methods: This study used an adult sample from the National Epidemiologic Survey of Alcohol and Related Conditions Wave 1 (2001-2002) and Wave 2 (2004-2005) data. We examined non-users, prior users, and current users of opioids and sedatives/tranquilizers at risk of initiation, reinitiation, and persistence between Wave 1 and Wave 2 in relation to early-onset and frequency of cannabis, cigarette, and alcohol use, controlling for sociodemographics.

Results: Early-onset of cigarette and alcohol use increased the odds of opioid use initiation; early-onset of cannabis, cigarette, and alcohol use increased the odds of sedative/tranquilizer use initiation and opioid reinitiation, persistence, while early-onset cannabis increased the odds of sedative/tranquilizer reinitiation and persistence. Frequency of cannabis and cigarette use predicted all three stages of opioid use, initiation/reinitiation of sedatives/tranquilizers, and frequency of cannabis use alone predicted sedative/tranquilizer persistence.

Conclusions: This study provided evidence that differentiating among those who have experienced initiation, reinitiation, or persistence of NMPDU via early-onset and frequency of alcohol, cigarettes, and cannabis is vital, as there are specific aspects that influence risk. Therefore, tailoring interventions at different stages to reduce NMPDU is crucial.