Motivations for the nonmedical use of prescription drugs in a longitudinal national sample of young adults

People's motivations for nonmedical use of prescription drugs (NMUPD) are not well studied, particularly in longitudinal representative samples. However, understanding which motivations are most popular and how these change over time for specific groups is important to inform interventions for NMUPD. The current study examined how young adults' motives for NMUPD changed over young adulthood, using a nationally representative sample of 12,223 young adults in 36 cohorts (1976–2012) as part of the Monitoring the Future study across three biennial waves (waves 1, 2, 3: modal ages 19/20, 21/22, and 23/24 years). We investigated these young adults' motivations for using stimulants, central nervous system depressants, and opioids when controlling for possible cohort effects. We included sex and college attendance as potential moderators. Participants commonly reported recreational and self-treatment motivations over time and across drug classes, reporting four to five popular motivations in each drug class. Generalized estimating equations repeated measure analyses revealed relatively stable NMUPD motivations across young adulthood. Participants reported some reductions in experimentation and boredom as motivations for NMUPD and increases in certain self-treatment motivations, depending on prescription drug class. Overall, men were more likely to endorse recreational motivations, whereas women were more likely to endorse self-treatment motivations, though this varied somewhat by prescription drug class. Young adults not enrolled in college courses were more likely to endorse using stimulants nonmedically for different reasons than their peers who were enrolled. NMUPD prevention and treatment efforts tailored to the young adult population should include methods to reduce both self-treatment and recreational use and need to consider prescription drug class, sex, and college attendance. •This study tested motives for non-prescription drug use in young adults over time.•Recreation and self-treatment motives were common over time and across drug classes.•Men were more likely to endorse recreational motivations.•Women were more likely to endorse self-treatment motivations.•College course enrollment impacted motivations for stimulant use.