Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Wendy Kliewer, PhD


Young adults are most at-risk for the non-medical use of prescription drugs (NMUPD) and many of its associated negative consequences. Understanding this population’s motivations for use can help to inform efforts to reduce NMUPD. Past research has been limited in scope, consisting primarily of cross-sectional work with college students focusing on prescription stimulants. The current study researched how motivations for NMUPD changed over young adulthood using three waves of data from a longitudinal, nationally representative sample of 14,990 19 to 24 year olds in the Monitoring the Future study cohorts collected between 1976 to 2013. Prescription stimulants, central nervous system (CNS) depressants, and opioids were investigated, along with sex and college attendance as potential moderators. Differences in NMUPD motivations for young adults who initiated NMUPD in high school versus in early young adulthood were studied. Additionally, motivation patterns of new users were investigated. Analyses indicated that both recreational and self-treatment motivations commonly were reported over time and across drug classes, with four to five popular motivations acknowledged in each class. In general, generalized estimated equations repeated measure analyses found that NMUPD motivations remained relatively stable across young adulthood, with some reductions for the motivations of experimentation and boredom, and an increase in select self-treatment motivations. Overall, men were more likely to endorse recreational motivations, while 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 non-medically for different reasons than their peers who were enrolled. There also were differences in motivations based on if young adults initiated NMUPD in high school compared to when they were 19/20 years old. However, motivations were fairly consistent across young adult development regardless of when NMUPD was initiated. These data suggest that efforts aimed at preventing or reducing NMUPD in young adult populations should include targets to reduce both self-treatment and recreational motivations; may need to be tailored by prescription drug class, sex, and college attendance status; could start in high school; and can be used for new and continued users across young adulthood.


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