Prevalence of and Pathways to Non-Medical Use of Prescription Medications Among Adolescents and Young Adults in Urban Switzerland

Non-medical use of prescription medications (NUPM) is on the rise in the Western world, especially among adolescents and young adults. In numerous countries, NUPM has increased during the COVID-19 pandemic. Many young people assume that prescriptions are safer to use than illicit substances. After all, they are prescribed by health care providers and dispensed by pharmacists. Accordingly, many young people engage in NUPM for recreation, self-medication, or self-enhancement. In reality, however, NUPM is linked to a variety of adverse health outcomes. It is also associated with an increased risk of problematic substance use patterns, including polysubstance use (e.g., NUMP along with use of alcohol or additional psychoactive substances). To effectively prevent NUPM, it is essential to understand the characteristics of young people at increased risk for this behavior, but research on pathways to NUPM in Switzerland is scarce. Indeed, even the prevalence of NUPM among young people in Switzerland is not well-understood, as are recent changes in NUPM due to the COVID-19 pandemic. The proposed PhD project addresses these gaps by drawing on and contributing to three large-scale community-representative datasets of young people, subsuming a total of ~55,000 participants (Zurich Youth Survey, The Zurich Project on Social Development from Childhood to Adulthood, Monitoring the Future Study). NUPM will be assessed with self-report, hair, and wastewater data, including items devised by the applicant. Data on NUPM will be available from before, during, and (presumably) after the COVID-19 pandemic. Three broad developmental pathways to NUPM from childhood to early adulthood will be examined: early substance use, psychopathology, and social pathways. This project will provide novel insights into the prevalence of and pathways to NUPM, which is key for developing effective prevention and interventions. With the inclusion of data from the United States, it will also provide an in-depth look at NUPM in an international context.