OBJECTIVE Adolescent controlled prescription drug misuse (PDM) co-occurs with significant consequences, including lower educational achievement, substance use disorder (SUD) symptoms, and psychopathology. Nonetheless, adolescent PDM sources and the prevalence of other substance use, SUD, and mental health outcomes associated with sources remain poorly understood. METHOD Data were from the 2009 to 2014 National Survey on Drug Use and Health, including 103,920 adolescents (12-17 years of age). Six mutually exclusive sources were used: physician source only, theft/fake prescription only, friend/relative for free only, purchases only, other source only, or multiple sources. Analyses occurred separately for prescription opioids, stimulants, and tranquilizer/sedatives. PDM source prevalence across adolescents and by sex and school enrollment/engagement were estimated. Adjusted odds of past-year DSM-IV substance-specific SUD, marijuana use, any SUD, major depressive disorder (MDD), anxiety diagnosis, mental health treatment, and past-month binge drinking were estimated by source. RESULTS Friends/relatives, for free, was the most common source (29.0%-33.2%), followed by physician sources for opioids (23.9%), purchases for stimulants (23.5%), and tranquilizer/sedatives (22.7%). Few school enrollment/engagement differences existed, but female adolescents were more likely to use multiple sources. Over 70% of adolescents using multiple sources had a past-year SUD. Multiple sources, purchases, and theft/fake prescription were more strongly associated with other substance use than physician source use, and multiple source use was linked with MDD. CONCLUSION Adolescents using multiple sources, purchases and theft/fake prescriptions have elevated rates of other substance use, SUD and MDD and particularly warrant intervention. Also, adolescents with other SUD and MDD should be screened for PDM and misuse sources.

中文翻译：

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处方药滥用：青少年控制药物的来源。

目标青少年控制的处方药滥用（PDM）并发发生，其后果严重，包括教育程度较低，物质使用障碍（SUD）症状和精神病理学。尽管如此，对青春期PDM来源以及与该来源相关的其他物质使用，SUD和心理健康结局的普遍性仍知之甚少。方法数据来自2009年至2014年全国药物使用和健康调查，其中包括103,920名青少年（12-17岁）。使用了六个互斥的来源：仅医生来源，仅盗窃/伪造处方，仅朋友/亲戚免费，仅购买，仅其他来源或多个来源。分别对处方阿片类药物，兴奋剂和镇静剂/镇静剂进行了分析。估计了各年龄段以及按性别和学校入学率/参与率划分的PDM来源患病率。通过来源估算了过去一年DSM-IV物质特定SUD，大麻使用，任何SUD，重大抑郁症（MDD），焦虑症诊断，心理健康治疗和过去一个月的暴饮暴食的调整后几率。结果朋友/亲戚是免费的，是最常见的来源（29.0％-33.2％），其次是阿片类药物（23.9％），兴奋剂的购买（23.5％）和镇静剂/镇静剂（22.7％）。几乎没有入学率/入学率差异，但是女性青少年更可能使用多种来源。超过70％的使用多种来源的青少年患有过往一年的SUD。多种来源，购买和盗窃/伪造处方与其他物质使用相比，与医生来源使用的关联更紧密，并且多源使用与MDD相关联。结论使用多种来源，购买和盗窃/伪造处方的青少年的其他物质使用，SUD和MDD的发生率升高，尤其值得干预。另外，应筛查患有其他SUD和MDD的青少年是否存在PDM和滥用来源。