Predicting Young Adults’ Risk for Engaging in Prescription Drug Misuse in Daily Life from Individual,Partner,and Relationship Factors

Background: Mounting evidence based on retrospective and global assessments has established associations between prescription drug misuse and illicit drug use, alcohol abuse, mental health problems, risky sexual behaviors, and overdose deaths. However, there is a notable absence of identified risk and protective factors for an individual's likelihood of engaging in misuse in real-world environments. Methods: Using an experience sampling approach, the authors collected repeated moments of young adults’ (n = 95 participants drawn from 49 romantic couples) prescription drug misuse instances in daily life and tested multiple factors associated with the misuse. Results: When examined in separate multilevel models, individual and relationship factors (but not partner factors) reliably predicted the likelihood of females’ and males’ prescription drug misuse in daily life. Specifically, females’ elevated dysphoria symptoms, alcohol problems, and relationship closeness were linked with an increased likelihood of misuse, whereas cohabiting decreased the likelihood of their misuse. Males’ higher levels of illicit drug use and relationship closeness were associated with increased likelihood of misuse, whereas their dysphoria symptoms were related to a lower likelihood of misuse. When examined in models that considered the predictors simultaneously, females’ misuse was associated with individual, partner, and relationship factors, whereas males’ misuse was not reliably associated with any of the factors. Conclusions: An experience sampling approach was effective for the near-real-time assessment of young adults’ prescription drug misuse in daily environments, and the likelihood of misuse was associated with risk and protective factors from multiple levels of influence. Education and treatment efforts designed to reduce prescription drug misuse may need to be tailored to accommodate males’ and females’ distinct predictors of misuse.