Everybody’s Doing It

In this article, we present findings from a qualitative National Institute on Drug Abuse-funded study of nonmedical prescription drug users in the San Francisco Bay Area. We interviewed young adults between the ages of 18 and 25 years, who used prescription drugs nonmedically at least 12 times in the 6 months prior to the interview. Employing Aker’s Social Learning Theory and Zinberg’s Drug, Set, and Setting, we explore the factors that contributed to participants’ choices to begin using prescription drugs nonmedically. Social Learning Theory provides the framework for understanding how deviant behaviors are learned and imitated, while set and setting emphasizes the psychological and social contexts of initiation and the ways in which the set and setting of the initiating user were influenced by exposure, motivation, access, and setting. Together, social learning, and set and setting allow us to understand the interaction of individual and social factors contributing to nonmedical prescription drug use initiation.

[1]  J. Potter,et al.  Substance use histories in patients seeking treatment for controlled-release oxycodone dependence. , 2004, Drug and alcohol dependence.

[2]  J. Strang,et al.  Retrospective recall of heroin initiation and the impact on peer networks , 2007 .

[3]  A. Wheeler,et al.  Initiation into Methamphetamine Use: Qualitative Findings from an Exploration of First Time Use Among a Group of New Zealand Users , 2009, Journal of psychoactive drugs.

[4]  K. McEvoy,et al.  Negative Experiences on Ecstasy: The Role of Drug, Set, and Setting , 2002, Journal of psychoactive drugs.

[5]  S. McCabe,et al.  Prevalence and Motives for Illicit Use of Prescription Stimulants in an Undergraduate Student Sample , 2005, Journal of American college health : J of ACH.

[6]  E. Brink,et al.  Constructing grounded theory : A practical guide through qualitative analysis , 2006 .

[7]  Kathryn A. Becker-Blease,et al.  Stimulant Medication Use, Misuse, and Abuse in an Undergraduate and Graduate Student Sample , 2006, Journal of American college health : J of ACH.

[8]  Anja Walter,et al.  Deviant Behavior A Social Learning Approach , 2016 .

[9]  Anna De Fina,et al.  The ethnographic interview , 2019, The Routledge Handbook of Linguistic Ethnography.

[10]  D. Kandel The Parental and Peer Contexts of Adolescent Deviance: An Algebra of Interpersonal Influences , 1996 .

[11]  S. McCabe,et al.  Subtypes of nonmedical prescription drug misuse. , 2009, Drug and alcohol dependence.

[12]  A. Strauss,et al.  The Discovery of Grounded Theory , 1967 .

[13]  D. Korf,et al.  The Role of Peers in the Initiation and Continuation of Ecstasy Use , 2008, Substance use & misuse.

[14]  R. Orwin,et al.  Marijuana Initiation Among American Youth and Its Risks as Dynamic Processes: Prospective Findings from a National Longitudinal Study , 2009, Substance use & misuse.

[15]  D. Moore Beyond Zinberg's 'social setting': a processural view of illicit drug use. , 1993, Drug and alcohol review.

[16]  L. Kroutil,et al.  Nonmedical use of prescription stimulants in the United States. , 2006, Drug and alcohol dependence.

[17]  S. McCabe,et al.  Medical Use, Illicit Use, and Diversion of Abusable Prescription Drugs , 2006, Journal of American college health : J of ACH.

[18]  E. Khantzian The Self‐Medication Hypothesis of Substance Use Disorders: A Reconsideration and Recent Applications , 1997, Harvard review of psychiatry.

[19]  R. Carlson,et al.  Initiation to Pharmaceutical Opioids and Patterns of Misuse: Preliminary Qualitative Findings Obtained by the Ohio Substance Abuse Monitoring Network , 2006 .

[20]  B. Kuehn Opioid prescriptions soar: increase in legitimate use as well as abuse. , 2007, JAMA.

[21]  G. Quintero Rx for a Party: A Qualitative Analysis of Recreational Pharmaceutical Use in a Collegiate Setting , 2009, Journal of American college health : J of ACH.

[22]  Katherine B. Morton,et al.  Results from the 2008 National Survey on Drug Use and Health: National findings , 2009 .

[23]  M. Brecht,et al.  Methamphetamine use behaviors and gender differences. , 2004, Addictive behaviors.

[24]  E. Wish,et al.  Perceived Harmfulness Predicts Nonmedical Use of Prescription Drugs Among College Students: Interactions with Sensation-Seeking , 2008, Prevention Science.

[25]  S. McCabe,et al.  Sources of prescription drugs for illicit use. , 2005, Addictive behaviors.

[26]  R. Pihl,et al.  Characteristics of Methylphenidate Misuse in a University Student Sample , 2005, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[27]  P. Biernacki,et al.  TARGETED SAMPLING: OPTIONS FOR THE STUDY OF HIDDEN POPULATIONS , 1989 .

[28]  S. McCabe,et al.  Adolescents' Motivations to Abuse Prescription Medications , 2006, Pediatrics.

[29]  A. Weiner Emerging drugs of abuse in Connecticut. , 2000, Connecticut medicine.

[30]  J. Parsons,et al.  Initiation into methamphetamine use for young gay and bisexual men. , 2007, Drug and alcohol dependence.

[31]  P. Biernacki,et al.  Snowball Sampling: Problems and Techniques of Chain Referral Sampling , 1981 .

[32]  N. Breslau,et al.  Investigations of causal pathways between PTSD and drug use disorders. , 1998, Addictive behaviors.

[33]  J. Ford SOCIAL LEARNING THEORY AND NONMEDICAL PRESCRIPTION DRUG USE AMONG ADOLESCENTS , 2008 .

[34]  R. Friedman The changing face of teenage drug abuse--the trend toward prescription drugs. , 2006, The New England journal of medicine.

[35]  R. Akers,et al.  Social Learning and Social Structure: A General Theory of Crime and Deviance. , 2000 .

[36]  B. Sproule,et al.  Prescription opioid abuse in patients presenting for methadone maintenance treatment. , 2004, Drug and alcohol dependence.

[37]  C. Storr,et al.  Potential Influences on Initiation and Persistence of Extramedical Prescription Pain Reliever Use in the US Population , 2006, The Clinical journal of pain.

[38]  A. Strauss Basics Of Qualitative Research , 1992 .

[39]  J. Steele,et al.  Nonmedical Prescription Drug Use Among US College Students at a Midwest University: A Partial Test of Social Learning Theory , 2010, Substance use & misuse.

[40]  Alex Harocopos,et al.  Initiation into prescription opioid misuse amongst young injection drug users. , 2012, The International journal on drug policy.

[41]  R. Carlson,et al.  "I'm not afraid of those ones just 'cause they've been prescribed": perceptions of risk among illicit users of pharmaceutical opioids. , 2012, The International journal on drug policy.

[42]  K. G. Low,et al.  Illicit use of psychostimulants among college students: A preliminary study , 2002 .

[43]  D. DeWalt,et al.  Predictors of opioid misuse in patients with chronic pain: a prospective cohort study , 2006, BMC Health Services Research.

[44]  Anton J. Kuzel,et al.  Sampling in qualitative inquiry. , 1992 .

[45]  Weiner Al Emerging drugs of abuse in Connecticut. , 2000 .

[46]  B. Kuehn Opioid Prescriptions Soar , 2007 .

[47]  A. Weil,et al.  Drug, Set, and Setting: The Basis for Controlled Intoxicant Use , 1984 .

[48]  Laxmaiah Manchikanti,et al.  National drug control policy and prescription drug abuse: facts and fallacies. , 2007, Pain physician.