Prevalence and patterns of commonly abused psychoactive prescription drugs in a sample of university students from Lebanon: An opportunity for cross-cultural comparisons

Background: Concerns about psychoactive prescription drug abuse among youth are growing worldwide, but the majority of published studies remain from the US and Canada impeding cross-cultural comparisons. This study examines the prevalence, sources, motivations and substance-use correlates of commonly abused medications among youth from Lebanon. Methods: An IRB-approved cross-sectional study was conducted (May 2010) at the American University of Beirut. Proportionate cluster sampling was used to generate a representative sample of AUB students (n=570). A self-filled anonymous questionnaire was administered. Results: Lifetime medical and nonmedical prevalence of medications were (respectively): pain (36.9%, 15.1%), anxiety (8.3%, 4.6%), sleeping (6.5%, 5.8%) and stimulants (2.6%, 3.5%). Gender differences were not observed. Lebanese were least likely to report non-medical use. Nonmedical users mostly used the drugs for their intended purpose (e.g., sleeping to help in sleep, stimulants to increase alertness). Parents and pharmacists (without a doctor's prescription) were the top two sources of all medications, except for stimulants (friends predominated). Diversion was observed in about 20% of the medical users. Lifetime marijuana users and past year alcohol abusers were three times as likely to use any prescription drug nonmedically. Conclusions: In Lebanon, as in Western cultures, a considerable proportion of youth may be self-medicating. The absence of medical supervision coupled with motivations such as "to get high" renders this issue a high priority on the national youth agenda. Besides larger more comprehensive surveys, the findings signal the immediate need to reinforce relevant policies, and raise awareness among youth, parents, health professionals and other stakeholders.