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Try out PMC Labs and tell us what you think. Learn More. Prescription drug misuse i. Limited studies focus on prescription drug misuse among young men who have sex with men YMSM, aged 18—29 years.

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The purpose of this study was to explore personal motivations for prescription drug misuse among YMSM, including the possible connection between misuse and sexual behaviors. As part of a larger mixed methods study of YMSM recruited in Philadelphia during —, we conducted semi-structured qualitative interviews with 25 of these participants to gather additional contextual information about their prescription drug misuse. We conducted thematic analysis of qualitative data.

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While our corroborated literature on motives for misuse of prescription drugs, our data yielded some distinct motivations specific among YMSM. Prescription drugs were commonly misused within the broader contexts of participants' polysubstance use, adding to the ificance of this problem.

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While substance use is likely related to various psychosocial issues impacting YMSM, it also may lead to ificant health consequences. support the need to include prescription drugs and polysubstance use in harm reduction messages and treatment approaches aimed at substance using YMSM.

Prescription drug misuse, defined as taking a prescription drug i. A few studies have explored prescription drug misuse among sexual minority youth Corliss et al,and among young men who have sex with men YMSM, aged 18—29 years Kecojevic et al, and found risk for prescription drug misuse to be high in sexual minority populations. To develop appropriate public health prevention and intervention strategies, researchers need to understand which subpopulations are at high risk for prescription drug misuse Zacny et al.


The role of motives for prescription drug misuse among young adults, which has been investigated in prior quantitative and qualitative studies, varies depending on the type of prescription drug. For example, the most commonly cited reasons for misuse of opioids include self-medicating to relive pain, to get high, to relax, to experiment, or to monitor the intake of other substances McCabe et al. Tranquilizers or benzodiazapines are often misused for their therapeutic indication, i.

A of different motives were cited for prescription stimulant misuse such as enhancing academic achievement Stein, ; Arria et al. The majority of prior research on motivations for prescription drug misuse has been conducted among adolescents, young women, college students, or high-risk populations i. Literature on motivations for prescription drug misuse among MSM and sexual minorities is scant.

Craigslist Norco CA sex one such quantitative study of MSM ages 18—78 attending gay pride festival Benotsch et al. The lack of literature investigating motivations for prescription drug misuse among MSM is surprising given that a of prior studies have examined motivations for use of popular club drugs, i.

Although some common perceived sexual effects exist across club drugs, motivations and unique sexual effects for each club drug varied among MSM Palamar et al. Another qualitative study of 16 Latino drug-using gay men in San Francisco found that participants used drugs to cope with sexual identity, to feel like part of the mainstream gay community, and to reduce sexual inhibitions Bauermeister, Additionally, prescription drug misuse often occurs within a larger context of polysubstance use, defined as the consumption of more than one drug over a defined period, simultaneously or at different times for either therapeutic or recreational purposes Connor et al.

In this analysis, we examined motives specific for prescription drug misuse in a sample of YMSM who are current substance users. We focus specifically on YMSM because of their greater risk of drug use compared to their heterosexual peers Cochran et al.

Prior research suggests that substance use in MSM plays an important role in high-risk sexual behaviors including unprotected anal intercourse UAI and having multiple sex partners Colfax et al. Thus, we aimed to identify, describe, and analyze the motives for and meanings of prescription drug misuse among a sample of substance using YMSM in Philadelphia.

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In particular, we sought to determine motivations for prescription drug misuse that are most important to YMSM. This analysis used both quantitative survey data e.

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This mixed methods approach Creswell has been used ly to describe risk Craigslist Norco CA sex and patterns of substance use among smaller samples of young adults Lankenau et al. Briefly, between November of to July ofYMSM ages 18—29 years who had misused prescription drugs in the past 6 months were recruited in Philadelphia to complete a larger structured, quantitative interview. We inquired about misuse of opioids, such as Vicodin and OxyContin, tranquilizers, such as Xanax and Klonapin, and stimulants, such as Adderall and Ritalin.

Recruitment involved active and passive distribution of fliers and study cards at nightclubs, coffee houses, LGBT youth organizations, social service agencies, craigslist. Those calling the study office to express an interest in participation were screened by telephone and informed that the purpose of the study was to better understand behaviors of YMSM such as drug use and sexual behaviors.

Upon completion of the quantitative survey component of the study, selected YMSM were invited to participate in an in-depth interview. Interviews were conducted by the first author in private offices at the Drexel University School of Public Health.

The semi-structured instrument consisted of four interview modules: substance use i. What do you like about that drug? What are some of reasons you used these drugs?

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Have you used any prescription drugs before having sex? Interviews lasted from 60 to 90 minutes and were audio-recorded.

Data from quantitative surveys on these 25 participants were used to provide more comprehensive portraits of participants, to support their qualitativeand are integrated with the interview findings below. Descriptive analyses were conducted using the SPSS All interviews were transcribed verbatim by a hired research assistant and imported in Atlas. Given the exploratory nature of this study, data analysis employed an inductive coding process. Analysis was guided by an awareness of the literature, which served as a point of origin for initial coding.

After initial review of transcripts during which we identified narratives that revolved around motivations for prescription drug misuse, we used a system of free coding to develop of concepts and consistent themes emerging from the data.

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Using ly identified coding procedures, we reconstructed codes filling inexpanded on code definitions extendingcollapsed or combined codes bridgingand added new codes to the list surfacing. Selective coding and memoing were also pursued to further define and interrogate. This process continued until all relevant themes were identified. In addition to overall data coding, a profile of each participant was developed that summarized his demographic characteristics.

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In the that follow, pseudonyms are used to identify participants. Socio-demographic and drug use characteristics of the qualitative sample mirrored those of the larger, quantitative, sample which are reported elsewhere Kecojevic et al. In Table 1we present these characteristics for the 25 MSM who participated in the qualitative interview. Socio-demographics and drug behaviors in the past 6 months of YMSM who participated in in-depth, semi-structured interviews. Opioids were the most commonly misused prescription drugs in the past 6 months, followed by tranquilizers and stimulants.

Of eight participants who reported using opioids in the past 6 months before having sex, seven reported not using condoms consistently. Of nine participants who reported using tranquilizers in the past 6 months before sex, four reported inconsistent use of condoms. Seven participants reported using stimulants in the past 6 months before sex, all of which reported inconsistent use of condoms. In our analysis, we highlight a of motives for prescription drug misuse that are frequent and salient for YMSM.

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We present our findings as distinctive themes and use specific examples of each prescription drug class within each theme. below illustrate the major motives for prescription drugs misuse derived from our data and point to some specific patterns. Within each motivation category, we describe occurrences of polysubstance use, which was widespread in this sample. Such motives often arose in the presence of their friends, as described by this college student, who took Percocet:.

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I was with my friends, and we just decided to do that. However, more often narratives centered around social activities i.

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Motivations included intent to use for social benefits, such as reducing anxiety when around other gay men. These drugs allowed participants to overcome social inhibitions when interacting with other men, allowing them to feel more confident and accepted in gay nightlife venues, and among their peers. It did make it more fun and more exciting. We took a lot of pictures that night. I was in my own little zone, I was in my own little world.

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I felt powerful. They really get you like that, Xanis. It's all about me, I just felt like I was a boss, I wasn't so shy, I wasn't so timid…I was more bold. Like I almost felt like the incredible hulk a little bit, you know?

Some participants described their misuse of prescription drugs as either an attempt to substitute a night of alcohol consumption or as a mean of achieving a level of soberness that will allow them to continue with dancing in a club. For example, one participant suggested that taking opioids was a substitute for drinking alcohol and might have led to reduced alcohol consumption for a night, which made sense economically for him:.

Another participant used stimulants to reduce alcohol intoxication. This narrative centered on using prescription drugs to "party" within the contexts of parties and dance clubs, as an aid to staying up and awake well into the night:.

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At nighttime when I'm too drunk, I'll take the Adderall to straighten me up a little bit, open my eyes, be more attentive. So, I'm always, feeling like I've got energy, I can go forever without stopping. These users take drugs in sequences so as to induce certain responses at specific points over the course of an evening.

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