Who is Engaging in Non-Medical Use of Prescription Drugs in Canada? An Intersectional Analysis

While non-medical use of prescription drugs (NMUPD) differs across sex and age groups, little is known about how NMUPD differs based on overlapping socioeconomic, health, and substance use characteristics. We identified patterns in the probability of NMUPD using chi-square automatic interaction detection (CHAID) analysis. Eighteen sociodemographic, health, and substance use variables were sourced from the 2023 Canadian Substance Use Survey from 32,586 respondents aged 15 and older. Overall, 2.2% of our sample engaged in NMUPD. Illegal drug use, self-rated mental health, disability, and student status emerged as key predictors of NMUPD. In a model without specific prescription drug use indicators, we observed the highest probability of NMUPD among individuals who used illegal drugs, particularly youth and young adults with a disability (25.0%). In a model with three specific prescription drug use indicators, males who used illegal drugs, prescription stimulants, and prescription opioids had the highest probability of NMUPD (74.5%). Our findings show clear patterns in NMUPD among this general population sample, especially related to illegal drug use, age, sex, disability, and mental health. It is important to consider how sociodemographic, health, and substance use factors work together to shape risks of NMUPD.