Prevalence of Over-the-Counter Drug Abuse and Associated Psychosocial Factors Among High School Students: A Nationwide Cross-Sectional Survey in Japan.

Aim: This study estimated the prevalence of over-the-counter (OTC) drug abuse among high school students in Japan and clarified the predictors related to their school and home life.

Methods: A nationwide cross-sectional survey was conducted between September 2021 and March 2022. The survey included 41 357 valid responses from 202 randomly selected regular high schools in Japan. Respondents were asked about their history of OTC drug abuse within the past year, which was the primary outcome of this study. Multivariate logistic regression analyses were performed to identify the predictors of OTC drug abuse.

Results: The estimated prevalence of OTC drug abuse over the past year was 1.5% (95% CI: 1.4-1.6). Dissatisfaction with school life (AOR = 2.57, 95% CI = 1.80-3.66), hours spent in a day without parents (AOR = 1.59, 95% CI = 1.27-2.00), and COVID-19-related stress (AOR = 1.53, 95% CI = 1.14-2.05) significantly increased the risk of OTC drug abuse. Conversely, positive extracurricular activities (AOR = 0.80, 95% CI = 0.63-1.00), close communication with the mother (AOR = 0.66, 95% CI = 0.51-0.87), and high drug-refusal skills (AOR = 0.57, 95% CI = 0.41-0.79) significantly reduced the risk.

Conclusions: OTC drug abuse is widespread among high school students in Japan, and attention should be paid to students who are isolated at school and home. Therefore, it is important to develop effective prevention, education, and treatment programs for adolescents that consider the risks and protective factors associated with OTC drug abuse.