Endemic asthma inhaler abuse among antisocial adolescents.

BACKGROUND Approximately 40 million prescriptions were dispensed in the U.S. for asthma inhalers in 2006. Although the pervasive distribution of asthma inhalers warrants greater attention to possible misuse of these products, few investigations have examined asthma inhaler misuse. The purpose of this study was to describe the prevalence, correlates and consequences of asthma inhaler misuse among antisocial youth. METHOD A cross-sectional survey with face-to-face interviews assessing substance use, psychiatric symptoms, and antisocial behaviors among adolescents (N=723) in residential treatment. RESULTS More than 26% (N=193) of youth were diagnosed with asthma; 91.2% of asthmatic youth had received a prescription for an inhaler. Of the 373 youth who had used a prescribed or non-prescribed asthma inhaler, 23.6% (N=88) reported using an inhaler to get high (i.e., were inhaler misusers). Asthma inhaler misusers had an earlier onset of antisocial conduct, significantly greater levels of current psychiatric distress and lifetime suicidality, higher rates of lifetime substance use problems and volatile solvent abuse, and significantly higher levels of temperamental impulsivity and fearlessness than did inhaler non-users or users. Caucasian racial status, current level of psychiatric distress, and lifetime volatile solvent abuse significantly distinguished lifetime asthma inhaler users and misusers in multivariate logistic regression analyses. Asthma inhaler misusers were significantly more likely to report euphoria, memory problems, slurred speech, blurred vision, confusion, dizziness, and a variety of other acute reactions to asthma inhaler use than were asthma inhaler users. CONCLUSIONS Asthma inhaler misuse for the purposes of getting high was prevalent among antisocial youth, co-occurred with other psychiatric and substance use problems, and was associated with adverse consequences.