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AIMS – Tranquillisers and sedatives are valuable medicines with high misuse potential, increasingly used by adolescents without a doctor’s prescription. We examined the changing association between lifetime non-prescribed use of tranquillisers or sedatives and their prescribed use in European adolescents in 2003–2011. DESIGN – Cross-sectional data from 199,231 16-year-old students were collected through anonymous questionnaires administered in schools in 22 European countries participating in the European School Survey Project on Alcohol and Other Drugs (ESPAD) in 2003, 2007 and 2011. RESULTS – Logistic regression analyses showed a modest increase in lifetime non-prescribed use of tranquillisers or sedatives (adjusted OR [AOR] = 1.08, 95% CI: 1.06–1.11, p < 0.001) and a decrease in prescribed use (AOR = 0.89, 95% CI: 0.87–0.91, p < 0.001) between 2003 and 2011. Adjusting for gender and survey year, any versus no prescribed use increased the odds tenfold for non-prescribed use (AOR = 10.15, 99% CI: 9.60–10.74, p < 0.001). Adjusting also for changes in cannabis use did not affect the strength of the association. Interactions of factors with survey year showed that between 2003 and 2011, there was an increase of 38% in the odds that tranquilliser or sedative misusers had not used these drugs also with a doctor’s prescription (AOR = 1.38, 99% CI: 1.28–1.50, p < 0.001). CONCLUSION – The waning strength of the association between prescribed and non-prescribed use of tranquillisers or sedatives among adolescents may suggest changes both in the patterns of use and the channels of diversion and access to this class of medication in Europe

Trends in the association between prescribed and non-prescribed use of tranquillisers or sedatives among adolescents in 22 European countries