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Objective: To provide evidence of the economic burden of the non-medical prescription drug (NMPD) use on health services utilization: emergency room (ER) visits and inpatient hospital nights. Data: The 2009 National Survey on Drug Use and Health (NSDUH) cross-section (52,267 observations). Study design. We employ propensity score matching techniques controlling for a rich set of covariates to reduce the potential individual heterogeneity bias. Principal findings: Our results reveal a positive, statistically significant, and robust relationship between NMPD use and health services utilization both in adolescents and adults. The estimated effects for adults are slightly smaller in magnitude than those for adolescents. Conclusion: These results have important policy implications as the burden imposed on society by NMPD use might be greater than initially assumed. Efforts to curb NMPD use such as expansion of Prescription Drug Monitoring Programs (PDMPs), prevention interventions, and increased funds allocated to treat prescription drug abuse might be economically justified.