1
|
Badour CL, Flores J, Hood CO, Jones AC, Brake CA, Tipsword JM, Penn CJ, McCann JP. Concurrent and proximal associations among PTSD symptoms, prescription opioid use, and co-use of other substances: Results from a daily monitoring study. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:367-376. [PMID: 35901427 PMCID: PMC10157500 DOI: 10.1037/tra0001303] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) and nonmedical prescription opioid use (NMPOU) are linked. Much of the research documenting this association uses cross-sectional or longitudinal designs that describe patterns of use over extended intervals. The present study used a daily monitoring design to examine how daily fluctuations in PTSD symptoms predicted patterns of prescription opioid use (both medical and nonmedical) and co-use of other substances. This approach has distinct advantages for understanding proximal temporal relations between PTSD symptom variation and substance use patterns. METHOD Forty adults with clinical or subclinical PTSD and past-month NMPOU completed daily measures of PTSD symptoms, physical pain, prescription opioid use, and other substance use for 28 days using a smartphone application. RESULTS Same day co-use of prescription opioids and at least one other substance was common. Higher-than-typical PTSD symptoms on a given day (within-person) was associated with an increased likelihood of reporting NMPOU (overall and with co-use of one or more additional substances) on the same day. This association was specific to PTSD alterations in arousal and reactivity symptoms (Criteria E). Neither total PTSD symptoms nor individual PTSD symptom clusters prospectively predicted next-day prescription opioid use (overall or with co-use). Use of prescription opioids also did not predict next-day PTSD symptom severity. CONCLUSION This is the first study to demonstrate positive associations between day-to-day fluctuations in PTSD symptoms and NMPOU. Results from the current study also highlight the importance of examining polysubstance use patterns among individuals with PTSD who use prescription opioids. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
|
2
|
Abarno CN, De Leon A, Sharp AG, Moore K, Boothroyd R. The Impact of Traumatic Stress, Social Support, and Substance Problems on Graduation Among Female Offenders in a Prescription Drug Court Program. J Trauma Stress 2022; 35:42-54. [PMID: 33743186 DOI: 10.1002/jts.22672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/28/2021] [Accepted: 02/15/2021] [Indexed: 11/08/2022]
Abstract
Trauma exposure and comorbid substance use are highly prevalent among female drug court participants. Despite the pervasiveness of the issue, few studies have investigated the impact of posttraumatic stress symptoms (PTSS) and nonmedical prescription drug use among this specific population. The present study examined the impact of posttraumatic stress, social support, and nonmedical prescription drug use on graduation outcomes among female participants in a specialized drug court program (N = 210). Participants either received motivational enhancement therapy/cognitive behavioral therapy (MET-CBT; N = 210) or both MET-CBT and Seeking Safety through intensive outpatient treatment (n = 109). The findings indicated that graduation was negatively correlated with posttraumatic stress, r = -.19, p = .007, d = 0.40; past 90-day nonmedical prescription painkiller, opiate, and analgesic use, r = -.19, p = .001, d = 0.44; tangible social support, r = -.24, p = < .001, d = 0.51; and past-month substance use problems, r = -.25, p < .001, d = .50. In addition, past-month substance use problems, OR = 0.84, 95% CI [0.72, 0.97]; PTSS, OR = 0.90, 95 % CI [0.82, 0.99]; and tangible social support, OR = 0.94, 95% CI [0.89, 0.98], were significant negative predictors of graduation. These results speak to the importance of facilitating the development of specialized evidence-based drug court interventions that target and improve comorbid substance use and trauma outcomes among female drug court participants to reduce recidivism and set a precedent for future research to replicate and expand upon these findings.
Collapse
Affiliation(s)
- Cristina N Abarno
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Ardhys De Leon
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Amanda G Sharp
- Department of Mental Health Law & Policy, University of South Florida, Tampa, Florida, USA
| | - Kathleen Moore
- Department of Mental Health Law & Policy, University of South Florida, Tampa, Florida, USA
| | - Roger Boothroyd
- Department of Mental Health Law & Policy, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
3
|
Almeida-González M, Boada LD, Henríquez-Hernández LA, Luzardo OP, Zaragoza E, Burillo-Putze G, Quintana-Montesdeoca MP, Zumbado M. Medical Psychotropics in Forensic Autopsies in European Countries: Results from a Three-Year Retrospective Study in Spain. TOXICS 2022; 10:toxics10020064. [PMID: 35202250 PMCID: PMC8876624 DOI: 10.3390/toxics10020064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 12/21/2022]
Abstract
Medical psychotropics are widely used and prescribed in developed countries. These medications may have an impairing effect on mood or perception and may induce harmful behaviors. Nevertheless, in Europe, studies on their importance from a medico-legal perspective are scarce. To fill this gap, we evaluate the determinants of these drugs in a retrospective study based on data obtained from forensic autopsies. Toxicological analyses were performed on 394 blood samples from compulsory autopsies at the Institute of Legal Medicine of Las Palmas. Of the samples, 41% (159) were positive for at least one psychotropic, with benzodiazepines being the most frequently detected (24.1%), followed by opiates and antidepressants. Benzodiazepines, opiates, and antidepressants were detected more frequently in men who suffered a violent death. More than 30% of the positive samples showed two or more drugs, suggesting a prevalence of polypharmacy among forensic autopsy subjects, with the most frequently combination found being benzodiazepines plus opiates (28.3% of positive samples). A combination of opiates plus antidepressants was also found in subjects involved in violent deaths. Our results suggest that more than 40% of the adult European population involved in medico-legal issues may be under the influence of legal psychotropics. The link between violent deaths and the use of medical psychotropics is particularly worrisome and indicates that these drugs should be carefully monitored in developed countries, in all forensic autopsies, in a similar way to illegal psychotropics.
Collapse
Affiliation(s)
- Maira Almeida-González
- Institute of Legal Medicine of Las Palmas, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (M.A.-G.); (L.D.B.); (E.Z.)
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
| | - Luis D. Boada
- Institute of Legal Medicine of Las Palmas, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (M.A.-G.); (L.D.B.); (E.Z.)
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
| | - Luis Alberto Henríquez-Hernández
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
- Correspondence: ; Tel.: +34-928-451-461
| | - Octavio P. Luzardo
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
| | - Enrique Zaragoza
- Institute of Legal Medicine of Las Palmas, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (M.A.-G.); (L.D.B.); (E.Z.)
| | - Guillermo Burillo-Putze
- Emergency Department, Hospital Universitario de Canarias, Carretera Ofra S/N, 38320 San Cristóbal de La Laguna, Spain;
| | - María P. Quintana-Montesdeoca
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
| | - Manuel Zumbado
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
| |
Collapse
|
4
|
Austin AE, Short NA. Sexual Violence, Mental Health, and Prescription Opioid Use and Misuse. Am J Prev Med 2020; 59:818-827. [PMID: 33220753 DOI: 10.1016/j.amepre.2020.06.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Previous research indicates that sexual violence is associated with prescription opioid use and misuse. However, this literature is limited by a lack of sex-specific analyses, an inability to establish temporality between experiences of sexual violence and prescription opioid outcomes, and little understanding of mechanisms underlying these associations. METHODS Data from Waves IV (2008) and V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health (N=10,685) were analyzed in March 2020. The association of sexual violence with past 30-day prescription opioid use and misuse among women and men and mediation by depression and anxiety diagnoses were examined using generalized structural equation modeling. Temporality was established using self-reported age at the first experience of sexual violence and age at first depression and anxiety diagnoses. RESULTS Sexual violence was associated with an increased likelihood of prescription opioid use and misuse among women (OR=1.68, 95% CI=1.19, 2.39 for use; OR=1.18, 95% CI=0.95, 1.55 for misuse) and men (OR=2.37, 95% CI=1.37, 4.12 for use; OR=1.71, 95% CI=1.06, 2.75 for misuse). Among women, depression (p=0.0420) and anxiety (p=0.0450) diagnoses mediated the association with prescription opioid use, and anxiety diagnosis (p=0.0210) mediated the association with prescription opioid misuse. Among men, anxiety diagnosis (p=0.038) mediated the association with prescription opioid use, and depression diagnosis (p=0.0390) mediated the association with prescription opioid misuse. CONCLUSIONS Secondary prevention efforts focused on evidence-based, trauma-informed behavioral health treatment among survivors of sexual violence may prevent prescription opioid use and misuse as strategies for coping with the psychological impact of these traumatic experiences.
Collapse
Affiliation(s)
- Anna E Austin
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Nicole A Short
- Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
5
|
Gilmore AK, Walsh K, Frazier P, Ledray L, Acierno R, Ruggiero KJ, Kilpatrick DG, Resnick HS. Prescription Opioid Misuse After a Recent Sexual Assault: A Randomized Clinical Trial of a Video Intervention. Am J Addict 2019; 28:376-381. [PMID: 31242340 DOI: 10.1111/ajad.12922] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/03/2019] [Accepted: 05/10/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Prescription opioid (PO) misuse is increasing and is associated with overdose. Individuals who experienced a recent sexual assault are at risk for increased substance use, yet limited interventions target PO misuse after sexual assault. The current study examined the efficacy of video interventions on PO misuse after sexual assault. METHODS Adolescent girls and women (n = 154) were recruited in the context of a sexual assault medical forensic exam in the emergency department. Effects of a prevention of post-rape stress (PPRS) video and a pleasant imagery and relaxation instruction (PIRI) video were compared with treatment as usual (TAU) during a sexual assault medical forensic exam on PO misuse. Participants reported if they had used POs for non-medical purposes since the sexual assault at 1.5 month follow-up. RESULTS Results from a logistic regression analysis indicated that participants with a prior sexual assault were less likely to misuse prescription opioids 1.5 months after the assault in the PIRI condition compared with TAU. There were no main effects for video condition and no interactions for the PPRS condition on PO misuse. DISCUSSION AND CONCLUSIONS Providing the PIRI video, or teaching other types of mindfulness or relaxation exercises, may be warranted as a secondary prevention for individuals during the sexual assault medical forensic exam for those with a prior sexual assault history. SCIENTIFIC SIGNIFICANCE This research provides an initial examination of the impact of mindfulness skills recently after traumatic event exposure on PO misuse. (Am J Addict 2019;28:376-381).
Collapse
Affiliation(s)
- Amanda K Gilmore
- Department of Nursing, College of Nursing, Medical University of South Carolina, Charleston, SC.,Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Kate Walsh
- Department of Psychology, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Patricia Frazier
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | | | - Ron Acierno
- Department of Nursing, College of Nursing, Medical University of South Carolina, Charleston, SC
| | - Kenneth J Ruggiero
- Department of Nursing, College of Nursing, Medical University of South Carolina, Charleston, SC
| | - Dean G Kilpatrick
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Heidi S Resnick
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| |
Collapse
|
6
|
Joudrey PJ, Khan MR, Wang EA, Scheidell JD, Edelman EJ, McInnes DK, Fox AD. A conceptual model for understanding post-release opioid-related overdose risk. Addict Sci Clin Pract 2019; 14:17. [PMID: 30982468 PMCID: PMC6463640 DOI: 10.1186/s13722-019-0145-5] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 03/26/2019] [Indexed: 12/28/2022] Open
Abstract
Post-release opioid-related overdose mortality is the leading cause of death among people released from jails or prisons (PRJP). Informed by the proximate determinants framework, this paper presents the Post-Release Opioid-Related Overdose Risk Model. It explores the underlying, intermediate, proximate and biological determinants which contribute to risk of post-release opioid-related overdose mortality. PRJP share the underlying exposure of incarceration and the increased prevalence of several moderators (chronic pain, HIV infection, trauma, race, and suicidality) of the risk of opioid-related overdose. Intermediate determinants following release from the criminal justice system include disruption of social networks, interruptions in medical care, poverty, and stigma which exacerbate underlying, and highly prevalent, substance use and mental health disorders. Subsequent proximate determinants include interruptions in substance use treatment, including access to medications for opioid use disorder, polypharmacy, polydrug use, insufficient naloxone access, and a return to solitary opioid use. This leads to the final biological determinant of reduced respiratory tolerance and finally opioid-related overdose mortality. Mitigating the risk of opioid-related overdose mortality among PRJP will require improved coordination across criminal justice, health, and community organizations to reduce barriers to social services, ensure access to health insurance, and reduce interruptions in care continuity and reduce stigma. Healthcare services and harm reduction strategies, such as safe injection sites, should be tailored to the needs of PRJP. Expanding access to opioid agonist therapy and naloxone around the post-release period could reduce overdose deaths. Programs are also needed to divert individuals with substance use disorder away from the criminal justice system and into treatment and social services, preventing incarceration exposure.
Collapse
Affiliation(s)
- Paul J Joudrey
- VA Connecticut Healthcare System, West Haven Campus, 950 Campbell Ave, West Haven, CT, 06516, USA.
- National Clinician Scholars Program, Yale School of Medicine, 333 Cedar Street, Sterling Hall of Medicine IE-68, PO Box 208088, New Haven, CT, 06520, USA.
| | - Maria R Khan
- Department of Population Health, New York University, 227 East 30th Street, New York, NY, 10016, USA
| | - Emily A Wang
- Department of Internal Medicine, Yale School of Medicine, Yale University, 367 Cedar Street, New Haven, CT, USA
| | - Joy D Scheidell
- Department of Population Health, New York University, 227 East 30th Street, New York, NY, 10016, USA
| | - E Jennifer Edelman
- Department of Internal Medicine, Yale School of Medicine, Yale University, 367 Cedar Street, New Haven, CT, USA
| | - D Keith McInnes
- Department of Veterans Affairs, Center for Healthcare Outcomes and Implementation Research, Edith Nourse Rogers VA Hospital, Bedford, MA, USA
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Aaron D Fox
- Albert Einstein College of Medicine, Bronx, NY, 10461, USA
- Montefiore Medical Center, Bronx, NY, 10467, USA
| |
Collapse
|
7
|
Transnational trends in prescription drug misuse among women: A systematic review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 63:56-73. [DOI: 10.1016/j.drugpo.2018.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 09/14/2018] [Accepted: 10/09/2018] [Indexed: 12/21/2022]
|
8
|
Price M, Brier ZMF, Mirhashem R, Allen HC. The impact of co-occurring opioid misuse and PTSD on response inhibition. Drug Alcohol Depend 2018; 189:187-192. [PMID: 30049531 DOI: 10.1016/j.drugalcdep.2018.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/09/2018] [Accepted: 05/04/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Posttraumatic Stress Disorder (PTSD) and opioid misuse are commonly co-occurring disorders. Both disorders are associated with deficits in response inhibition; however, these associations have not considered their comorbidity. Response inhibition has not been examined in a sample with comorbid PTSD and opioid misuse. The present study examined the effect of PTSD symptom severity on response inhibition in current and past opioid misusers. METHODS Participants were currently (used within the last month) misusing opioids (56.6%) or in recovery (43.4%). All participants met DSM 5 criteria for PTSD. Response inhibition was measured with the stop signal task. RESULTS Response inhibition was associated with increased PTSD symptom severity for those in recovery but not among current users. Additionally, across both groups, there were deficits in response inhibition when withholding automatic responses for a threatening stimulus compared to a neutral stimulus. CONCLUSIONS PTSD Symptoms may exert a stronger effect on response inhibition among those in recovery as opposed to those who are actively using opioids.
Collapse
Affiliation(s)
- Matthew Price
- Center for Research on Emotion, Stress, and Technology, Department of Psychological Science, University of Vermont, 2 Colchester Ave, Room 248, Burlington, VT 05405, USA.
| | - Zoe M F Brier
- Center for Research on Emotion, Stress, and Technology, Department of Psychological Science, University of Vermont, 2 Colchester Ave, Room 248, Burlington, VT 05405, USA
| | - Rebecca Mirhashem
- Center for Research on Emotion, Stress, and Technology, Department of Psychological Science, University of Vermont, 2 Colchester Ave, Room 248, Burlington, VT 05405, USA
| | - Holley C Allen
- Center for Research on Emotion, Stress, and Technology, Department of Psychological Science, University of Vermont, 2 Colchester Ave, Room 248, Burlington, VT 05405, USA
| |
Collapse
|
9
|
Hall MT, Ball D, Sears J, Higgins GE, Logan TK, Golder S. Past-year nonmedical use of prescription drugs among women on probation and parole: A cross-sectional study. Subst Abus 2018; 39:280-285. [PMID: 29452065 DOI: 10.1080/08897077.2018.1442382] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Prescription drug-related overdose deaths have increased dramatically in recent years. Women in the justice system experience high rates of drug use, victimization, trauma symptoms, and other health problems and would appear to be at high risk for nonmedical use of prescription drugs (NMUPD). This study will be among the first to describe prevalence and correlates of NMUPD among this population. METHODS This cross-sectional study collected data from 406 victimized women on probation and parole between 2010 and 2012. In a multiple logistic regression model, we differentiated women who reported past-year NMUPD from those who did not using demographic, health, other drug use, substance use treatment, and trauma symptom severity variables. RESULTS Past-year NMUPD was reported by 26.8% (n = 109) of the overall sample. Women reporting NMUPD were significantly younger and more likely to be white. Past-year use of alcohol (adjusted odds ratio [AOR]: 3.3; 95% confidence interval [CI]: 1.8-6.1), marijuana (AOR: 3.6; 95% CI: 1.8-7.0), methamphetamines (AOR: 6.1; 95% CI: 1.7-21.3), and heroin (AOR: 8.4; 95% CI: 2.0-35.2) were significantly associated with NMUPD. Additionally, each unit increase in the measure assessing bodily pain was associated with a 40% increase (AOR: 1.4; 95% CI: 1.1-1.7) in the odds of NMUPD. Finally, meeting diagnostic criteria for posttraumatic stress disorder almost doubled (AOR: 1.9; 95% CI: 1.1-3.4) the odds of reporting past-year NMUPD. CONCLUSIONS Victimized women on probation and parole report high rates of NMUPD, and this behavior intersects with other complex social, behavioral, psychological, and physical needs. The authors recommend increased access to trauma-informed correctional care among women in the justice system.
Collapse
Affiliation(s)
- Martin T Hall
- a Kent School of Social Work, University of Louisville , Louisville , Kentucky , USA
| | - Diana Ball
- a Kent School of Social Work, University of Louisville , Louisville , Kentucky , USA
| | - Jeanelle Sears
- a Kent School of Social Work, University of Louisville , Louisville , Kentucky , USA
| | - George E Higgins
- b Department of Justice Administration , University of Louisville , Louisville , USA
| | - T K Logan
- c Department of Behavioral Science and Center on Drug and Alcohol Research , University of Kentucky , Lexington , Kentucky , USA
| | - Seana Golder
- a Kent School of Social Work, University of Louisville , Louisville , Kentucky , USA
| |
Collapse
|
10
|
Rougemont-Bücking A, Grazioli VS, Marmet S, Daeppen JB, Lemoine M, Gmel G, Studer J. Non-medical use of prescription drugs by young men: impact of potentially traumatic events and of social-environmental stressors. Eur J Psychotraumatol 2018; 9:1468706. [PMID: 29760868 PMCID: PMC5944370 DOI: 10.1080/20008198.2018.1468706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 04/03/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Non-medical use of prescription drugs (NMUPD) is an increasing phenomenon associated with physical and psychological consequences. This study investigated the effects of distinct forms of stress on NMUPD. Methods: Data from 5308 young adult men from the Swiss cohort study on substance use risk factors (C-SURF) were analysed regarding NMUPD of sleeping pills, tranquilizers, opioid analgesics, psychostimulants, and antidepressants. Various forms of stress (discrete, potentially traumatic events, recent and long-lasting social-environmental stressors) during the period preceding the NMUPD assessment were measured. Backward log-binomial regression was performed and risk ratios (RR) were calculated. Results: NMUPD was significantly associated with the cumulative number of potentially traumatic events (e.g. for opioid analgesics, RR = 1.92, p < .001), with problems within the family (e.g. for sleeping pills, RR = 2.45, p < .001), and the peer group (e.g. for tranquilizer use, RR = 2.34, p < .01). Factors describing family functioning in childhood showed very few significant associations. Sexual assault by acquaintances was associated only with use of sleeping pills (RR = 2.91, p p <.01); physical assault by acquaintances was not associated with NMUPD. Physical (e.g. for psychostimulants, RR = 2.01, p < .001) or sexual assaults (e.g. for antidepressants, RR = 4.64, p < .001) perpetrated outside the family context did show associations with several drug categories. Conclusion: NMUPD appears to be more consistently associated with discrete and potentially traumatic events and with recent social-environmental stressors than with long-lasting stressors due to family functioning during childhood and youth. Physical and sexual assaults perpetrated by strangers showed more associations with NMUPD than those perpetrated by a family member.
Collapse
Affiliation(s)
- Ansgar Rougemont-Bücking
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland.,Chair of Psychiatry and Psychotherapy, University of Fribourg, Department of Neurosciences and Movement Science (NMS), Psychiatry and Psychotherapy, Fribourg, Switzerland
| | - Véronique S Grazioli
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
| | - Simon Marmet
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
| | - Jean-Bernard Daeppen
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
| | - Mélissa Lemoine
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
| | - Gerhard Gmel
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland.,Addiction Suisse, Lausanne, Switzerland.,Centre for Addiction and Mental Health, Toronto, Canada.,Frenchay Campus, University of the West of England, Bristol, UK
| | - Joseph Studer
- Alcohol Treatment Center, Centre Hospitalier Universitaire Vaudois CHUV, Lausanne, Switzerland
| |
Collapse
|
11
|
A systematic review of the motivations for the non-medical use of prescription drugs in young adults. Drug Alcohol Depend 2016; 162:3-25. [PMID: 26851986 DOI: 10.1016/j.drugalcdep.2016.01.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 01/12/2016] [Accepted: 01/17/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND Young adults (18-25) are most at-risk for the non-medical use of prescription drugs (NMUPD). Understanding this population's motivations for use can help inform efforts to reduce NMUPD. Therefore, this systematic review synthesizes the findings from research on young adults' motivations to engage in NMUPD. METHODS Based on PRISMA guidelines, relevant databases were systematically searched for articles that assessed the motivations for NMUPD in young adults and college-aged students. Search strings included a range of prescription drug classes and terms to ensure an exhaustive review. RESULTS The search resulted in identifying 353 potential articles after duplicates were removed, and 37 articles were included in the final qualitative synthesis. Of the final articles, the majority investigated the non-medical use of prescription stimulants in U.S. student populations cross-sectionally. Seven studies, either exclusively or in combination with other medications, researched prescription opioids, and five investigated central nervous system depressants. Only one study investigated motivations over time. CONCLUSION There are many ways in which the current literature can be expanded, including researching other populations and focusing on prescriptions other than stimulants. Using the medications for their prescribed properties and known side effects emerged as a consistent theme. It was also fairly common for young adults to report recreational motives. Issues with measurement and definitions of key terms (e.g., non-medical) would benefit from consistency in future work. Research on motivations should continue and be incorporated into the larger drug use context, as well as existing prevention and intervention strategies.
Collapse
|
12
|
Misuse of Prescription Opioid Medication among Women: A Scoping Review. Pain Res Manag 2016; 2016:1754195. [PMID: 27445597 PMCID: PMC4904621 DOI: 10.1155/2016/1754195] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 12/14/2015] [Indexed: 11/18/2022]
Abstract
Background. National data from Canada and the United States identify women to be at greater risk than men for the misuse of prescription opioid medications. Various sex- and gender-based factors and patient and physician practices may affect women's use and misuse of prescription opioid drugs. Objectives. To explore the particular risks, issues, and treatment considerations for prescription opioid misuse among women who experience chronic noncancer pain and trauma. Methods. A scoping review for articles published between January 1990 and May 2014 was conducted on sex- and gender-based risks and treatment considerations among women who experience chronic noncancer pain and trauma. Results. A total of 57 articles were identified. The present narrative review summarizes the specific risks for the misuse of prescription opioid medication among women who have experienced violence and trauma, Aboriginal women, adolescents and young women, older women, pregnant women, women of a sexual minority, and transwomen. Discussion. The majority of the literature is descriptive, with few studies that evaluate approaches and interventions to respond to the issue of chronic pain, trauma, and misuse of prescription opioids among women, particularly vulnerable subgroups of women. Conclusions. Trauma-informed and women-centred approaches that address women's vulnerabilities and complex needs require further attention.
Collapse
|
13
|
Shors TJ, Millon EM. Sexual trauma and the female brain. Front Neuroendocrinol 2016; 41:87-98. [PMID: 27085856 DOI: 10.1016/j.yfrne.2016.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 01/01/2023]
Abstract
Sexual aggression and violence against women (VAM) are not only social problems; they are mental health problems. Women who experience sexual trauma often express disruptions in emotional and cognitive processes, some of which lead to depression and post-traumatic stress disorder (PTSD). Animal models of neurogenesis and learning suggest that social yet aggressive interactions between a pubescent female and an adult male can disrupt processes of learning related to maternal care, which in turn reduce survival of new neurons in the female hippocampus. Mental and Physical (MAP) Training is a novel clinical intervention that was translated from neurogenesis research. The intervention, which combines meditation and aerobic exercise, is currently being used to help women learn to recover from traumatic life experiences, especially those related to sexual violence and abuse.
Collapse
Affiliation(s)
- Tracey J Shors
- Behavioral and Systems Neuroscience, Department of Psychology, Center for Collaborative Neuroscience, Rutgers University, 152 Frelinghuysen Road Room 201, Piscataway, NJ 08854, USA.
| | - Emma M Millon
- Behavioral and Systems Neuroscience, Department of Psychology, Center for Collaborative Neuroscience, Rutgers University, 152 Frelinghuysen Road Room 201, Piscataway, NJ 08854, USA
| |
Collapse
|
14
|
Hall MT, Golder S, Higgins GE, Logan T. Nonmedical prescription opioid use among victimized women on probation and parole. Addict Behav 2016; 53:113-9. [PMID: 26476007 DOI: 10.1016/j.addbeh.2015.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 09/16/2015] [Accepted: 10/03/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Nonmedical prescription opioid use (NPOU) is a major public health concern and few studies have described this phenomenon among victimized women involved in the criminal justice system. OBJECTIVE This study will describe the relationship between victimization, psychological distress, health status and NPOU among the vulnerable population of victimized women on probation and parole. METHODS A sample of 406 women on probation and parole responded to items assessing victimization history, self-reported health status, physical pain, psychological distress, and post-traumatic stress disorder. Multiple logistic regression analysis was utilized to differentiate NPOUs versus nonusers. RESULTS Overall, 169 (41.6%) women reported lifetime NPOU, and 20% reported use in the past year. Compared to women who did not report NPOU, NPOUs were more likely to be White, have poorer general health, and more severe psychological distress across nine symptom domains. In multiple logistic regression models, each year of age reduced the odds of NPOU by 4%; White women were twice as likely as women of other races to report NPOU; each unit increase in the measure for physical pain was associated with a 30% increase in the odds of NPOU; and participants who met diagnostic criteria for PTSD were 60% more likely to report NPOU compared to individuals who did not. CONCLUSION Victimized women on probation and parole report high rates of NPOU and comorbid mental and physical health problems. The criminal justice system should routinely screen for NPOU, as well as untreated or poorly managed physical pain and psychological distress, which may increase risk of NPOU.
Collapse
|
15
|
Ham LS, Wiersma-Mosley JD, Feldner MT, Melkonian AJ, Milner LA, Lewis SF. Posttraumatic Stress Symptoms and Nonmedical Prescription Drug Use Among College Students With Trauma Exposure. J Dual Diagn 2016; 12:43-54. [PMID: 26829261 DOI: 10.1080/15504263.2016.1146556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Nonmedical prescription drug use, defined as using the drug without a prescription or in ways for which it is not prescribed, and traumatic event exposure are highly prevalent among college students. Despite evidence that posttraumatic stress symptoms could place college students at risk for nonmedical prescription drug problems, no studies have examined this relationship. This study was a preliminary examination of posttraumatic stress symptoms, lifetime nonmedical prescription drug use, hazardous use, and dependence symptoms among college students with trauma exposure. METHODS Participants were students attending a rural college in Virginia, recruited through psychology classes, flyers, LISTSERVs, and announcements at student events. All students who reported experiencing at least one traumatic event were included (N = 119); participants' mean age was 19.7 years (SD = 1.90), about half were women (n = 63, 53%), and most were Caucasian (n = 103, 87%). RESULTS Nearly 60% of participants (n = 71) reported using nonmedical prescription drugs at least once during their lifetime and were more likely than those with no use to report hazardous alcohol use (p < .01) and depressive symptoms (p < .05). There were no other significant differences between those who did and did not report use of nonmedical prescription drugs. Regression analyses showed that posttraumatic stress symptom frequency was positively associated with hazardous nonmedical prescription drug use, after controlling for gender, depressive symptoms, and hazardous alcohol use (p < .001). Posttraumatic stress symptom frequency was higher for those with any nonmedical prescription drug dependence symptoms (p < .001), but was unrelated to whether the student had ever engaged in nonmedical prescription drug use. CONCLUSIONS Findings suggest that consideration of the types of behaviors and problems a college student is experiencing related to nonmedical prescription drug use may be more relevant to posttraumatic stress symptom frequency than dichotomous measures of nonmedical prescription drug use alone. Further, the association between the frequency of posttraumatic stress symptoms and both hazardous nonmedical prescription drug use and dependence symptoms among college students with a trauma history deserves further investigation due to the resulting vulnerability to increasingly negative outcomes.
Collapse
Affiliation(s)
- Lindsay S Ham
- a Department of Psychological Science , University of Arkansas , Fayetteville , Arkansas , USA
| | | | - Matthew T Feldner
- a Department of Psychological Science , University of Arkansas , Fayetteville , Arkansas , USA
| | - Alexander J Melkonian
- a Department of Psychological Science , University of Arkansas , Fayetteville , Arkansas , USA
| | - Lauren A Milner
- c Louis Stokes Cleveland VA Medical Center , Cleveland , Ohio , USA
| | - Sarah F Lewis
- d Center for Research, Assessment and Treatment Efficacy , Asheville , North Carolina , USA
| |
Collapse
|
16
|
Benotsch EG, Zimmerman RS, Cathers L, Pierce J, McNulty S, Heck T, Perrin PB, Snipes DJ. Non-medical use of prescription drugs and HIV risk behaviour in transgender women in the Mid-Atlantic region of the United States. Int J STD AIDS 2015; 27:776-82. [PMID: 26185044 DOI: 10.1177/0956462415595319] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 06/15/2015] [Indexed: 11/17/2022]
Abstract
Male-to-female transgender women (TGW) experience high rates of substance use and HIV. A recent substance use trend is the use of prescription medication without a doctor's consent. No research to date has examined the associations between this non-medical use of prescription drugs and HIV risk behaviour in TGW. In the present study, TGW recruited from community venues (N = 104) in the Mid-Atlantic region of the United States completed surveys assessing demographic information, non-medical use of prescription drugs, other substance use, injection practices and sexual risk behaviour. Twenty-four per cent of the sample reported lifetime non-medical use of prescription drugs across the following categories: analgesics (21.2%), anxiolytics (14.4%), stimulants (12.5%) and sedatives (8.7%). Participants reporting non-medical use of prescription drugs were more likely to report other substance use, needle use to inject drugs, injecting silicone and sharing needles. In multivariable analyses, non-medical use of prescription drugs was associated with unprotected sex, sex after engaging in substance use, and commercial sex work, after controlling for demographic factors. Self-esteem and social support from family served as protective factors for non-medical use of prescription drugs. HIV-prevention programmes focused on TGW in the United States may wish to expand their assessment of substance use to include the use of prescription medications without a physician's consent.
Collapse
Affiliation(s)
- Eric G Benotsch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA Institute for Women's Health, Virginia Commonwealth University Richmond, VA , USA
| | - Rick S Zimmerman
- St. Louis, College of Nursing, University of Missouri, St. Louis, MO, USA
| | - Laurie Cathers
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA Institute for Women's Health, Virginia Commonwealth University Richmond, VA , USA
| | - Juan Pierce
- Minority Health Consortium, Richmond, VA, USA
| | | | - Ted Heck
- Virginia Department of Health, Richmond, VA, USA
| | - Paul B Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Daniel J Snipes
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
17
|
McHugh RK, Nielsen S, Weiss RD. Prescription drug abuse: from epidemiology to public policy. J Subst Abuse Treat 2015; 48:1-7. [PMID: 25239857 PMCID: PMC4250400 DOI: 10.1016/j.jsat.2014.08.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 08/25/2014] [Indexed: 11/26/2022]
Abstract
Prescription drug abuse has reached an epidemic level in the United States. The prevalence of prescription drug abuse escalated rapidly beginning in the late 1990s, requiring a significant increase in research to better understand the nature and treatment of this problem. Since this time, a research literature has begun to develop and has provided important information about how prescription drug abuse is similar to, and different from the abuse of other substances. This introduction to a special issue of the Journal of Substance Abuse Treatment on prescription drug abuse provides an overview of the current status of the research literature in this area. The papers in this special issue include a sampling of the latest research on the epidemiology, clinical correlates, treatment, and public policy considerations of prescription drug abuse. Although much has been learned about prescription drug abuse in recent years, this research remains in early stages, particularly with respect to understanding effective treatments for this population. Future research priorities include studies on the interaction of prescription drugs with other licit and illicit substances, the impact of prescription drug abuse across the lifespan, the optimal treatment for prescription drug abuse and co-occurring conditions, and effective public policy initiatives for reducing prescription drug abuse.
Collapse
Affiliation(s)
- R Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Suzanne Nielsen
- University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia; Drug and Alcohol Services, South Eastern Sydney Local Health District, New South Wales, Australia
| | - Roger D Weiss
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| |
Collapse
|
18
|
Mackesy-Amiti ME, Donenberg GR, Ouellet LJ. Prescription opioid misuse and mental health among young injection drug users. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2015; 41:100-6. [PMID: 25105884 PMCID: PMC4262584 DOI: 10.3109/00952990.2014.940424] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Prescription opioid (PO) misuse is a significant concern in the United States. OBJECTIVES This study describes the prevalence and timing of PO misuse, diagnoses of opiate abuse and dependence, and their associations with psychiatric disorders in a sample of young people who inject drugs (PWID). METHODS Participants were 570 young (18-25 years) PWID, primarily heroin users, recruited through outreach and respondent-driven sampling. Trained interviewers administered a semi-structured psychiatric interview. Diagnoses of substance use and mental disorders were based on DSM-IV diagnostic criteria. RESULTS Estimated rates of lifetime PO abuse and dependence were 19% and 17%, respectively. Past year PO misuse was significantly associated with anti-social personality disorder (ASPD, OR = 2.15, 95% CI 1.43-3.24), past year substance-induced major depression (SIMD, OR = 1.81, 95% CI 1.16-2.83), and prior post-traumatic stress disorder (PTSD, OR = 2.45, 95% CI 1.31-4.60). Among male PO users, PTSD was a significant predictor of PO abuse (prior, OR = 7.62, 95% CI 2.16-26.88; past year, OR = 21.67 95% CI 2.46-190.75), and dependence (prior, OR = 4.82, 95% CI 1.48-15.67; past year, OR = 9.65, 95% CI 1.75-53.32). CONCLUSION Among young PWID, PTSD is a significant risk factor for PO misuse for both men and women, and men with PTSD are in addition at increased risk for PO abuse and dependence. These findings have implications for harm reduction and substance abuse prevention efforts.
Collapse
Affiliation(s)
- Mary E Mackesy-Amiti
- Community Outreach Intervention Projects, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago , Chicago, IL , USA
| | | | | |
Collapse
|
19
|
Snipes DJ, Green BA, Benotsch EG, Perrin PB. The Non-Medical Use of Prescription Drugs and Lifetime Experiences of Sexual Victimization Among College Men. JOURNAL OF INTERPERSONAL VIOLENCE 2014; 29:2482-2496. [PMID: 24488123 DOI: 10.1177/0886260513520229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The non-medical use of prescription drugs (NMUPD) has been linked with many negative outcomes in previous studies. Recent literature has begun to examine the role of NMUPD among sexual victimization survivors. The present study examined the associations between NMUPD, recreational drug use, and experiences of sexual victimization among college men. Undergraduate men (n = 253) elected to take an online survey examining drug use and lifetime sexual victimization experiences. A total of 17% of the sample reported instances of being sexually victimized in their lifetime across four domains (being coerced, threatened, physically forced, or taken advantage of while incapacitated). Results indicate that, across all domains of sexual victimization, non-medical sedative use was robustly associated with sexual victimization in a multivariate model controlling for recreational drug use and demographics. No other non-medically used drug class (anxiolytics, pain medications, and stimulants) was associated with experiences of sexual victimization in the multivariate model. Results expand past literature by illustrating specific drug classes used by survivors of sexual victimization. Implications for interventions for male sexual victimization survivors are discussed.
Collapse
|
20
|
Meier A, Lambert-Harris C, McGovern MP, Xie H, An M, McLeman B. Co-occurring prescription opioid use problems and posttraumatic stress disorder symptom severity. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 40:304-11. [PMID: 24809229 DOI: 10.3109/00952990.2014.910519] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Prescription opioids are the most rapidly growing category of abused substances, and result in significant morbidity, mortality and healthcare costs. Co-occurring with psychiatric disorders, persons with prescription opioid problems have negative treatment outcomes. Data are needed on the prevalence of co-occurring prescription opioid abuse and specific disorders, such as posttraumatic stress disorder (PTSD), to better inform clinical practice. OBJECTIVE To determine prevalence rates of current co-occurring prescription opioid use problems and PTSD symptom severity among patients in community addiction treatment settings. METHODS We abstracted administrative and chart information on 573 new admissions to three addictive treatment agencies during 2011. Systematic data were collected on PTSD symptoms, substance use, and patient demographics. RESULTS Prescription opioid use was significantly associated with co-occurring PTSD symptom severity (OR: 1.42, p < 0.05). Use of prescription opioids in combination with sedatives (OR: 3.81, p < 0.01) or cocaine (OR: 2.24, p < 0.001) also were associated with PTSD severity. The odds of having co-occurring PTSD symptoms and prescription opioid use problem were nearly three times greater among females versus males (OR: 2.63, p < 0.001). Younger patients (18-34 years old) also were at higher risk (OR: 1.86, p < 0.01). CONCLUSIONS Prescription opioid use problems are a risk factor for co-occurring PTSD symptom severity. Being female or younger increase the likelihood of this co-morbidity. Further research is needed to confirm these finding, particularly using more rigorous diagnostic procedures. These data suggest that patients with prescription opioid use problems should be carefully evaluated for PTSD symptoms.
Collapse
Affiliation(s)
- Andrea Meier
- Departments of Psychiatry, Geisel School of Medicine at Dartmouth , Lebanon, New Hampshire , USA
| | | | | | | | | | | |
Collapse
|
21
|
Tapscott BE, Schepis TS. Nonmedical use of prescription medications in young adults. ADOLESCENT MEDICINE: STATE OF THE ART REVIEWS 2013; 24:597-610. [PMID: 24654550 PMCID: PMC4882925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Nonmedical use of prescription medications (NUPM) is an area of increasing public health concern, particularly in young adults. Young adults aged 18 to 25 have the highest annual and monthly rates of NUPM of any age group in the US, with notable consequences from using opioid, stimulant, tranquilizer and sedative medication. This article will review the literature on young adult NUPM, focusing first on the characteristics of those young adults engaged in NUPM. Then, we will examine the most common motives for NUPM, the sources young adults use to engage in nonmedical use and the related process of medication diversion. Finally, we will outline treatment and make specific recommendations of ways clinicians can help prevent the spread of NUPM in young adults, completing the work by covering future directions for research.
Collapse
|
22
|
Lo CC, Monge AN, Howell RJ, Cheng TC. The role of mental illness in alcohol abuse and prescription drug misuse: gender-specific analysis of college students. J Psychoactive Drugs 2013; 45:39-47. [PMID: 23662330 DOI: 10.1080/02791072.2013.763561] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The present study examined whether and how collegians' misuse of prescription drugs and alcohol abuse are associated with mental illness and with a lack of mental health care. Nationally representative data were derived from 5,241 full-time American college students who completed the 2010 National Survey on Drug Use and Health. We observed the presence of alcohol abuse/dependence and the nonmedical use of prescription drugs to be associated with relatively serious mental illness and with lack of health care. In pursuing gender-specific results, we found that the association between alcohol abuse and mental illness was stronger among females than males.
Collapse
Affiliation(s)
- Celia C Lo
- School of Social Work, University of Alabama, Tuscaloosa, AL 35487-0314, USA.
| | | | | | | |
Collapse
|
23
|
The association between non-medical prescription drug use, depressive symptoms, and suicidality among college students. Addict Behav 2012; 37:890-9. [PMID: 22541802 DOI: 10.1016/j.addbeh.2012.02.008] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 12/30/2011] [Accepted: 02/13/2012] [Indexed: 11/22/2022]
Abstract
PURPOSE Studies have substantiated a relationship between drug use, depression, and suicidality. However, little research has examined this relationship with prescription drugs. Given the prevalence of non-medical prescription drug use (NMPDU) among college students, this study explored the association between general and specific NMPDU, depressive symptoms, and suicidality. METHODS Data from the Fall 2008 National College Health Assessment (NCHA) was utilized (N=22,783). Five separate logistic regression models were employed, with the first combining any NMPDU (antidepressants, painkillers, sedatives, and stimulants) followed by four additional regressions for each drug, and then separated by gender. Models were estimated before and after control for key covariates. RESULTS Approximately 13% of participants reported NMPDU. After covariate adjustment, those who reported feeling hopeless, sad, depressed, or considered suicide were 1.22-1.31 times more likely to report NMPDU (p<.05). Those who reported feeling hopeless, sad, or depressed were 1.18-1.43 times more likely to report opioid painkiller use; those who reported feeling sad, depressed, or considered suicide were 1.22-1.38 times more likely to report stimulant use; those who reported being depressed were 1.36 times more likely to report sedative use; and those who reported feeling hopeless or depressed were 1.44 and 1.91 times more likely to report antidepressant use (p<.05). When the adjusted models were repeated separately by gender, results were more pronounced for females, especially for females who reported painkiller use. CONCLUSIONS Depressive symptoms and suicidality were significantly associated with greater odds of any NMPDU, with painkiller use (especially for females) representing the greatest correlate among college students. Results suggest that students may be inappropriately self-medicating psychological distress with prescription medications.
Collapse
|
24
|
Schepis TS, Hakes JK. Non-medical prescription use increases the risk for the onset and recurrence of psychopathology: results from the National Epidemiological Survey on Alcohol and Related Conditions. Addiction 2011; 106:2146-55. [PMID: 21631624 DOI: 10.1111/j.1360-0443.2011.03520.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Given the rising rates of the non-medical use of prescription medications (NUPM) and strong cross-sectional associations between psychopathology and NUPM, we examined whether a history of NUPM increased the risk for onset and recurrence of psychopathology. DESIGN Longitudinal data are from waves 1 and 2 of the National Epidemiological Survey on Alcoholism and Related Conditions (NESARC). SETTING The NESARC is a nation-wide, household-based survey. PARTICIPANTS A total of 34,653 US resident participants who completed both NESARC waves were included in analyses. MEASUREMENTS Primary measures were history of NUPM and Axis I psychopathology at wave 1. Wave 1 personality disorder diagnosis and sociodemographic characteristics were used as control variables. FINDINGS Design-based logistic regression analyses indicated that life-time and past year NUPM at wave 1 increased risk for onset of psychopathology among those with no history of psychopathology at baseline, with particular risk for non-NUPM substance use and bipolar disorders. Life-time and past year NUPM were associated with recurrence of alcohol and non-NUPM substance use disorders among those with these diagnoses at baseline. In contrast, life-time and past year NUPM was associated with the onset of all examined disorders among those with a different diagnosis at baseline. CONCLUSIONS Non-medical use of prescription medications is a consistent risk factor for the onset and recurrence of psychopathology.
Collapse
Affiliation(s)
- Ty S Schepis
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666, USA.
| | | |
Collapse
|
25
|
Kaysen D, Atkins DC, Moore SA, Lindgren KP, Dillworth T, Simpson T. Alcohol Use, Problems, and the Course of Posttraumatic Stress Disorder: A Prospective Study of Female Crime Victims. J Dual Diagn 2011; 7:262-279. [PMID: 23538605 PMCID: PMC3607458 DOI: 10.1080/15504263.2011.620449] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE This study examines whether alcohol use disorder status and consequences of drinking moderate the course of PTSD over the first 6 months following trauma exposure in a sample of female victims of interpersonal violence. METHODS Female sexual and physical assault victims (n = 64) were recruited through police, hospital, and victim service agencies. Women completed structured clinical interviews and self-report measures within the first five weeks, three months, and six months post-trauma with 73% retention across all three time points (n = 47). Analyses were conducted using Hierarchical Linear Modeling using alcohol abuse/dependence, peak alcohol use, and consequences during the 30 days prior to assault as moderators of the course of PTSD over time. RESULTS Women with alcohol use disorder at baseline had lower initial PTSD symptoms but also less symptom recovery over time than women without alcohol use disorder. This pattern of results was also found for those with high negative drinking consequences during the month prior to the assault. Baseline alcohol use was not found to significantly moderate PTSD course over the 6 months. CONCLUSIONS Findings suggest that negative consequences associated with alcohol use may be a risk factor for PTSD. Incorporating assessment of drinking problems for women presenting early post-trauma may be useful for identifying PTSD risk.
Collapse
Affiliation(s)
- Debra Kaysen
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington
| | | | | | | | | | | |
Collapse
|
26
|
Cisler JM, Amstadter AB, Begle AM, Resnick HS, Danielson CK, Saunders BE, Kilpatrick DG. PTSD symptoms, potentially traumatic event exposure, and binge drinking: a prospective study with a national sample of adolescents. J Anxiety Disord 2011; 25:978-87. [PMID: 21783340 PMCID: PMC3546501 DOI: 10.1016/j.janxdis.2011.06.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 06/13/2011] [Accepted: 06/16/2011] [Indexed: 12/21/2022]
Abstract
Research demonstrates substantial comorbidity between PTSD and alcohol use disorders. Evidence for functional relationships between PTSD and problematic alcohol use has not always been consistent, and there have been few investigations with adolescent samples. Further, research has not consistently controlled for cumulative potentially traumatic event (PTE) exposure when examining prospective relationships between PTSD and problematic alcohol use (i.e., binge drinking). This study examines the prospective relationships between PTSD symptoms, problematic alcohol use, and cumulative PTE exposure measured at three time points over approximately three years among a nationally representative sample of adolescents exposed to at least one PTE (n=2399 and age range=12-17 at Wave 1). Results from parallel process latent growth curve models demonstrated that increases in cumulative PTE exposure over time positively predicted increases in both PTSD symptoms and binge drinking, whereas increases in PTSD symptoms and increases in binge drinking were not related when controlling for the effect of cumulative PTE exposure. Further analyses suggested that these relationships are specific to assaultive PTEs and are not found with non-assaultive PTEs. Theoretical implications are discussed.
Collapse
Affiliation(s)
- Josh M Cisler
- Brain Imaging Research Center, Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham #554, Little Rock, AR 72205, United States.
| | | | | | | | | | | | | |
Collapse
|
27
|
McCauley JL, Amstadter AB, Macdonald A, Danielson CK, Ruggiero KJ, Resnick HS, Kilpatrick DG. Non-medical use of prescription drugs in a national sample of college women. Addict Behav 2011; 36:690-5. [PMID: 21356576 DOI: 10.1016/j.addbeh.2011.01.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 01/12/2011] [Indexed: 11/26/2022]
Abstract
Non-medical use of prescription drugs (NMUPD) is one of the fastest growing forms of illicit drug use, with research indicating that college students represent a particularly high risk population. The current study examined demographic characteristics, health/mental health, substance misuse, and rape experiences as potential risk correlates of NMUPD among a national sample of college women (N=2000). Interviews were conducted via telephone using Computer-Assisted Telephone Interviewing technology. NMUPD was assessed by asking if, participants had used a prescription drug non-medically in the past year. NMUPD was endorsed by 7.8% of the sample (n=155). Although incapacitated and drug-alcohol facilitated rape were associated with NMUPD in the initial model, the final multivariable model showed that only lifetime major depression and other forms of substance use/abuse were significantly uniquely associated with an increased likelihood of NMUPD. Implications for primary and secondary prevention and subsequent research are addressed.
Collapse
|
28
|
Young A, Grey M, Boyd CJ, McCabe SE. Adolescent Sexual Assault and the Medical and Nonmedical Use of Prescription Medication. J Addict Nurs 2011; 11:25-31. [PMID: 22065397 DOI: 10.3109/10884601003628138] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Previous research has documented an association between sexual victimization and prescription medication use among adults. The purpose of this study was to determine whether such a relationship was present for adolescent girls when considering sexual victimization by a peer and the use of four drug classes for medical and nonmedical reasons. The study was based on a secondary analysis of a cross-sectional Web-based, self-administered survey of female students from a middle and high school (n = 490). As predicted, sexual victimization increased the likelihood of non-medical prescription medication use of opioid analgesics and sedative medication, although these relationships varied based on the severity of sexual assault. Findings are discussed in light the importance of increasing awareness among health professionals, researchers, and the wider community of the increased risk for prescription medication abuse among adolescent girls who have a history of sexual violence.
Collapse
Affiliation(s)
- Amy Young
- University of Michigan, Institute for Research on Women and Gender, Ann Arbor, Michigan, USA
| | | | | | | |
Collapse
|
29
|
Stene LE, Dyb G, Jacobsen GW, Schei B. Psychotropic drug use among women exposed to intimate partner violence: A population-based study. Scand J Public Health 2010; 38:88-95. [DOI: 10.1177/1403494810382815] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: To investigate psychotropic drug use among women ever exposed to intimate partner violence (IPV) in relation to mental distress and sociodemographic, lifestyle and somatic health characteristics, and to assess whether drug use differed for physical and/or sexual violence compared with psychological abuse alone. Methods: Cross-sectional data from women aged 30—60 years were drawn from self-reported questionnaires in the Oslo Health study 2000—2001. Women reporting hypnotic, anxiolytic and/or antidepressant drug use in the previous four weeks were defined as users. Differences in psychotropic drug use by IPV exposure were examined by logistic regression analyses. Results: In total, 880 (14%) of 6,471 included women reported ever experiencing IPV; 494 (8%) reported physical and/or sexual IPV, and 386 (6%) reported psychological IPV alone. Physical and/or sexual IPV was significantly associated with use of all psychotropic drugs: hypnotics (odds ratio (OR) 2.28; 95% confidence interval (95% CI), 1.73—3.00); anxiolytics (OR 3.29; 95% CI, 2.43—4.44); and antidepressants (OR 2.72; 95% CI, 1.97—3.76). The associations remained significant for anxiolytics (OR 1.67; 95% CI, 1.14—2.45) and antidepressants (OR 1.50; 95% CI, 1.02—2.19) after adjusting for mental distress, sociodemographic, lifestyle and somatic health characteristics. Psychological IPV alone was associated with use of anxiolytics (OR 1.81; 95% CI, 1.20—2.75) and antidepressants (OR 2.38; 95% CI, 1.64—3.45). After adjustments the association persisted for use of antidepressants only (OR 1.64; 95% CI, 1.05—2.55). Conclusions: Women exposed to IPV were more likely to report use of psychotropic drugs, even after adjusting for mental distress. The study indicates that exposure to IPV; including psychological abuse should be evaluated as a possible source of distress when psychotropic drug treatment is considered.
Collapse
Affiliation(s)
- Lise Eilin Stene
- Department of Public Health and General Practice, Faculty of Medicine,
Norwegian University of Science and Technology, Trondheim, Norway,
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, University of
Oslo, Oslo, Norway
| | - Geir Wenberg Jacobsen
- Department of Public Health and General Practice, Faculty of Medicine,
Norwegian University of Science and Technology, Trondheim, Norway
| | - Berit Schei
- Department of Public Health and General Practice, Faculty of Medicine,
Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
30
|
Back SE, Payne RL, Simpson AN, Brady KT. Gender and prescription opioids: findings from the National Survey on Drug Use and Health. Addict Behav 2010; 35:1001-7. [PMID: 20598809 DOI: 10.1016/j.addbeh.2010.06.018] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 05/09/2010] [Accepted: 06/14/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND Significant gender differences in drug and alcohol use have been reported; however, little is known about gender differences in prescription opioid misuse and dependence. This study compared correlates, sources and predictors of prescription opioid non-medical use, as well as abuse or dependence among men and women in a nationally-representative sample. METHODS Participants were 55,279 (26,746 men, 28,533 women) non-institutionalized civilians aged 12years and older who participated in the National Survey on Drug Use and Health. RESULTS Rates of lifetime and past-year non-medical use of prescription opiates were 13.6% and 5.1%, respectively. Significantly more men than women endorsed lifetime (15.9% vs. 11.2%) and past-year use (5.9% vs. 4.2%; ps<0.0001). Among past-year users, 13.2% met criteria for current prescription opiate abuse or dependence, and this did not differ significantly by gender. Polysubstance use and treatment underutilization were common among both men and women, however significantly fewer women than men had received alcohol or drug abuse treatment (p=0.001). Men were more likely than women to obtain prescription opioids for free from family or friends, and were more likely to purchase them from a dealer (ps<.01). Gender-specific predictors of use as compared to abuse/dependence were also observed. CONCLUSIONS The findings highlight important differences between men and women using prescription opiates. The observed differences may help enhance the design of gender-sensitive surveillance, identification, prevention and treatment interventions.
Collapse
Affiliation(s)
- Sudie E Back
- Department of Psychiatry and Behavioral Sciences, Clinical Neuroscience Division, Medical University of South Carolina, 125 Doughty St., PO Box 250861, Charleston, SC 29425, United States.
| | | | | | | |
Collapse
|
31
|
Carr ER, Szymanski DM. Sexual Objectification and Substance Abuse in Young Adult Women. COUNSELING PSYCHOLOGIST 2010. [DOI: 10.1177/0011000010378449] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectification Theory (Fredrickson & Roberts, 1997) provides an important perspective for understanding the experiences of women living in a culture that sexualizes and objectifies the female body. The purpose of this study was to examine the relationships between interpersonal sexual objectification experiences and women’s substance abuse in a sample of 289 young adult women. Findings indicate that both everyday (e.g., body evaluation) and extreme (i.e., sexual victimization) forms of sexual objectification experiences were positively correlated with alcohol, nicotine, and other drug abuse. Furthermore, the findings provide support for a theorized mediated model in which sexual objectification is linked to women’s substance abuse both directly and indirectly via self-objectification, body shame, and depression.
Collapse
|