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Kwagala C, Munube D, Abbo C, Muhwezi WW, Mwesiga EK. Prevalence and factors associated with opioid use disorder among adolescents with sickle cell disease in Mulago hospital, Uganda. Child Adolesc Psychiatry Ment Health 2024; 18:94. [PMID: 39090740 PMCID: PMC11295896 DOI: 10.1186/s13034-024-00790-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Opioid use disorder (OUD) among adolescents with sickle cell disease (SCD) patients increases their risk of complications from sickle cell disease, such as infections, stroke, acute chest syndrome, sudden death, and organ failure. This negatively impacts families, communities, the national health system, and the economy. This study aimed to determine the prevalence and factors associated with opioid use disorder among adolescents with SCD at Mulago Hospital Uganda. METHODS This study was carried out at the Sickle Cell Clinic of Mulago Hospital, the national referral hospital in Uganda. The study participants were adolescents aged 10 to 19 years. Following informed consent/ assent, a sociodemographic questionnaire, the WHO Alcohol, Smoking and Substance Involvement Screening Test - Young (ASSIST-Y), the Beck Depression Inventory-II (BDI II), and Generalized Anxiety Disorder - 7 (GAD-7) questionnaires were used to collect data. Data was entered in EpiInfo and analyzed in STATA 15. RESULTS The prevalence of opioid use disorder was 5.3%. The significant risk factor was increasing depressive score AOR: 1.11(95% CI: 1.01-1.22, p = 0.035), while living with a family was protective against opioid use disorders AOR: 0.01; (95% CI: 0.0004, 0.27, p = 0.007). CONCLUSION There was a significant problem of OUD among adolescents with SCD. There is, therefore, needed to integrate screening of OUD and mental illnesses like depression among adolescents with SCD and to emphasize the importance of family support in their care.
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Affiliation(s)
- Claire Kwagala
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Deogratias Munube
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Catherine Abbo
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Wilson Winstons Muhwezi
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
| | - Emmanuel Kiiza Mwesiga
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda
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Maynard BR, Vaughn MG, Prasad-Srivastava S, Alsolami A, DeLisi M, McGuire D. Towards more accurate classification of risk of arrest among offenders on community supervision: An application of machine learning versus logistic regression. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2023; 33:156-171. [PMID: 37101327 DOI: 10.1002/cbm.2289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/08/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Although there is general consensus about the behavioural, clinical and sociodemographic variables that are risk factors for reoffending, optimal statistical modelling of these variables is less clear. Machine learning techniques offer an approach that may provide greater accuracy than traditional methods. AIM To compare the performance of advanced machine learning techniques (classification trees and random forests) to logistic regression in classifying correlates of rearrest among adult probationers and parolees in the United States. METHOD Data were from the subgroup of people on probation or parole who had taken part in the National Survey on Drug Use and Health for the years 2015-2019. We compared the performance of logistic regression, classification trees and random forests, using receiver operating characteristic curves, to examine the correlates of arrest within the past 12 months. RESULTS We found that machine learning techniques, specifically random forests, possessed significantly greater accuracy than logistic regression in classifying correlates of arrest. CONCLUSIONS Our findings suggest the potential for enhanced risk classification. The next step would be to develop applications for criminal justice and clinical practice to inform better support and management strategies for former offenders in the community.
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Affiliation(s)
| | | | | | | | | | - Dyan McGuire
- Saint Louis University, St. Louis, Missouri, USA
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Correlates of cannabis use disorder in the United States: A comparison of logistic regression, classification trees, and random forests. J Psychiatr Res 2022; 151:590-597. [PMID: 35636037 DOI: 10.1016/j.jpsychires.2022.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 05/11/2022] [Accepted: 05/19/2022] [Indexed: 10/18/2022]
Abstract
Although several recent studies have examined psychosocial and demographic correlates of cannabis use disorder (CUD) in adults, few, if any, recent studies have evaluated the performance of machine learning methods relative to standard logistic regression for identifying correlates of CUD. The present study used pooled data from the 2015-2018 National Survey on Drug Use and Health to evaluate psychosocial and demographic correlates of CUD in adults. In addition, we compared the performance of logistic regression, classification trees, and random forest methods in classifying CUD. When comparing the performance of each method on the test data set, classification trees (AUC = 0.84, 95%CI: 0.82, 0.85) and random forest (AUC = 0.83, 95%CI: 0.82, 8.05) performed similarly and superior to logistic regression (AUC = 0.77, 95%CI: 0.74, 0.79). Results of the random forests reveal that marital status, risk propensity, age, and cocaine dependence variables contributed most to node purity, whereas model accuracy would decrease significantly if county type, income, race, and education variables were excluded from the model. One possible approach to improving the efficiency, interpretability, and clinical insights of CUD correlates is the employment of machine learning techniques.
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Dell NA, Prasad Srivastava S, Vaughn MG, Salas-Wright C, Hai AH, Qian Z. Binge drinking in early adulthood: A machine learning approach. Addict Behav 2022; 124:107122. [PMID: 34598011 DOI: 10.1016/j.addbeh.2021.107122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/01/2022]
Abstract
Binge drinking among young adults (18-25) has been recognized as a public health concern. Considerable variation among drinking behaviors have been found among this group. Several statistical methods are available to identify theoretically and empirically meaningful correlates of binge drinking. The present study evaluated three methods for identifying correlates of binge drinking, comparing logistic regression to two machine learning methods-classification tress and random forests. While each model identified similar correlates of binge drinking-such as propensity for engaging in risky behaviors, marijuana dependence, cocaine dependence, identifying as non-Hispanic white, and higher education-the AUC analysis showed that the random forest analysis more accurately classified positive cases of binge drinking. Random forests modelling of psychosocial data is a feasible approach for identifying correlates of binge drinking behaviors among young adults. Clinical implications are discussed related to screening for binge drinking in behavioral health organizations.
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Kelley-Quon LI, Kirkpatrick MG, Ricca RL, Baird R, Harbaugh CM, Brady A, Garrett P, Wills H, Argo J, Diefenbach KA, Henry MCW, Sola JE, Mahdi EM, Goldin AB, St Peter SD, Downard CD, Azarow KS, Shields T, Kim E. Guidelines for Opioid Prescribing in Children and Adolescents After Surgery: An Expert Panel Opinion. JAMA Surg 2021; 156:76-90. [PMID: 33175130 PMCID: PMC8995055 DOI: 10.1001/jamasurg.2020.5045] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
IMPORTANCE Opioids are frequently prescribed to children and adolescents after surgery. Prescription opioid misuse is associated with high-risk behavior in youth. Evidence-based guidelines for opioid prescribing practices in children are lacking. OBJECTIVE To assemble a multidisciplinary team of health care experts and leaders in opioid stewardship, review current literature regarding opioid use and risks unique to pediatric populations, and develop a broad framework for evidence-based opioid prescribing guidelines for children who require surgery. EVIDENCE REVIEW Reviews of relevant literature were performed including all English-language articles published from January 1, 1988, to February 28, 2019, found via searches of the PubMed (MEDLINE), CINAHL, Embase, and Cochrane databases. Pediatric was defined as children younger than 18 years. Animal and experimental studies, case reports, review articles, and editorials were excluded. Selected articles were graded using tools from the Oxford Centre for Evidence-based Medicine 2011 levels of evidence. The Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument was applied throughout guideline creation. Consensus was determined using a modified Delphi technique. FINDINGS Overall, 14 574 articles were screened for inclusion, with 217 unique articles included for qualitative synthesis. Twenty guideline statements were generated from a 2-day in-person meeting and subsequently reviewed, edited, and endorsed externally by pediatric surgical specialists, the American Pediatric Surgery Association Board of Governors, the American Academy of Pediatrics Section on Surgery Executive Committee, and the American College of Surgeons Board of Regents. Review of the literature and guideline statements underscored 3 primary themes: (1) health care professionals caring for children who require surgery must recognize the risks of opioid misuse associated with prescription opioids, (2) nonopioid analgesic use should be optimized in the perioperative period, and (3) patient and family education regarding perioperative pain management and safe opioid use practices must occur both before and after surgery. CONCLUSIONS AND RELEVANCE These are the first opioid-prescribing guidelines to address the unique needs of children who require surgery. Health care professionals caring for children and adolescents in the perioperative period should optimize pain management and minimize risks associated with opioid use by engaging patients and families in opioid stewardship efforts.
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Affiliation(s)
- Lorraine I Kelley-Quon
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
- Department of Preventive Medicine, University of Southern California, Los Angeles
- Keck School of Medicine, Department of Surgery, University of Southern California, Los Angeles
| | | | - Robert L Ricca
- Department of Pediatric Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia
| | - Robert Baird
- Division of Pediatric Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Ashley Brady
- Department of Pediatric Surgery, University of Michigan, Ann Arbor
| | - Paula Garrett
- Department of Pediatric Surgery, University of Michigan, Ann Arbor
| | - Hale Wills
- Division of Pediatric Surgery, Hasbro Children's Hospital, Providence, Rhode Island
- Department of Surgery, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Jonathan Argo
- Department of Pediatric Anesthesiology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Karen A Diefenbach
- Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University, Columbus
| | - Marion C W Henry
- Department of Surgery, University of Arizona College of Medicine, Tucson
| | - Juan E Sola
- Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Elaa M Mahdi
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
- Keck School of Medicine, Department of Surgery, University of Southern California, Los Angeles
| | - Adam B Goldin
- Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, Seattle, Washington
- Department of Surgery, University of Washington School of Medicine, Seattle
| | - Shawn D St Peter
- Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri
| | - Cynthia D Downard
- Division of Pediatric Surgery, Hiram C. Polk Jr MD Department of Surgery, University of Louisville, Louisville, Kentucky
| | - Kenneth S Azarow
- Division of Pediatric Surgery, Department of Surgery, Oregon Health & Science University, Portland
| | - Tracy Shields
- Division of Library Services, Naval Medical Center, Portsmouth, Virginia
| | - Eugene Kim
- Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California
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Montiel Ishino FA, McNab PR, Gilreath T, Salmeron B, Williams F. A comprehensive multivariate model of biopsychosocial factors associated with opioid misuse and use disorder in a 2017-2018 United States national survey. BMC Public Health 2020; 20:1740. [PMID: 33208132 PMCID: PMC7672927 DOI: 10.1186/s12889-020-09856-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 11/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Few studies have comprehensively and contextually examined the relationship of variables associated with opioid use. Our purpose was to fill a critical gap in comprehensive risk models of opioid misuse and use disorder in the United States by identifying the most salient predictors. METHODS A multivariate logistic regression was used on the 2017 and 2018 National Survey on Drug Use and Health, which included all 50 states and the District of Columbia of the United States. The sample included all noninstitutionalized civilian adults aged 18 and older (N = 85,580; weighted N = 248,008,986). The outcome of opioid misuse and/or use disorder was based on reported prescription pain reliever and/or heroin use dependence, abuse, or misuse. Biopsychosocial predictors of opioid misuse and use disorder in addition to sociodemographic characteristics and other substance dependence or abuse were examined in our comprehensive model. Biopsychosocial characteristics included socioecological and health indicators. Criminality was the socioecological indicator. Health indicators included self-reported health, private health insurance, psychological distress, and suicidality. Sociodemographic variables included age, sex/gender, race/ethnicity, sexual identity, education, residence, income, and employment status. Substance dependence or abuse included both licit and illicit substances (i.e., nicotine, alcohol, marijuana, cocaine, inhalants, methamphetamine, tranquilizers, stimulants, sedatives). RESULTS The comprehensive model found that criminality (adjusted odds ratio [AOR] = 2.58, 95% confidence interval [CI] = 1.98-3.37, p < 0.001), self-reported health (i.e., excellent compared to fair/poor [AOR = 3.71, 95% CI = 2.19-6.29, p < 0.001], good [AOR = 3.43, 95% CI = 2.20-5.34, p < 0.001], and very good [AOR = 2.75, 95% CI = 1.90-3.98, p < 0.001]), no private health insurance (AOR = 2.12, 95% CI = 1.55-2.89, p < 0.001), serious psychological distress (AOR = 2.12, 95% CI = 1.55-2.89, p < 0.001), suicidality (AOR = 1.58, 95% CI = 1.17-2.14, p = 0.004), and other substance dependence or abuse were significant predictors of opioid misuse and/or use disorder. Substances associated were nicotine (AOR = 3.01, 95% CI = 2.30-3.93, p < 0.001), alcohol (AOR = 1.40, 95% CI = 1.02-1.92, p = 0.038), marijuana (AOR = 2.24, 95% CI = 1.40-3.58, p = 0.001), cocaine (AOR = 3.92, 95% CI = 2.14-7.17, p < 0.001), methamphetamine (AOR = 3.32, 95% CI = 1.96-5.64, p < 0.001), tranquilizers (AOR = 16.72, 95% CI = 9.75-28.65, p < 0.001), and stimulants (AOR = 2.45, 95% CI = 1.03-5.87, p = 0.044). CONCLUSIONS Biopsychosocial characteristics such as socioecological and health indicators, as well as other substance dependence or abuse were stronger predictors of opioid misuse and use disorder than sociodemographic characteristics.
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Affiliation(s)
- Francisco A Montiel Ishino
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 7201 Wisconsin Ave Ste. 533, Bethesda, MD, 20814, USA. .,Transdisciplinary Center for Health Equity Research, College of Education and Human Development, Texas A&M University, 4243 TAMU, 311 Blocker, College Station, TX, 77843, USA.
| | - Philip R McNab
- Center for a Livable Future, Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, 111 Market Place, Suite 840, Baltimore, MD, 21202, USA
| | - Tamika Gilreath
- Transdisciplinary Center for Health Equity Research, College of Education and Human Development, Texas A&M University, 4243 TAMU, 311 Blocker, College Station, TX, 77843, USA
| | - Bonita Salmeron
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 7201 Wisconsin Ave Ste. 533, Bethesda, MD, 20814, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 7201 Wisconsin Ave Ste. 533, Bethesda, MD, 20814, USA
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Becker KJ, King KA, Vidourek RA, Merianos AL. Examining the influence school factors have on stimulant misuse among a national sample of adolescents. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1821805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Kelsi J. Becker
- Health Promotion and Education, University of Cincinnati, Cincinnati, OH, USA
| | - Keith A. King
- Health Promotion and Education, University of Cincinnati, Cincinnati, OH, USA
| | - Rebecca A. Vidourek
- Health Promotion and Education, University of Cincinnati, Cincinnati, OH, USA
| | - Ashley L. Merianos
- Health Promotion and Education, University of Cincinnati, Cincinnati, OH, USA
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Serdarevic M, Elliott A, Striley CW, Cottler LB, Osborne V. If kids ruled the world, how would they stop non-medical use of prescription drugs? JOURNAL OF HEALTH RESEARCH 2020; 34:283-294. [PMID: 34296069 PMCID: PMC8293975 DOI: 10.1108/jhr-02-2019-0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE We examined ideas about how youth would mitigate non-medical use of prescription medications among their peers. DESIGN/METHODOLOGY/APPROACH The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) interviewed 11,048 youth10-18 years of age between 2008 and 2011 from entertainment venues of 10 US urban, suburban, and rural areas. Using a mixed-methods approach, participants completed a survey culminating in open ended questions asking: 1) How should kids your age be told about prescription drugs and their effects?; 2) If you ran the world, how would you stop kids from taking other people's prescription medicines?; 3)Why do people use prescription stimulants without a prescription? Responses from a random sample of 900 children were analyzed using qualitative thematic analyses. FINDINGS The random sample of 900 youth (52% female, 40% white, with a mean age was 15.1 years) believed they should be educated about prescription drugs and their negative effects at schools, at home by parents, through the media, and health professionals. Youth would stop kids from using other people's prescription drugs through more stringent laws that restricted use, and education about negative consequences of use. Peer pressure was the most common reason youth gave for using other's pills, though some reported using for curiosity. ORIGINALITY/VALUE This analysis shows the importance of considering youth's opinions on non-medical use of prescription medications, which are often overlooked. Studies should disseminate this data from youth to stop the illicit use of prescription drugs among teens and youth.
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Affiliation(s)
| | - Amy Elliott
- University of Florida, Gainesville, Florida, United States
| | | | | | - Vicki Osborne
- Drug Safety Research Unit, Southampton, Southampton, United Kingdom of Great Britain and Northern Ireland
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Prince MA, Conner BT, Davis SR, Swaim RC, Stanley LR. Risk and Protective Factors of Current Opioid Use Among Youth Living on or Near American Indian Reservations: An Application of Machine Learning. TRANSLATIONAL ISSUES IN PSYCHOLOGICAL SCIENCE 2020; 7:130-140. [PMID: 34447859 PMCID: PMC8386181 DOI: 10.1037/tps0000236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Opioid use among youth, particularly among American Indian (AI) youth, is rising, resulting in a large number of accidental overdoses and deaths. In order to develop effective prevention strategies, we need to use exploratory data analysis to identify previously unknown predictors of opioid use among youth living on or near reservations. The present study is an application of Machine Learning, a type of exploratory data analysis, to the Our Youth, Our Future epidemiological survey (N = 6482) to determine salient risk and protective factors for past 30-day opioid use. The Machine Learning algorithm identified 11 salient risk and protective factors. Importantly, highest risk was conferred for those reporting recent cocaine use, having ever tried a narcotic other than heroin, and identifying as American Indian. Protective factors included never having tried opioids other than heroin, infrequent binge drinking, having fewer friends pressuring you to use illicit drugs, initiating alcohol use at a later age, and being older. This model explained 61% of the variance in the training sample and, on average, 24% of the variance in the bootstrapped samples. Taken together, this model identifies known predictors of 30-day opioid use, for example, recent substance use, as well as unknown predictors including being AI, Snapchat use, and peer encouragement for use. Notably, recent cocaine use was a more salient predictor of recent opioid use than lifetime opioid use.
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Affiliation(s)
- Mark A. Prince
- Department of Psychology, Colorado State University
- Tri-Ethnic Center for Prevention Research, Colorado State University
| | - Bradley T. Conner
- Department of Psychology, Colorado State University
- Tri-Ethnic Center for Prevention Research, Colorado State University
| | | | - Randall C. Swaim
- Department of Psychology, Colorado State University
- Tri-Ethnic Center for Prevention Research, Colorado State University
| | - Linda R. Stanley
- Tri-Ethnic Center for Prevention Research, Colorado State University
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Zuckermann AME, Qian W, Battista K, Jiang Y, de Groh M, Leatherdale ST. Factors influencing the non-medical use of prescription opioids among youth: results from the COMPASS study. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1736669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Alexandra M. E. Zuckermann
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Wei Qian
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Katelyn Battista
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Ying Jiang
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Margaret de Groh
- Applied Research Division, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Scott T. Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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Axson SA, Giordano NA, McDonald CC, Pinto-Martin JA. Opioid Prescribing to Adolescents upon Discharge from an Admission of 48 Hours or Less. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2019. [DOI: 10.1080/1067828x.2019.1679688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sydney A. Axson
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Catherine C. McDonald
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- The Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer A. Pinto-Martin
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Selective invalidation of ambivalent pro-marijuana attitude components. Addict Behav 2019; 97:77-83. [PMID: 31153095 DOI: 10.1016/j.addbeh.2019.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/17/2019] [Accepted: 05/19/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Attitudes of drug-abstinent youth considering marijuana initiation can be highly ambivalent. Invalidating pro-usage elements (i.e., opinions) of ambivalent marijuana attitudes, while leaving anti-marijuana elements intact, may create stronger, less ambivalent marijuana-resistant attitudes and lower usage intentions, while concurrently elucidating the role of ambivalence in persuasive prevention. METHOD From an initial pool of marijuana-abstinent middle-school students (N = 538), the quintile expressing the most negative attitudes toward a marijuana prevention appeal (N = 101) were randomly assigned to one of three conditions designed to invalidate pro-marijuana opinions. Analyses then tested their susceptibility to a second marijuana prevention appeal. RESULTS Personally threatening messages were found ineffective, but appeals contesting resistant responses significantly decreased ambivalence (p < .01). Mediational analyses showed that this decreased ambivalence was associated with less favorable attitudes and lower marijuana usage intentions (both p < .001). An attribution-based manipulation increased ambivalence (p < .05), which was associated with positive usage intentions mediated through positive attitudes (both p < .001). CONCLUSION Analyses elucidated the role of attitude ambivalence in prevention, providing a more complete understanding of potential facilitative use of ambivalence in prevention models based on prevention. Results support the further examination and use of methods that invalidate pro-marijuana opinions, thereby leading to greater susceptibility to subsequent prevention appeals.
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Rolling CA, Vaughn MG, Velez D, Jackson DB, Holzer KJ, Jaegers L, Boutwell BB. Prevalence and correlates of diabetes among criminal justice-involved individuals in the United States. Ann Epidemiol 2019; 36:55-61. [PMID: 31301945 DOI: 10.1016/j.annepidem.2019.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 05/02/2019] [Accepted: 05/29/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE Diabetes is one of the most prevalent and fastest-growing adverse health conditions in the United States and disproportionately affects those demographic and socioeconomic groups that are also more likely to be involved with the criminal justice (CJ) system. This study examines the prevalence and correlates of diabetes among CJ-involved individuals in the United States. METHODS Using traditional statistical modeling and modern machine learning methods, data from the National Study on Drug Use and Health were analyzed to compare the correlates and predictive interactions of diabetes diagnosis among those respondents on probation and parole to a sample, matched by age and gender, who were not. RESULTS Subjects involved in the CJ system were 15% more likely (1.66% vs. 1.44%, P = .015) to report a past-year diagnosis of diabetes than a sample of noninvolved individuals matched by age and sex, although this association was not statistically significant after adjusting for demographic and behavioral confounders. Similar trends in diabetes prevalence emerged for the non-CJ and CJ groups with regard to income, depression (OR of 2.38 and 1.65 for the CJ and non-CJ groups, respectively) and attainment of college education (OR of 0.64 and 0.30 for the CJ and non-CJ groups, respectively, compared with those with less than a high school education). Results also suggested that a generally high propensity toward risk taking had a negative effect on diabetes for the non-CJ group (OR 0.78; 95% CI 0.69-0.87), yet increased the odds of diabetes (OR 1.38; 95% CI 1.02-1.85) for the CJ group. CONCLUSIONS Involvement in the U.S. CJ system is correlated with a higher prevalence of diabetes and differing risk factors for diabetes diagnosis. Further research is necessary, however, to unpack the precise causal pathways that underlie the associational trends in the current analysis.
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Affiliation(s)
- Craig A Rolling
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO.
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO; Graduate School of Social Work, Yonsei University, Seoul, Republic of Korea
| | | | - Dylan B Jackson
- Department of Criminal Justice, The University of Texas at San Antonio, San Antonio
| | - Katherine J Holzer
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO
| | - Lisa Jaegers
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO; Department of Occupational Science and Occupational Therapy, Doisy College of Health Sciences, Saint Louis University, St. Louis, MO
| | - Brian B Boutwell
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO; School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO; Department of Family and Community Medicine, School of Medicine, Saint Louis University, St. Louis, MO
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Wang W, Luo M, Xi C, Lei Y, Pan S, Gao X, Xu Y, Huang G, Deng X, Guo L, Lu C. Cross-sectional study on influence of the family environment on the lifetime non-medical use of prescription drugs among Chinese adolescents in Guangdong: an analysis of sex differences. BMJ Open 2019; 9:e026758. [PMID: 31278096 PMCID: PMC6615848 DOI: 10.1136/bmjopen-2018-026758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES This study aimed to assess if adolescents had used any prescription drugs non-medically, to explore the associations between the family environment and non-medical use of prescription drugs (NMUPD) and to investigate whether there are any sex differences in the aforementioned associations. DESIGN A population-based cross-sectional study. SETTING A secondary analysis of the cross-sectional data collected from high school students in Guangdong who were sampled using a multistage, stratified-cluster, random-sampling method in the 2015 School-based Chinese Adolescents Health Survey. PARTICIPANTS A total of 21 774 students aged 12-20 years. DATA ANALYSIS Multilevel logistic regression models were used to explore the univariable and multivariable relationship between family environment and NMUPD among adolescents. Adjusted ORs and corresponding 95% CI were calculated. OUTCOME MEASURES Questions regarding to adolescent' NMUPD (including sedative, opioid and stimulant) were surveyed in the study. RESULTS A total of 6.3% students reported lifetime NMUPD in this study. The most commonly used drugs were opioids (3.9%), followed by sedatives (3.2%) and stimulants (2.5%). Multilevel analyses indicated that living arrangements, family economic status, parental relationships, parental education levels, monthly pocket money, parental drinking and drug problems were significantly correlated to the NMUPD among all students. Among boys, living arrangements, family economic status, maternal education levels, monthly pocket money, parental drinking and drug problems were significantly related to different types of NMUPD. The same factors were related to girls' NMUPD, except for maternal education levels. Parental relationships and paternal education levels were also associated with girls' NMUPD. CONCLUSION The family environment exerts an important influence on adolescents' NMUPD. Interventions targeted at families are highly recommended considering the negative effects of NMUPD. In addition, the child's sex might be taken into consideration when developing and implementing preventive strategies.
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Affiliation(s)
- Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Min Luo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chuhao Xi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yiling Lei
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Siyuan Pan
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xue Gao
- Department of Drug Abuse Control, Center for ADR Monitoring of Guangdong, Guangzhou, China
| | - Yan Xu
- Department of Drug Abuse Control, Center for ADR Monitoring of Guangdong, Guangzhou, China
| | - Guoliang Huang
- Department of Drug Abuse Control, Center for ADR Monitoring of Guangdong, Guangzhou, China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - CiYong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Jordan AE, Blackburn NA, Des Jarlais DC, Hagan H. Past-year prevalence of prescription opioid misuse among those 11 to 30years of age in the United States: A systematic review and meta-analysis. J Subst Abuse Treat 2017; 77:31-37. [PMID: 28476268 DOI: 10.1016/j.jsat.2017.03.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/08/2017] [Accepted: 03/08/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND There are high levels of prescription and consumption of prescription opioids in the US. Misuse of prescription opioids has been shown to be highly correlated with prescription opioid-related morbidity and mortality including fatal and non-fatal overdose. We characterized the past-year prevalence of prescription opioid misuse among those 11-30years of age in the US. METHODS A systematic review and meta-analysis were carried out following a published protocol and PRISMA guidelines. We searched electronic databases; reports were eligible if they were published between 1/1/1990-5/30/2014, and included data on individuals 11-30years of age from the US. Study quality was assessed using the Newcastle-Ottawa Scale. RESULTS A total of 3211 abstracts were reviewed for inclusion; after discarding duplicates and identifying non-eligible reports, a total of 19 unique reports, providing 34 estimates, were included in the final systematic review and meta-analysis. The range of past-year prescription opioid misuse prevalence the reports was 0.7%-16.3%. An increase in prevalence of 0.4% was observed over the years of data collection. CONCLUSIONS This systematic review and meta-analysis found a high prevalence of past-year prescription opioid misuse among individuals 11-30years of age. Importantly, we identified an increase in past-year prevalence 1990-2014. Misuse of prescription opioids has played an important role in national increases of fatal and non-fatal drug overdose, heroin use and injection, and HIV and HCV infection among young people. The observed high and increasing prevalence of prescription opioid misuse is an urgent public health issue.
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Affiliation(s)
- Ashly E Jordan
- New York University, Rory Meyers College of Nursing, New York, NY, United States; Center for Drug Use and HIV Research, New York, NY, United States.
| | - Natalie A Blackburn
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, United States
| | - Don C Des Jarlais
- Center for Drug Use and HIV Research, New York, NY, United States; Icahn School of Medicine Mount Sinai, Mount Sinai Beth Israel, New York, NY, United States
| | - Holly Hagan
- New York University, Rory Meyers College of Nursing, New York, NY, United States; Center for Drug Use and HIV Research, New York, NY, United States
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Striley CW, Kelso-Chichetto NE, Cottler LB. Nonmedical Prescription Stimulant Use Among Girls 10-18 Years of Age: Associations With Other Risky Behavior. J Adolesc Health 2017; 60:328-332. [PMID: 27998704 PMCID: PMC5596869 DOI: 10.1016/j.jadohealth.2016.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/17/2016] [Accepted: 10/17/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Little is known about the risk factors for nonmedical use (NMU) of prescription stimulants among adolescent girls. We aimed to measure the association of nonmedical prescription stimulant use with empirically linked risk factors, including weight control behavior (WCB), gambling, and depressed mood, in pre-teen and teenaged girls. METHODS We assessed the relationship between age and race, gambling, WCB, depressive mood, and nonmedical prescription stimulant use using multivariable logistic regression. The study sample included 5,585 females, aged 10-18 years, recruited via an entertainment venue intercept method in 10 U.S. metropolitan areas as part of the National Monitoring of Adolescent Prescription Stimulants Study (2008-2011). RESULTS NMU of prescription stimulants was reported by 6.6% (n = 370) of the sample. In multivariable logistic regression, 1-year increase in age was associated with a 21% (95% confidence interval [CI]: .15, .28) increase in risk for NMU. Whites and other race/ethnicity girls had 2.67 (CI: 1.85, 3.87) and 1.71 (1.11, 2.65) times higher odds for NMU, compared to African-Americans. Depressive mood (adjusted odds ratio: 2.69, CI: 2.04, 5.57) and gambling (adjusted odds ratio: 1.90, 1.23, 2.92) were associated with increased odds for NMU. A dose-response was identified between WCB and NMU, where girls with unhealthy and extreme WCB were over five times more likely to endorse NMU. CONCLUSIONS We contribute to the literature linking WCB, depression, gambling, and the NMU of prescription stimulants in any population and uniquely do so among girls.
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Affiliation(s)
- Catherine Woodstock Striley
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida.
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Stewart TD, Reed MB. Lifetime nonmedical use of prescription medications and socioeconomic status among young adults in the United States. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 41:458-64. [PMID: 26337203 DOI: 10.3109/00952990.2015.1060242] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Despite decreases in the use of illicit drugs in the United States, prescription medications have become a major category of substances used by young adults. OBJECTIVE This study examines the relationship between the socioeconomic status (SES) of young adult respondents (ages 24-32) and their history of nonmedical use of prescription medications (NUPM). METHOD A secondary analysis was conducted with nationally representative data gathered from several waves (n = 15 701) of the National Longitudinal Study of Adolescent Health (Add Health). Four categories of NUPM were examined: (i) sedatives; (ii) tranquilizers; (iii) stimulants; and (iv) pain killers. SES was defined by several measures in the Add Health survey. Given the complex sampling plan of the Add Health, all analyses were weighted appropriately. RESULTS Results indicated higher levels of personal SES, such as having health insurance or not experiencing a financial hardship in the past year, decreased the likelihood of reporting lifetime NUPM. In contrast higher levels of parent SES (e.g. parental education) were associated with an increased likelihood of reporting lifetime use of NUPM tranquilizers and stimulants. CONCLUSIONS The results of this study suggest parental SES may have a stronger influence over NUPM than personal levels of SES, particularly for the categories of tranquilizers and stimulants. Furthermore, these findings indicate more research is needed on this subject to better understand the NUPM epidemic in order to effectively develop comprehensive clinical, public health, and policy-related intervention and prevention approaches.
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Affiliation(s)
- Thomas Darryl Stewart
- a Center for Alcohol and Drug Research, San Diego State University School of Social Work , San Diego , CA , USA
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18
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Scherer M, Harrell P, Romano E. Marijuana and Other Substance Use Among Motor Vehicle Operators: A Latent Class Analysis. J Stud Alcohol Drugs 2016; 76:916-23. [PMID: 26562599 DOI: 10.15288/jsad.2015.76.916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The deleterious effect of multiple-substance use on driving performance is well established, but relatively little research has examined the patterns of drug use among multiple-substance users and its relationship to both alcohol use and adverse driving outcomes. METHOD The current study used latent class analysis to examine subgroups of substance users among a population of drivers who screened positively for 2 or more of 13 substances other than alcohol (N = 250). A series of logistic regression analyses was conducted to examine demographic predictors of latent class assignment and class association with adverse driving outcomes. RESULTS Four distinct subclasses of users were identified among multiple-substance-using drivers: Class 1 consisted of individuals who demonstrated high levels of all substances indicators (5%). The second class demonstrated high levels of marijuana and cocaine use and lower levels of all other substances (27%). The third class screened high for marijuana and nonmedical prescription opiate analgesics use (36%), whereas the last class demonstrated high nonmedical prescription opiate analgesics and benzodiazepine use (32%). Drivers in Class 2 (marijuana and cocaine users) were more likely to be younger and have a positive breath alcohol concentration than drivers in any other class. CONCLUSIONS Because multidrug users show dissimilar characteristics, the propensity of researchers to lump all multiple-substance users together may either erroneously attribute the potentially profound impact of those in the marijuana and cocaine use class to all multiple-substance users or dilute their specific contribution to crash risk.
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Affiliation(s)
- Michael Scherer
- Pacific Institute for Research and Evaluation, Calverton, Maryland
| | - Paul Harrell
- Eastern Virginia Medical School, Norfolk, Virginia
| | - Eduardo Romano
- Pacific Institute for Research and Evaluation, Calverton, Maryland
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19
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Guo L, Xu Y, Deng J, He Y, Gao X, Li P, Wu H, Zhou J, Lu C. Non-medical use of prescription pain relievers among high school students in China: a multilevel analysis. BMJ Open 2015; 5:e007569. [PMID: 26169805 PMCID: PMC4513537 DOI: 10.1136/bmjopen-2014-007569] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Given the differences between general high school (GHS) and vocational high school (VHS) students, this study aimed to investigate the lifetime prevalence of non-medical use of prescription pain relievers (NMUPPR) among high school students as well as the associations between NMUPPR and individual-level factors and school category. METHODS A cross-sectional study was conducted in GHS and VHS students in 2012 in Chongqing, and 11 906 students' questionnaires were completed and qualified for the survey. Self-reported NMUPPR and information regarding individual-level determinants and school category were collected. A multilevel multivariate logistic regression model was fitted to explore independent predictors of NMUPPR. RESULTS The total lifetime prevalence of NMUPPR was 11.3%, and NMUPPR was more prevalent among VHS students (15.8%) compared with GHS students (9.8%). Overall, the results indicated that VHS students were more likely to be involved in NMUPPR (adjusted OR (AOR)=1.64, 95% CI 1.42 to 1.89). Regarding the individual-level predictors of NMUPPR, below-average family economic status was negatively correlated with NMUPPR (AOR=0.77, 95% CI 0.60 to 0.98), and students with more pocket money were more likely to be engaged in NMUPPR. Students who had difficult family relationships, had poor relationships with teachers, had parents or friends who engaged in non-medical prescription drug use, and considered or attempted suicide were more likely to be engaged in NMUPPR. CONCLUSIONS NMUPPR among high school students is a multidetermined phenomenon. The current findings indicate that VHS students are an important subgroup of adolescents and highlight the need for additional research as well as targeted prevention and intervention programmes for NMUPPR.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yan Xu
- Center for ADR Monitoring of Guangdong, Guangzhou, China
| | - Jianxiong Deng
- Center for ADR Monitoring of Guangdong, Guangzhou, China
| | - Yuan He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xue Gao
- Center for ADR Monitoring of Guangdong, Guangzhou, China
| | - Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hong Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jinhua Zhou
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
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20
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Donaldson CD, Nakawaki B, Crano WD. Variations in parental monitoring and predictions of adolescent prescription opioid and stimulant misuse. Addict Behav 2015; 45:14-21. [PMID: 25622102 PMCID: PMC5902021 DOI: 10.1016/j.addbeh.2015.01.022] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 12/18/2014] [Accepted: 01/12/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study examined relations between adolescents' family structures, social ties, and drug-related attitudes, and their misuse of prescription opioids and stimulants. Different relationships were anticipated for the substances based on prior research highlighting varying motivations for their use. METHOD Based on an earlier model of adolescent substance misuse, two path analytic models were tested using data from 12 to 17 year olds in the 2012 U.S. National Survey on Drug Use and Health (NSDUH: N=17,399). RESULTS Female respondents reported higher levels of parental warmth, as did youth from wealthier families. Greater parental monitoring was reported by adolescents from wealthier and intact families. Parental monitoring and warmth predicted adolescents' social ties and individual differences associated with drug use, and both variables predicted prescription opioid and stimulant misuse. Contrary to previous research, for adolescents aged 12 to 14, high levels of parental monitoring, while positively associated with attitudes and social ties, also predicted higher rates of prescription stimulant misuse when combined with low levels of parental warmth. Results were cross-validated with data from the 2011 NSDUH. CONCLUSIONS Analyses highlighted the importance of understanding and differentiating the underlying factors associated with adolescent prescription stimulant and opioid misuse, and the role of parental behaviors in prevention.
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Affiliation(s)
- Candice D Donaldson
- Department of Psychology, Claremont Graduate University, 150 E. 10th St., Claremont, CA 91711, USA.
| | - Brandon Nakawaki
- Department of Psychology, Claremont Graduate University, 150 E. 10th St., Claremont, CA 91711, USA.
| | - William D Crano
- Department of Psychology, Claremont Graduate University, 150 E. 10th St., Claremont, CA 91711, USA.
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21
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Wells BE, Kelly BC, Rendina HJ, Parsons JT. Prescription Drug Misuse and Sexual Behavior Among Young Adults. JOURNAL OF SEX RESEARCH 2015; 52:659-68. [PMID: 25569204 PMCID: PMC4489979 DOI: 10.1080/00224499.2014.918085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Though research indicates a complex link between substance use and sexual risk behavior, there is limited research on the association between sexual risk behavior and prescription drug misuse. In light of alarming increases in prescription drug misuse and the role of demographic characteristics in sexual risk behavior and outcomes, the current study examined demographic differences (gender, sexual identity, age, relationship status, parental class background, and race/ethnicity) in sexual risk behavior, sexual behavior under the influence of prescription drugs, and sexual risk behavior under the influence of prescription drugs in a sample of 402 young adults (ages 18 to 29) who misused prescription drugs. Nearly half of the sexually active young adult prescription drug misusers in this sample reported recent sex under the influence of prescription drugs; more than three-quarters reported recent sex without a condom; and more than one-third reported recent sex without a condom after using prescription drugs. Zero-inflated Poisson regression models indicated that White race, younger age, higher parental class, and being a heterosexual man were all associated with sexual risk behavior, sex under the influence of prescription drugs, and sexual risk under the influence of prescription drugs. Findings have implications for the targeting of prevention and intervention efforts.
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Affiliation(s)
- Brooke E. Wells
- Center for HIV Educational Studies & Training; 250 W. 26 St., Suite 300, New York, NY 10001
- Hunter College of the City University of New York; 695 Park Avenue, New York, NY 10065
- The Graduate Center of the City University of New York, 365 Fifth Avenue, New York, NY 10016
| | - Brian C. Kelly
- Purdue University, Dept of Sociology, 700 W State Street, West Lafayette, IN 47907
- Center for HIV Educational Studies & Training; 250 W. 26 St., Suite 300, New York, NY 10001
- Please direct all correspondence to: Brian C. Kelly, Purdue University Department of Sociology 700 W State St. West Lafayette, IN 47907
| | - H. Jonathon Rendina
- Center for HIV Educational Studies & Training; 250 W. 26 St., Suite 300, New York, NY 10001
- The Graduate Center of the City University of New York, 365 Fifth Avenue, New York, NY 10016
| | - Jeffrey T. Parsons
- Center for HIV Educational Studies & Training; 250 W. 26 St., Suite 300, New York, NY 10001
- Hunter College of the City University of New York; 695 Park Avenue, New York, NY 10065
- The Graduate Center of the City University of New York, 365 Fifth Avenue, New York, NY 10016
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Castaldelli-Maia JM, Martins SS, de Oliveira LG, de Andrade AG, Nicastri S. The role of first use of inhalants within sequencing pattern of first use of drugs among Brazilian university students. Exp Clin Psychopharmacol 2014; 22:530-40. [PMID: 25150538 PMCID: PMC4250330 DOI: 10.1037/a0037794] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The present study investigated the role of first use of inhalants within a first drug sequencing pattern. In a representative sample of university students from 27 Brazilian capitals (n = 12,711), we analyzed the patterns of transition from/to first use of inhalants to/from the first use of alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, amphetamines, prescription opioids, and tranquilizers. Cox proportional hazards models were used to analyze data. Drugs that were not specified as the pair of drugs tested in each model were included as time-varying covariates in all models. In this sample, first use of inhalants was preceded only by the first use of alcohol and tobacco. However, first use of inhalants preceded first use of cannabis, amphetamines, cocaine, and tranquilizers. First use of inhalants preceded the first use of prescription opioids, and vice versa. This study highlights the need to intervene early with youths who are at risk of or just beginning to use inhalants, because this class of drugs seems to be the first illegal drug in Brazil to be experimented by respondents in our sample. There is also a call for attention to individuals who have already first used inhalants because of their higher chance to experiment with other drugs such as cannabis, cocaine, and prescription drugs. All these findings show an in-transition culture of drug use, which should be tracked through time, because some classical models (i.e., gateway model) might be outdated and might also not fit within different settings.
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Affiliation(s)
- João Maurício Castaldelli-Maia
- Department of Psychiatry, Medical School, University of São Paulo, Brazil., Department of Neuroscience, Medical School, Fundação do ABC, Brazil
| | - Silvia S. Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
| | | | - Arthur Guerra de Andrade
- Department of Psychiatry, Medical School, University of São Paulo, Brazil., Department of Neuroscience, Medical School, Fundação do ABC, Brazil
| | - Sérgio Nicastri
- Department of Psychiatry, Medical School, University of São Paulo, Brazil
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Divin AL, Zullig KJ. The Association between Non-Medical Prescription Drug Use and Suicidal Behavior among United States Adolescents. AIMS Public Health 2014; 1:226-240. [PMID: 29546088 PMCID: PMC5690255 DOI: 10.3934/publichealth.2014.4.226] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 10/10/2014] [Indexed: 11/27/2022] Open
Abstract
Adolescence represents a vulnerable time for the development of both drug use/abuse and mental illness. Although previous research has substantiated a relationship between drug use and suicidal behavior, little research has examined this relationship with non-medical prescription drug use. Given the growing prevalence of non-medical prescription drug use (NMPDU) among adolescents, this study explored the association between NMPDU and suicidal behavior. Nationally representative data were derived from 16, 410 adolescents who completed the 2009 National Youth Risk Behavior Survey. Approximately 19.8% of participants reported lifetime NMPDU. NMPDU was associated with significantly increased odds of suicidal behavior (P < 0.01), with seriously considering attempting suicide and making a plan about attempting suicide representing the strongest correlates for males and females. Results suggest the importance of 1) continued reinforcement of drug education programs in high school begun at earlier ages and 2) mental health care and screenings among adolescents.
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Affiliation(s)
- Amanda L. Divin
- Department of Health Sciences and Social Work, Western Illinois University, Macomb, IL 61455, USA
| | - Keith J. Zullig
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, WV 26501, USA
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Shehnaz SI, Agarwal AK, Khan N. A systematic review of self-medication practices among adolescents. J Adolesc Health 2014; 55:467-83. [PMID: 25245937 DOI: 10.1016/j.jadohealth.2014.07.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 06/30/2014] [Accepted: 07/01/2014] [Indexed: 10/24/2022]
Abstract
The purpose was to systematically review the global trends and factors influencing self-medication (SM) among adolescents. Databases (Medline/Pubmed, Ingenta, Cochrane Library, EMBASE, CINAHL, Proquest, Scopus, and Google Scholar) were searched for peer-reviewed research published between January 2000 and December 2013 on SM among adolescents aged 13-18 years. Articles were scrutinized for country of origin, sample size, recall period, prevalence rates and associations, influencing factors, medicines used, self-medicated health complaints, sources of drug information, recommendation and procurement, knowledge about medicines, and adverse drug reactions. One hundred and sixty-three publications met the inclusion criteria. SM prevalence ranged from 2% to 92% in different countries. The most frequently self-medicated over-the-counter and prescription-only medicines were analgesics and antibiotics, respectively. Headache, allergies, and fever were the most common self-medicated health complaints reported. Misuse of both over-the-counter and prescription-only medicines reflected a risky trend. Female gender, older age, maternal education, and familial practices were associated with SM among adolescents. The primary sources of drug information, recommendation, and procurement included pharmacists, parents, and friends. High-risk practices such as diversion of prescription medicines and utilization of previous prescriptions were also reported. Most studies revealed gaps in drug knowledge, although adolescents self-rated it as satisfactory. However, few adverse drug reactions were reported, probably because of lack of awareness about the potential harmful effects of medicines. Recommendations for "responsible SM" have been made to minimize the adverse effects of SM. Understanding the links between various factors promoting SM can be helpful in deriving strategies aimed at reducing drug-related health risks among adolescents. Moreover, these will aid in creating awareness among adolescents about the potential risks of using drugs without proper information and consultation. Studies need to be designed to assess the changing trend and identify new correlates of self-medication practices among adolescents, which pose fresh challenges to monitor the menace.
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Affiliation(s)
- Syed Ilyas Shehnaz
- Department of Pharmacology, Gulf Medical University, Ajman, United Arab Emirates.
| | - Anoop Kumar Agarwal
- Department of Pharmacology, Gulf Medical University, Ajman, United Arab Emirates
| | - Nelofer Khan
- Department of Biochemistry, Gulf Medical University, Ajman, United Arab Emirates
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25
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Ehrentraut JH, Kern KD, Long SA, An AQ, Faughnan LG, Anghelescu DL. Opioid misuse behaviors in adolescents and young adults in a hematology/oncology setting. J Pediatr Psychol 2014; 39:1149-60. [PMID: 25225182 DOI: 10.1093/jpepsy/jsu072] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe the occurrence and psychosocial correlates of aberrant opioid-associated behavior (AOB) in adolescent and young adult (AYA) hematology and oncology patients prescribed opioid therapy. METHODS Structured retrospective chart reviews were conducted for AYA patients (N = 398) accepted for active treatment at a large pediatric hematology/oncology institution over a 17-month period. Opioid therapy was documented in the records of 94 out of the 398 patients. The records of those 94 patients were further reviewed to identify documented AOB and documented correlates of AOB. RESULTS Of the 94 patients prescribed opioid therapy, 11.7% exhibited AOB. At least one psychosocial risk factor was identified in 90.9% of patients with AOB. Concurrent use of multiple opioids was significantly associated with AOB (p = .003). CONCLUSIONS Hematology/oncology AYA patients may exhibit AOB despite a legitimate clinical indication for opioid therapy. Clinicians should consider young patients' psychosocial risk factors when using opioid therapy.
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Affiliation(s)
- Jennifer Harman Ehrentraut
- Department of Psychology, Division of Anesthesia, Department of Pediatric Medicine, and Department of Biostatistics, St. Jude Children's Research Hospital
| | - Kathleen Danielle Kern
- Department of Psychology, Division of Anesthesia, Department of Pediatric Medicine, and Department of Biostatistics, St. Jude Children's Research Hospital
| | - Sarah A Long
- Department of Psychology, Division of Anesthesia, Department of Pediatric Medicine, and Department of Biostatistics, St. Jude Children's Research Hospital
| | - Angel Qi An
- Department of Psychology, Division of Anesthesia, Department of Pediatric Medicine, and Department of Biostatistics, St. Jude Children's Research Hospital
| | - Lane G Faughnan
- Department of Psychology, Division of Anesthesia, Department of Pediatric Medicine, and Department of Biostatistics, St. Jude Children's Research Hospital
| | - Doralina L Anghelescu
- Department of Psychology, Division of Anesthesia, Department of Pediatric Medicine, and Department of Biostatistics, St. Jude Children's Research Hospital
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Wang H, Deng J, Zhou X, Lu C, Huang J, Huang G, Gao X, He Y. The nonmedical use of prescription medicines among high school students: a cross-sectional study in Southern China. Drug Alcohol Depend 2014; 141:9-15. [PMID: 24875678 DOI: 10.1016/j.drugalcdep.2014.04.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 03/18/2014] [Accepted: 04/12/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The objective of this study was to examine the prevalence of the nonmedical use of prescription medicines (NMUPM) and the association between NMUPM and demographic, family and school factors. METHODS A cross-sectional study was conducted from 2007 to 2009. A total of 21,672 middle and high school students were surveyed in seven cities of Guangdong Province. Self-reported NMUPM and information regarding family and school factors were collected. Multilevel logistic regression analyses were used to explore potentially influential factors. RESULTS Of the total sample, the mean age was 16 (±1.9) years. Approximately 6.0% of respondents reported lifetime NMUPM. The most common nonmedically used prescription drug among NMUPM users was scattered analgesics, at approximately 3.9%, followed by cough medicine with codeine (2.1%). Multilevel logistic regression analysis indicated that living arrangements, available money, social friends, and smoking were significantly correlated with NMUPM among boys and girls. Academic achievement and family relationships were only significantly correlated with NMUPM among girls, and communication with parents was only associated with NMUPM among boys. CONCLUSIONS These results indicate that NMUPM represented a considerable problem for particular subgroups of adolescents. A well-established surveillance system and target intervention programs are needed given the potential long-term negative outcomes of NMUPM.
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Affiliation(s)
- Hui Wang
- Guangzhou Centre for Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, No. 1, Qide Road, Jiahe, Baiyun, Guangzhou 510440, China
| | - Jianxiong Deng
- Centre for ADR Monitoring of Guangdong, No. 74-2, Dongfengdong Road, Yuexiu, Guangzhou 510000, China
| | - Xiaolan Zhou
- The Second Affiliated Hospital of Chongqing Medical University, No. 76, Lingjiang Road, Chongqing 400010, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou 510000, China.
| | - Jinghui Huang
- The Second Affiliated Hospital of Chongqing Medical University, No. 76, Lingjiang Road, Chongqing 400010, China
| | - Guoliang Huang
- The Second Affiliated Hospital of Chongqing Medical University, No. 76, Lingjiang Road, Chongqing 400010, China
| | - Xue Gao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou 510000, China
| | - Yuan He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd Road, Yuexiu, Guangzhou 510000, China
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Pulver A, Davison C, Pickett W. Recreational use of prescription medications among Canadian young people: identifying disparities. Canadian Journal of Public Health 2014; 105:e121-6. [PMID: 24886847 DOI: 10.17269/cjph.105.4208] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Revised: 04/03/2014] [Accepted: 01/26/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES While the recreational use of prescription medications is widely recognized as a growing public health issue, there are limited epidemiological studies on patterns of use in Canada, particularly studies identifying populations at highest risk. The objective of this study was to describe recreational prescription drug use among Canadian adolescents by age, sex, socio-economic, immigration and geographic status. METHODS Data were obtained from grade 9 and 10 students participating in the 2009/2010 cycle of the nationally representative Canadian Health Behaviour in School-aged Children study (n=10,429). Students were asked about past-year recreational use of pain relievers, stimulants and sedative/tranquilizer medications. Cross-tabulations and multi-level Poisson regression were conducted to evaluate the prevalence of use and to explore disparities. RESULTS Approximately 7% of students reported past-year recreational use of one or more prescription medication(s). Females reported 1.25 times the risk of recreational use of pain relievers as compared with males (95% confidence interval [CI]: 1.04-1.51). Students of lower socio-economic status (SES) were 2.41 times more likely to report recreational use of any type of medication (95% CI: 1.94-2.99). Recreational use of pain reliever medications was highest among rural youth living in close proximity to urban centres. Rates for all medications were similar between immigrant and non-immigrant students. CONCLUSIONS Recreational prescription drug use disproportionately affects certain subgroups of youth, including females, those of lower SES and those in some rural settings more than others. These results provide foundational data to inform preventive efforts aimed at management of the nonmedical use and divergence of prescription medications.
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Affiliation(s)
| | - Colleen Davison
- Department of Public Health Sciences Department of Emergency Medicine Kingston General Hospital Research Centre Queens University.
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Jeffers AJ, Vatalaro Hill KE, Benotsch EG. Energy drinks, weight loss, and disordered eating behaviors. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2014; 62:336-342. [PMID: 24635529 DOI: 10.1080/07448481.2014.902838] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders. PARTICIPANTS/METHODS This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association-National College Health Assessment II confidentially online during February 2012. RESULTS This study revealed that the majority reported lifetime consumption of energy drinks (68.4%) and a substantial minority (30.2%) reported past-30-day consumption. Chi-square and t test results suggest that consumption is associated with concerns about personal appearance, weight loss attempts, and disordered eating behaviors (eg, vomiting). Hierarchical logistic regressions revealed that after controlling for demographics, the relations between energy drink consumption and the act of trying to lose weight, the use of diet pills, and the use of vomiting/laxatives remained significant. CONCLUSIONS The current findings suggest that energy drink consumption is associated with weight loss attempts, poor body image, and unhealthy weight loss behaviors. Future research should examine the prevalence of energy drink consumption for the purpose of weight loss.
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Affiliation(s)
- Amy J Jeffers
- a Department of Psychology , Virginia Commonwealth University , Richmond , Virginia
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Scherer M, Voas RB, Furr-Holden D. Marijuana as a predictor of concurrent substance use among motor vehicle operators. J Psychoactive Drugs 2013; 45:211-7. [PMID: 24175485 DOI: 10.1080/02791072.2013.804230] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite the adverse effects associated with marijuana abuse and dependence, marijuana is becoming more common-place in activities such as driving. Previous literature has discussed the high rates of cocaine, opioid and benzodiazepine use among users of marijuana, but no research has addressed the rates of concurrent use among drivers meeting abuse or dependence criteria. Each of these substances may produce effects detrimental to driving safety which may be compounded by concurrent substance use. This research examines rates of marijuana use, abuse, and dependence among an active sample of drivers (N = 7,734) in the 2007 National Roadside Survey. Mean age of participants was 36.89 years, and the majority were male (60.1%) and identified as White (59.2%). Participants who used marijuana but did not meet diagnostic criteria for abuse (n = 165) or dependence (n = 112) were significantly more likely to test positive for all substances than were those who did not use marijuana. Further, those that met criteria for marijuana abuse or dependence were more likely than those who did not meet criteria to test positive for THC, cocaine, and benzodiazepines and THC, cocaine, and opioids, respectively. The current research has implications for policy development and drugged driving interventions.
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Affiliation(s)
- Michael Scherer
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Abstract
PURPOSE OF REVIEW Assessing the medical and nonmedical use (NMU) of stimulants and diversion is a challenge, especially among youth, with different methods for recruitment and definitions of NMU. The field needs inexpensive, yet effective and reliable, methods of data collection to understand the prescription drug use problem. Most studies of youth are school or web-based, and conducted with teens. RECENT FINDINGS The National Monitoring of Adolescent Prescription Stimulants Study recruited 11,048 youth 10-18 years of age from urban, rural, and suburban areas in 10 US cities using an entertainment venue intercept study. This review discusses the effectiveness of the method and results from four cross-sections as well as the representativeness of the sample. Lifetime prevalence of any stimulant use was 14.8%, with rates highest among rural 16-18 year olds. The rate of last 30-day use was 7.3%, with over half (3.9%) NMU. Nearly 12% of all youth (whether a user or not) reported lifetime incoming/outgoing diversion of prescription stimulants. SUMMARY Because no study has focused on stimulant use among youth as young as 10 and 11, this study is a landmark for future comparisons and offers a unique strategy for sampling and data collection.
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