Correlates of prescription drug market involvement among young adults

Nightlife scene involvement and patterns of prescription drug misuse

INTRODUCTION AND AIMS

Participation in nightlife influences a range of health behaviours. Participants in various nightlife scenes have increasingly adopted prescription drug misuse into their substance use repertoires.

DESIGN AND METHODS

With 404 young adults recruited via time-space sampling in New York, we examine the relationship of nightlife participation-measured by number of scenes and the number of nights out in nightlife scenes-to prescription drug misuse during the past 3 months. Outcomes included frequency of misuse, escalation to non-oral consumption, polydrug use, social problems and symptoms of dependence.

RESULTS

Negative binomial regressions indicate nightlife participation is associated with increased frequency of misuse measured by number of scenes (incidence rate ratio = 1.114, P < 0.05) and number of nights out (incidence rate ratio = 1.009, P < 0.001). Logistic regression models show nightlife participation is associated with increased odds of non-oral use (adjusted odds ratio; AOR = 1.334, P < 0.01) and polydrug use (AOR = 1.776, P < 0.001) measured by number of scenes, and non-oral use (AOR = 1.021, P < 0.001) and polydrug use (AOR = 1.023, P < 0.001) as measured by number of nights out. Nightlife participation is not associated with prescription drug problems or symptoms of dependence. Frequency of participation is associated with peer norms favourable to prescription drugs (B = 0.003, P < 0.01).

DISCUSSION AND CONCLUSIONS

Nightlife participation has implications for prescription drug misuse. While shaping how often and in what manner young people consume prescription drugs, nightlife participation is not associated with harms experienced. Given the significance of the prescription drug trend in many world regions, these results suggest that increasing participation in nightlife shapes patterns of drug use, but in ways that do not lead to reported problems.

Sources of drug acquisition among females and males in the European Web Survey on Drugs

BACKGROUND

Social networks determine the availability of drugs, which in turn affects use patterns. Yet, there is some limited evidence that as frequency of drug use increases, people who use drugs increasingly utilize drug dealers. Further, females more often report receiving drugs for free. Studies on these two phenomena are limited by the substances they examine and the countries in which they have been conducted, and they have not been considered together. We examine whether gender differences in sources is moderated by increased frequency of use across four different substances in a web survey of sixteen European countries.

METHODS

The European Web Survey on Drugs was collected from 2016-2018 among the national partners of the European Monitoring Centre for Drugs and Drug Addiction. Individuals who use drugs in sixteen European countries completed an online survey. For herbal cannabis, cannabis resin, cocaine, and MDMA, we examine drug acquisition sources by gender and frequency of use. Sources include through dealers and sharing or free, as well as growing and online markets for cannabis. We model each source with logistic regression with chained multiple imputation and a country fixed-effect and clustered standard errors.

RESULTS

Across all substances, females who use drugs at low frequencies had significantly lower probabilities than males in using dealers; however, females were equally likely to use dealers when use is frequent. The probability of acquiring drugs for free was higher for females except among those who use most frequently, where the difference became non-significant except for herbal cannabis.

CONCLUSIONS

Females and males use dealers to acquire illicit drugs at similar rates when use is more frequent. Except for highest frequency use, females are typically more likely than males to acquire drugs for free. Examinations of supply should consider these gendered differences in acquisition.

The source and diversion of pharmaceutical drugs for non-medical use: A systematic review and meta-analysis

BACKGROUND

The non-medical use (NMU) of pharmaceutical drugs is an increasing public health concern. This systematic review consolidates current knowledge about how pharmaceutical drugs are obtained for NMU and the processes and people involved in diversion.

METHODS

Peer-reviewed and grey literature databases were searched for empirical studies published between 1996 and 2017 that examined the source or diversion of pharmaceutical opioids, sedatives or stimulants for NMU in countries with reported misuse problems. Pooled prevalence meta-analyses using random effects models were used to estimate the prevalence of medical and non-medical sourcing reported by end-users, and gifting, selling and trading by various populations.

RESULTS

This review synthesizes the findings of 54 cross-sectional studies via meta-analyses, with a remaining 95 studies examined through narrative review. Pharmaceutical drugs are primarily sourced for NMU from friends and family (57%, 95% CI 53%-62%, I² = 98.5, n = 30) and despite perceptions of healthcare professionals to the contrary, illegitimate practices such as doctor shopping are uncommon (7%, 95% CI 6%-10%, I² = 97.4, n = 29). Those at risk of diversion include patients displaying aberrant medication behaviors, people with substance use issues and students in fraternity/sorority environments. Sourcing via dealers is also common (32%, 95% CI 23%-41%, I² = 99.8, n = 25) and particularly so among people who use illicit drugs (47%, 95% CI 35%-60%, I² = 99.1, n = 15). There is little to no organized criminal involvement in the pharmaceutical black market.

CONCLUSION

Pharmaceutical drugs for NMU are primarily sourced by end-users through social networks. Future research should examine how dealers source pharmaceutical drugs.

It’s the Same, Only It’s Not: Perceptions of the Prescription Drug Market in Comparison With Other Illicit Drug Markets

Given the rapid rise of prescription (Rx) opioid overdoses in the United States, it is crucial to understand how people acquire Rx drugs. Prior research suggests individuals obtain Rx drugs through both legal and illegal channels, but there has been limited qualitative research focused upon the intersections between Rx drug markets and other drug markets. To understand the similarities and differences, we interviewed 40 incarcerated women about their experiences with both markets. Based upon these conversations, we find that few women received pills exclusively through doctors and 90% of them had used illicit markets or informal social networks to acquire Rx drugs. Although there is extensive overlap between the users, dealers, and operations between Rx and illicit drug markets, these women draw attention to how certain agents, processes, and social reactions differ in meaningful ways that are crucial to an effective public health response.