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'I Was Present but I Was Absent': Perceptions and Experiences of the Non-Medical Use of Prescription or over the Counter Medication among Employed South African Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127151. [PMID: 35742395 PMCID: PMC9222615 DOI: 10.3390/ijerph19127151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND The need for workplace substance use prevention programmes globally and in South Africa is driven by the growing problem of substance use and the associated burden on the health and welfare of employees, their families and organizations. Substance use, which include the non-medical use of medications (both prescription and over-the counter), remains widespread and is a major cause of mortality and a risk factor for non-communicable diseases (NCDs). METHOD Twenty in-depth semi-structured qualitative interviews were conducted with employed women in treatment or shortly out of treatment for the non-medically indicated use of over the counter or/and prescription medications (NMIU). These interviews were conducted face-to face with women residing in the Western and Eastern Cape provinces of South Africa. Thematic analysis using NVIVO was used to analyse data collected. RESULTS The findings from this study suggest that previous use of legal or illegal substances and challenging life experiences underpin pathways to the non-medical use of over-the-counter and prescription medications among employed women. Factors found to contribute to misuse relate to a lack of understanding on risks, and health professional prescribing practices, while mitigators to harmful use were related to increased awareness and understanding harmful practices, the need for improved access and referral to specialist treatment as well as prevention programmes for women. CONCLUSION With the improved understanding of the issues surrounding the NMIU of over-the-counter and prescription medications among employed women, the need for interventions to prevent misuse and inadvertently dependency is highlighted.
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Abayateye F, Fornssler B, Feng C, D’Arcy C, Alphonsus K. Prescription drug misuse among adults in Canada: a scoping review. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2053890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Francis Abayateye
- Department of Community Health & Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Barb Fornssler
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Cindy Feng
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Carl D’Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
| | - Khrisha Alphonsus
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
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Bar-Or RL, Kor A, Jaljuli I, Lev-Ran S. The Epidemiology of Substance Use Disorders among the Adult Jewish Population in Israel. Eur Addict Res 2021; 27:362-370. [PMID: 33730716 DOI: 10.1159/000513776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 12/11/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Substance use disorders (SUDs) are a leading cause of morbidity and mortality worldwide, having a profound and global impact on health, well-being, safety, and productivity. Although traditionally the prevalence of SUDs in Israel has been estimated to be lower than those in high-income countries, estimates and characteristics of individuals with SUDs in the past decade are lacking. In this work, we explored the prevalence of SUDs among the adult Jewish population in Israel, per different classes of substances across sex, age group, and other sociodemographic factors. METHODS Data from an online representative sample of 4,025 respondents were collected, including the alcohol, smoking, and substance involvement screening test (ASSIST) metric and sociodemographic data. RESULTS We found that the most common SUDs were alcohol (10.5% [9.5-11.4]), cannabis (9.0% [8.2-9.9]), and sedative (3.6% [3.0-4.2]) use disorders. Alcohol-cannabis (3.2% [2.7-3.7]) and alcohol-sedative (1.04% [0.7-1.35]) were the most prevalent co-occurring SUDs. Among those with cannabis use disorder, the prevalence of alcohol use disorder was found to be 35.3% [30.4-40.2]. The estimated risk for alcohol use disorder was found to be inversely proportional to age, cannabis use disorder increased, peaked, and decreased with age, and that of sedative use disorder increased with age, particularly among women. While older individuals (in the 51-60 years of age group) were at lower risk (OR = 0.5 [0.3, 0.8]) compared to those <20 years of age for alcohol use disorder, they were at increased risk for sedative use disorder (OR = 3.1 [1.2, 9.7]). CONCLUSIONS These findings represent substantially higher rates of SUDs in Israel than those previously reported and should affect resources allocated to addiction prevention and treatment. Further research on the role of gender, age, culture, and ethnicity in the propensity to develop SUDs is necessary for the development of more focused preventive and intervention measures. Focusing on non-Jewish populations in Israel and broadening the scope to include behavioral addictions should be addressed in future studies.
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Affiliation(s)
- Ruth Lev Bar-Or
- Israel Center on Addiction (ICA), Netanya, Israel, .,Hadassah School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel,
| | - Ariel Kor
- Israel Center on Addiction (ICA), Netanya, Israel.,Interdisciplinary Center (IDC), Herzliya, Israel.,Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Iman Jaljuli
- Department of Statistics and Operations Research, Tel-Aviv University, Tel-Aviv, Israel
| | - Shaul Lev-Ran
- Israel Center on Addiction (ICA), Netanya, Israel.,Lev-Hasharon Medical Center, Netanya, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Singier A, Noize P, Berdaï D, Daveluy A, Arnaud M, Molimard M, Bégaud B, Salvo F. Medicine misuse: A systematic review and proposed hierarchical terminology. Br J Clin Pharmacol 2020; 87:1695-1704. [PMID: 33295072 DOI: 10.1111/bcp.14604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/25/2020] [Accepted: 10/05/2020] [Indexed: 12/31/2022] Open
Abstract
AIMS Although medicine misuse is a public health issue, it has multiple meanings in the medical literature. This study aimed to characterize, classify and identify the most appropriate definitions of medicine misuse. METHODS A systematic review was performed in Medline, ISI Web of Science, SocINDEX, PsycInfo, PsycArticles and Psychological and Behavioral Sciences Collection, using keywords related to "misuse", "appropriateness" and "medicine" between 1 November 2008 and 25 August 2020. Additional searches were conducted in websites of regulatory agencies and public health institutions. Two authors independently selected studies providing both definitions and examples of misuse, while a third resolved disagreements. Definitions were used to propose a hierarchical classification based on initiator, intent, purpose and context of medicine misuse. The study is registered on PROSPERO: CRD42018115789. RESULTS Of 3404 identified records, 51 were included. A total of 71 definitions and 74 examples of misuse were retrieved. When the prescriber is initiator and according to intent, potential medicine misuse referred to "intentional or unintentional prescribing not in line with clinical evidence". Based on context, they could prescribe medicines not clinically justified, i.e. overprescribing, or prescribe indicated medicines incorrectly, i.e. misprescribing. Among other groups of definitions, those overlapping with drug abuse or medication use errors were considered out-of-scope. CONCLUSION This systematic review provides a comprehensive overview of the terms and definitions used to characterize medicine misuse and could serve as a basis for a terminology that makes clear distinctions between misuse, abuse and errors.
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Affiliation(s)
| | - Pernelle Noize
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France.,CHU de Bordeaux, Service de Pharmacologie Médicale, Bordeaux, France
| | - Driss Berdaï
- CHU de Bordeaux, Service de Pharmacologie Médicale, Bordeaux, France
| | - Amélie Daveluy
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France.,CHU de Bordeaux, Service de Pharmacologie Médicale, Bordeaux, France
| | | | - Mathieu Molimard
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France.,CHU de Bordeaux, Service de Pharmacologie Médicale, Bordeaux, France
| | | | - Francesco Salvo
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux, France.,CHU de Bordeaux, Service de Pharmacologie Médicale, Bordeaux, France
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Dumbili EW, Gardner J, Degge HM, Hanewinkel R. Enhancement motivations for using prescription drugs among young adults in Nigeria. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 95:102995. [PMID: 33707065 DOI: 10.1016/j.drugpo.2020.102995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/14/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The desire for enhancement is a common motive for non-medical use of prescription drugs in Western countries. Little is known about the factors that motivate use in non-Western contexts. METHODS The study explores access to prescription drugs and the motivations for using them among educated young adults in a city located in Anambra State, South-Eastern Nigeria. Semi-structured interviews were conducted with 23 participants aged 23-29 years. Data were thematically analysed using NVivo 12 Software. RESULTS The data indicate that prescription drugs are widely available and easy to access without a prescription in the unregistered 'pharmacies' and medicine shops that form part of Nigeria's informal healthcare system. Social networks are also a source of drugs. Participants shared detailed perspectives on their use of prescription drugs, revealing that codeine, Rohypnol, and high doses of tramadol are used to enhance performance in several social life domains. These drugs were described as enhancing performance and productivity in the workplace, and were taken by participants working as labourers and sales representatives. Male participants also shared accounts of using high doses of tramadol to improve stamina and skill in sports. Some participants took Rohypnol to enhance their creative and academic performance. Participants stated that drug use enabled them to meet the pressures associated with work, academia, and parental expectations. CONCLUSION The findings suggest that prescription drugs are being strategically and instrumentally deployed by users to enhance different domains of social life. This is driven by users' experiences of the drugs' bodily effects, and it is supported by a context in which self-medication and informal healthcare are common. Participants' reasons for seeking drug-induced enhancement reflect sociocultural factors within Nigeria and some West African countries, such as employment scarcity and the championing of sporting prowess. The findings can be used to inform the design of tailored approaches to reduce the harms presented by the non-medical use of pharmaceuticals among young adults.
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Affiliation(s)
- Emeka W Dumbili
- Institute for Therapy and Health Research, Harmsstrasse 2, 24114, Kiel, Germany; Department of Sociology and Anthropology, Nnamdi Azikiwe University, Enugu-Onitsha Express Way, Awka, Anambra State, Nigeria; Department of Social and Political Sciences, Brunel University London, Uxbridge, London, United Kingdom, UB8 3PW.
| | - John Gardner
- School of Social Sciences, Monash University, Wellington Rd, Clayton VIC 3800, Australia
| | - Hannah M Degge
- Coventry University, Scarborough, YO11 2JW, United Kingdom
| | - Reiner Hanewinkel
- Institute for Therapy and Health Research, Harmsstrasse 2, 24114, Kiel, Germany
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Risk Factors for Misuse of Prescribed Opioids: A Systematic Review and Meta-Analysis. Ann Emerg Med 2019; 74:634-646. [DOI: 10.1016/j.annemergmed.2019.04.019] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/02/2019] [Accepted: 04/17/2019] [Indexed: 01/24/2023]
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