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Miller-Roenigk BD, Wheeler PB, Jester JK, Hargons CN, Stevens-Watkins DJ. Generational and Gender Patterns of Prescription Opioid Misuse Among Black Adults. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 164:209436. [PMID: 38852823 PMCID: PMC11300149 DOI: 10.1016/j.josat.2024.209436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/29/2024] [Accepted: 05/21/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION Opioid-related overdose mortality disproportionally affects Black adults in Kentucky, particularly overdoses associated with prescription opioid misuse (POM). Black adults also face other consequences of POM, such as disparate health and legal outcomes. While several factors effect POM, such as generational factors and gender, these risk factors are understudied among Black adults with a history of POM. Current literature primarily focuses on White individuals who use opioids. METHOD The present study qualitatively examined reasons for POM, prescription opioids misused, how prescription opioids are obtained, and initiation of POM among Black adults using thematic analysis. Participants included a sample (n = 39) of Black adults from a southern state, stratified by gender and age across four cohorts: born (1) 1995-2001, (2) 1980-1994, (3) 1970-1979, and (4) 1955-1969. RESULTS Results revealed similarities and differences in these themes across age cohorts and gender. CONCLUSIONS Implications for findings include the importance of culturally responsive interventions that utilize dual diagnosis treatment and idiographic approaches due to heterogeneous experiences with POM among Black adults.
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Affiliation(s)
- Brittany D Miller-Roenigk
- University of Kentucky, Department of Educational, School, and Counseling Psychology, 251 Scott St, Lexington, KY 40508, United States of America.
| | - Paris B Wheeler
- Univeristy of Cincinnati, Department of Psychology, 66 Corry Blvd, Cincinnati, OH 45219, United States of America.
| | - Jasmine K Jester
- University of Kentucky, Department of Educational, School, and Counseling Psychology, 251 Scott St, Lexington, KY 40508, United States of America.
| | - Candice N Hargons
- University of Kentucky, Department of Educational, School, and Counseling Psychology, 251 Scott St, Lexington, KY 40508, United States of America.
| | - Danelle J Stevens-Watkins
- University of Kentucky, Department of Educational, School, and Counseling Psychology, 251 Scott St, Lexington, KY 40508, United States of America.
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Cannabis Use and Increased Nonaneurysmal Subarachnoid Hemorrhage in the Past Decade. World Neurosurg 2021; 154:e580-e589. [PMID: 34325028 DOI: 10.1016/j.wneu.2021.07.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Spontaneous subarachnoid hemorrhage is often due to rupture of an intracranial aneurysm, but some patients present with no identifiable source. Increased incidence of nonaneurysmal subarachnoid hemorrhage (naSAH) has been reported over time. METHODS We performed a retrospective analysis of naSAH from 2008-2017 to determine the rate of naSAH change over time and its association with cannabis use. Univariable and multivariable regression analyses were performed to study the trend over time, radiographic patterns of hemorrhage, and clinical outcome at the time of discharge. In addition, we compared the rate of naSAH with the rate of aneurysmal SAH (aSAH) to adjust for changes in hospital volume and prevalence/reporting of cannabis use in the population over time. RESULTS A total of 86 naSAH and 328 aSAH patients were identified, with an increase in naSAH over time compared with aSAH (P = 0.0034). Increased cannabis use was associated with naSAH (odds ratio [OR] 2.1, 95% confidence interval 1.1, 4.1, P = 0.035) but not aSAH over time. Cannabis use was also associated with different subarachnoid hemorrhage patterns (P = 0.0065) in naSAH. Multivariable analysis demonstrated good neurologic outcome after naSAH to be inversely associated with cocaine use (OR 0.008 [0.002-0.4]), ventriculostomy placement (OR 0.004 [0.03-0.50]), and anticoagulant use (OR 0.016 [0.003-0.54]) but not with cannabis use. CONCLUSIONS As cannabis use becomes more prevalent with legalization, it is important to further investigate this association with spontaneous SAH.
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Carrasco-Garrido P, Jiménez-Trujillo I, Hernández-Barrera V, Lima Florencio L, Palacios-Ceña D. Patterns of non-medical use of benzodiazepines and Z-Drugs among adolescents and young adults: gender differences and related factors. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2020.1800846] [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)
- Pilar Carrasco-Garrido
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Madrid, Spain
| | - Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Madrid, Spain
| | - Lidiane Lima Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain
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Shanahan L, Hill SN, Bechtiger L, Steinhoff A, Godwin J, Gaydosh LM, Harris KM, Dodge KA, Copeland WE. Prevalence and Childhood Precursors of Opioid Use in the Early Decades of Life. JAMA Pediatr 2021; 175:276-285. [PMID: 33369615 PMCID: PMC7770613 DOI: 10.1001/jamapediatrics.2020.5205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE Opioid use disorder and opioid deaths have increased dramatically in young adults in the US, but the age-related course or precursors to opioid use among young people are not fully understood. OBJECTIVE To document age-related changes in opioid use and study the childhood antecedents of opioid use by age 30 years in 6 domains of childhood risk: sociodemographic characteristics; school or peer problems; parental mental illness, drug problems, or legal involvement; substance use; psychiatric illness; and physical health. DESIGN, SETTING, AND PARTICIPANTS This community-representative prospective longitudinal cohort study assessed 1252 non-Hispanic White individuals and American Indian individuals in rural counties in the central Appalachia region of North Carolina from January 1993 to December 2015. Data were analyzed from January 2019 to January 2020. EXPOSURES Between ages 9 and 16 years, participants and their parents were interviewed up to 7 times using the Child and Adolescent Psychiatric Assessment and reported risk factors in 6 risk domains. MAIN OUTCOMES AND MEASURES Participants were assessed again at ages 19, 21, 25, and 30 years for nonheroin opioid use (any and weekly) and heroin use using the structured Young Adult Psychiatric Assessment. RESULTS Of 1252 participants, 342 (27%) were American Indian. By age 30 years, 322 participants had used a nonheroin opioid (24.2%; 95% CI, 21.8-26.5), 155 had used a nonheroin opioid weekly (8.8%; 95% CI, 7.2-10.3), and 95 had used heroin (6.6%; 95% CI, 5.2-7.9). Childhood risk markers for later opioid use included male sex, tobacco use, depression, conduct disorder, cannabis use, having peers exhibiting social deviance, parents with legal involvement, and elevated systemic inflammation. In final models, childhood tobacco use, depression, and cannabis use were most robustly associated with opioid use in young adulthood (ages 19 to 30 years). Chronic depression and dysthymia were strongly associated with any nonheroin opioid use (OR. 5.43; 95% CI, 2.35-12.55 and OR, 7.13; 95% CI, 1.99-25.60, respectively) and with weekly nonheroin opioid use (OR, 8.89; 95% CI, 3.61-21.93 and OR, 11.51; 95% CI, 3.05-42.72, respectively). Among young adults with opioid use, those with heroin use had the highest rates of childhood psychiatric disorders and comorbidities. CONCLUSIONS AND RELEVANCE Childhood tobacco use and chronic depression may be associated with impaired reward system functioning, which may increase young adults' vulnerability to opioid-associated euphoria. Preventing and treating early substance use and childhood mental illness may help prevent later opioid use.
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Affiliation(s)
- Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland,Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Sherika N. Hill
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Jennifer Godwin
- Center for Child and Family Policy, Duke University, Durham, North Carolina
| | - Lauren M. Gaydosh
- Center for Medicine, Health, and Society, Public Policy Studies, Vanderbilt University, Nashville, Tennessee
| | - Kathleen Mullan Harris
- Carolina Population Center, Department of Sociology, University of North Carolina at Chapel Hill
| | - Kenneth A. Dodge
- Center for Child and Family Policy, Duke University, Durham, North Carolina,Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - William E. Copeland
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington
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Park JY, Wu LT. Sources of Misused Prescription Opioids and Their Association with Prescription Opioid Use Disorder in the United States: Sex and Age Differences. Subst Use Misuse 2020; 55:928-936. [PMID: 31975639 PMCID: PMC7166157 DOI: 10.1080/10826084.2020.1713818] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Prescription opioid (PO) misuse and prescription opioid use disorder (POUD) are a national crisis in the USA. To inform strategies for reducing the PO epidemic, research is needed on the sources of misused POs and their association with POUD. Methods: Past-year PO misusers aged ≥12 (N = 6033) from the 2015 to 2016 National Surveys on Drug Use and Health were analyzed. The most recent source of misused POs was assessed. Logistic regression analyses were used to determine the association between the sources of misused POs and past-year POUD. All analyses were stratified by age groups for each sex. Results: Overall, the most common sources of misused POs were obtaining from friends/relatives for free (40.27%) and physicians (36.59%). Males had a higher prevalence of buying POs from friends/relatives or drug dealers/strangers than females. Significant age differences also emerged. Buying POs from drug dealers/strangers (vs. obtaining POs free from friends/relatives) was strong predictor of past-year POUD in both sexes. In the sex- and age-stratified analyses, significant associations of past-year POUD with (1) buying from drug dealers/strangers emerged among males aged 18+ and females aged 26+; (2) buying from friends/relatives emerged among males aged 12+ and females aged 18-25; (3) obtaining from physicians emerged among males aged 18+ and females aged 26+. Conclusions: Our findings indicate different risk profiles for POUD across sex and age groups with different diversion sources. Prevention and treatment programs for POUD should be tailored to consider sex and developmental age differences in sources of opioids.
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Affiliation(s)
- Ji-Yeun Park
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.,Center for Child and Family Policy, Sanford School of Public Policy, Duke University, Durham, North Carolina, USA
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Carrasco-Garrido P, Jiménez-Trujillo I, Hernández-Barrera V, Alonso-Fernández N, García-Gómez-Heras S, Palacios-Ceña D. Gender differences in the nonmedical use of psychoactive medications in the school population- national trends and related factors. BMC Pediatr 2019; 19:362. [PMID: 31630682 PMCID: PMC6802303 DOI: 10.1186/s12887-019-1728-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 09/20/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The nonmedical use of prescribed medicines among adolescents has increased significantly in recent years. Our study was designed to describe the prevalence of the nonmedical use of tranquilizers, sedatives, and sleeping pills (TSSp) among the school-age population residing in Spain from a gender perspective, and to identify factors associated with such use. METHODS Nationwide, epidemiological, cross-sectional study on the nonmedical use during the previous 30 days, of TSSp by the Spanish school population. We used individualized secondary data retrieved from the 2004, 2006, 2008, 2010, 2012 and 2014 Spanish state survey on Drug Use in Secondary Education and a total of 179,114 surveys from respondents aged 14 to 18 years. Using logistic multivariate regression models, we estimated the independent effect of each of these variables on the nonmedical use of medicines. Two models were generated- one for females and one for males. RESULTS 2.86% (5116) of the Spanish school population of both sexes made nonmedical use of TSSp. Prevalence was greater among girls than among boys for all the study years. Patterns of nonmedical use among female adolescents were related to alcohol, tobacco and marijuana use. Consumption of illegal psychoactive substances, other than marijuana, was the variable showing the greatest value among male teenagers (aOR 6.21 (95% CI 4.97-7.77). CONCLUSIONS The prevalence of the nonmedical use of TSSp is higher in girls than in boys. The influence of legal and illegal psychoactive substances leads to a higher likelihood of nonmedical use of TSSp in high-school students in Spain.
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Affiliation(s)
- Pilar Carrasco-Garrido
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Av. Atenas s/n. 28 922, Alcorcon, Madrid, Spain.
| | - Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Av. Atenas s/n. 28 922, Alcorcon, Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Av. Atenas s/n. 28 922, Alcorcon, Madrid, Spain
| | - Nazaret Alonso-Fernández
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Av. Atenas s/n. 28 922, Alcorcon, Madrid, Spain
| | - Soledad García-Gómez-Heras
- Department of Basic Health Sciences, Health Sciences Faculty, Universidad Rey Juan Carlos, Av. Atenas s/n. 28 922, Alcorcon, Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Av. Atenas s/n. 28 922, Alcorcon, Madrid, Spain
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Canizares M, Power JD, Rampersaud YR, Badley EM. Patterns of opioid use (codeine, morphine or meperidine) in the Canadian population over time: analysis of the Longitudinal National Population Health Survey 1994-2011. BMJ Open 2019; 9:e029613. [PMID: 31345978 PMCID: PMC6661673 DOI: 10.1136/bmjopen-2019-029613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE This study aimed to investigate cohort effects in selected opioids use and determine whether cohort differences were associated with changes in risk factors for use over time. DESIGN This study presents secondary analyses of a longitudinal survey panel of the general population that collected data biannually. SETTING Data from the Canadian Longitudinal National Population Health Survey 1994-2011. POPULATION This study included 12 542 participants from the following birth cohorts: post-World War I (born 1915-1924), pre-World War II (born 1925-1934), World War II (born 1935-1944), Older Baby Boom (born 1945-1954), Younger Baby Boom (born 1955-1964), Older Generation X (born 1965-1974) and Younger Generation X (born 1975-1984). MAIN OUTCOME Responses to a single question asking about the use of codeine, morphine or meperidine in the past month (yes/no) were examined. RESULTS Over and above age and period effects, there were significant cohort differences in selected opioids use: each succeeding recent cohort had greater use than their predecessors (eg, Gen Xers had greater use than younger baby boomers). Selected opioids use increased significantly from 1994 to 2002, plateauing between 2002 and 2006 and then declining until 2011. After accounting for cohort and period effects, there was a decline in use of these opioids with increasing age. Although pain was significantly associated with greater selected opioids use (OR=3.63, 95% CI 3.39 to 3.94), pain did not explain cohort differences. Cohort and period effects were no longer significant after adjusting for the number of chronic conditions. Cohort differences in selected opioids use mirrored cohort differences in multimorbidity. Use of these opioids was significantly associated with taking antidepressants or tranquillisers (OR=2.52, 95% CI 2.27 to 2.81 and OR=1.60, 95% CI 1.46 to 1.75, respectively). CONCLUSIONS The findings underscore the need to consider multimorbidity including possible psychological disorders and associated medications when prescribing opioids (codeine, morphine, meperidine), particularly for recent birth cohorts. Continued efforts to monitor prescription patterns and develop specific opioid use guidelines for multimorbidity appear warranted.
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Affiliation(s)
- Mayilee Canizares
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - J Denise Power
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Y Raja Rampersaud
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Elizabeth M Badley
- Arthritis Community Research and Evaluation Unit, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
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Moss SL, Santaella-Tenorio J, Mauro PM, Keyes KM, Martins SS. Changes over time in marijuana use, deviant behavior and preference for risky behavior among US adolescents from 2002 to 2014: testing the moderating effect of gender and age. Addiction 2019; 114:674-686. [PMID: 30461115 PMCID: PMC6619500 DOI: 10.1111/add.14506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/23/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS Among adolescents, risk preference and deviant behaviors are associated with marijuana use, which exhibit substantial historical trends. We examined (1) trends, (2) effect modification by sex and age, (3) associations of marijuana use with deviant behaviors and risk preferences and (4) differences by sex, age and year. DESIGN Adjusted logistic and relative risk regression models, using data from the 2002-14 National Survey on Drug Use and Health, annual cross-sectional surveys of US households. SETTING United States. PARTICIPANTS A nationally representative sample of adolescents aged 12-17 years (n = 230 452). MEASUREMENTS We estimated associations between past-year marijuana use [self-reported using computer-assisted personal interviewing/audio computer-assisted self-interviewing (CAPI/ACASI)], deviant behavior (i.e. selling drugs; stealing; attacking someone) and risk preference (i.e. getting a kick; testing oneself). FINDINGS Marijuana use, deviant behaviors and risk preferences declined among adolescents from 2002 to 2014. There were no significant sex or age differences in the decline of marijuana use over time. There were sex [sold drugs: β = 0.90, 95% confidence interval (CI) = 0.75, 1.04] and age (attacked someone: β = 0.32, 95% CI = 0.22, 0.42) differences in the prevalence of deviant behaviors, and trends over time differed by sex and age for attacking someone. CONCLUSIONS While marijuana use, deviant behavior and risk preferences among US adolescents declined from 2002 to 2014, associations have remained stable, with marijuana use positively associated with deviant behaviors and risk preferences.
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Affiliation(s)
- Shadiya L. Moss
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | | | - Pia M. Mauro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Silvia S. Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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Trends in the Misuse of Tranquilizers, Sedatives, and Sleeping Pills by Adolescents in Spain, 2004-2014. J Adolesc Health 2018; 63:709-716. [PMID: 30064889 DOI: 10.1016/j.jadohealth.2018.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 04/01/2018] [Accepted: 04/03/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE Misuse of prescription medication has increased during the last 20 years among adolescents and young adults. We aimed to report the prevalence and factors associated with misuse of tranquilizers, sedatives, and sleeping pills (TSSp) in high-school students in Spain. We also analyzed misuse of these drugs during the decade 2004-2014. METHODS Nationwide, epidemiological, cross-sectional study on the misuse of TSSp by the Spanish school population. We used individualized secondary data retrieved from the 2004 and 2014 Spanish State Survey on Drug Use in Secondary Education. A total of 179,114 surveys respondents aged 14-18 years. Estimates and trends of previous 30 days misuse of TSSp. RESULTS The prevalence of TSSp misuse among school population aged 14-18-years increased significantly from 2004 (2.40%) to 2014 (2.96%). The values for consumption were always greater in adolescent girls than boys throughout the study (3.51% vs. 2.18%). The variables associated with a greater probability of TSSp misuse were consumption of alcohol, tobacco, and marijuana. Students who reported consumption of an illicit drug other than marijuana during the previous year are 4.91 times more likely to misuse TSSp (adjusted odds ratio = 4.91; 95% confidence interval, 4.15-5.81). CONCLUSIONS We found that misuse of TSSp by adolescents in Spain has significantly increased from 2004 to 2014. Misuse of TSSp was more likely in adolescent girls than Spanish boys. Alcohol, tobacco, and marijuana consumption are factors associated with the use of TSSp.
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Eluri M, Spiller HA, Casavant MJ, Chounthirath T, Conner KA, Smith GA. Analgesic-Related Medication Errors Reported to US Poison Control Centers. PAIN MEDICINE (MALDEN, MASS.) 2018; 19:2357-2370. [PMID: 29186557 PMCID: PMC6659012 DOI: 10.1093/pm/pnx272] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective This study investigates the characteristics and trends of medication errors involving analgesic medications. Design and Methods A retrospective analysis was conducted of analgesic-related medication errors reported to the National Poison Data System (NPDS) from 2000 through 2012. Results From 2000 through 2012, the NPDS received 533,763 reports of analgesic-related medication errors, averaging 41,059 medication errors annually. Overall, the rate of analgesic-related medication errors reported to the NPDS increased significantly by 82.6% from 2000 to 2009, followed by a 5.7% nonsignificant decrease from 2009 to 2012. Among the analgesic categories, rates of both acetaminophen-related and opioid-related medication errors reported to the NPDS increased during 2000-2009, but the opioid error rate leveled off during 2009-2012, while the acetaminophen error rate decreased by 17.9%. Analgesic-related medication errors involved nonsteroidal anti-inflammatory drugs (37.0%), acetaminophen (35.5%), and opioids (23.2%). Children five years or younger accounted for 38.8% of analgesics-related medication errors. Most (90.2%) analgesic-related medication errors were managed on-site, rather than at a health care facility; 1.6% were admitted to a hospital, and 1.5% experienced serious medical outcomes, including 145 deaths. The most common type of medication error was inadvertently taking/given the medication twice (26.6%). Conclusion Analgesic-related medication errors are common, and although most do not result in clinical consequences, they can have serious adverse outcomes. Initiatives associated with the decrease in acetaminophen-related medication errors among young children merit additional research and potential replication as a model combining government policy and multisectoral collaboration.
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Affiliation(s)
- Madhulika Eluri
- Center for Injury Research and Policy at Nationwide Children’s Hospital, Columbus, Ohio
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Henry A Spiller
- Central Ohio Poison Center, Columbus, Ohio
- The Ohio State University College of Medicine, Department of Pediatrics, Columbus, Ohio
| | - Marcel J Casavant
- Center for Injury Research and Policy at Nationwide Children’s Hospital, Columbus, Ohio
- Central Ohio Poison Center, Columbus, Ohio
- The Ohio State University College of Medicine, Department of Pediatrics, Columbus, Ohio
| | | | - Kristen A Conner
- Center for Injury Research and Policy at Nationwide Children’s Hospital, Columbus, Ohio
| | - Gary A Smith
- Center for Injury Research and Policy at Nationwide Children’s Hospital, Columbus, Ohio
- The Ohio State University College of Medicine, Department of Pediatrics, Columbus, Ohio
- Child Injury Prevention Alliance, Columbus, Ohio, USA
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Cheng T, Small W, Dong H, Nosova E, Hayashi K, DeBeck K. An age-based analysis of nonmedical prescription opioid use among people who use illegal drugs in Vancouver, Canada. Subst Abuse Treat Prev Policy 2018; 13:41. [PMID: 30482215 PMCID: PMC6260714 DOI: 10.1186/s13011-018-0180-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 11/13/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Nonmedical prescription opioid use (NMPOU) is a serious public health problem in North America. At a population-level, previous research has identified differences in the prevalence and correlates of NMPOU among younger versus older age groups; however, less is known about age-related differences in NMPOU among people who use illegal drugs. METHODS Data were collected between 2013 and 2015 from two linked prospective cohort studies in Vancouver, Canada: the At-Risk Youth Study (ARYS) and the Vancouver Injection Drug Users Study (VIDUS). Factors independently associated with NMPOU among younger (ARYS) and older (VIDUS) participants were examined separately using bivariate and multivariate generalized estimating equations. RESULTS A total of 1162 participants were included. Among 405 eligible younger participants (Median age = 25; Inter-Quartile Range [IQR]: 22-28), 40% (n = 160) reported engaging in NMPOU at baseline; among 757 older participants (Median age = 48, IQR: 40-55), 35% (n = 262) reported engaging in NMPOU at baseline. In separate multivariate analyses of younger and older participants, NMPOU was positively and independently associated with heroin use (younger: Adjusted Odds Ratio [AOR] = 3.12, 95% Confidence Interval [CI]: 2.08-4.68; older: AOR = 2.79, 95% CI: 2.08-3.74), drug dealing (younger: AOR = 2.22, 95% CI: 1.58-3.13; older: AOR = 1.87, 95% CI: 1.40-2.49), and difficulty accessing services (younger: AOR = 1.47, 95% CI: 1.04-2.09; older: AOR = 1.74, 95% CI: 1.32-2.29). Among the youth cohort only, NMPOU was associated with younger age (AOR = 1.12, 95% CI: 1.05-1.19), crack use (AOR = 1.56, 95% CI: 1.06-2.30), and binge drug use (AOR = 1.41, 95% CI: 1.00-1.97); older participants who engaged in NMPOU were more likely to report crystal methamphetamine use (AOR = 1.97, 95% CI: 1.46-2.66), non-fatal overdose (AOR = 1.76, 95% CI: 1.20-2.60) and sex work (AOR = 1.49, 95% CI: 1.00-2.22). DISCUSSION The prevalence of NMPOU is similar among younger and older people who use drugs, and independently associated with markers of vulnerability among both age groups. Adults who engage in NMPOU are at risk for non-fatal overdose, which highlights the need for youth and adult-specific strategies to address NMPOU that include better access to health and social services, as well as a range of addiction treatment options for opioid use. Findings also underscore the importance of improving pain treatment strategies tailored for PWUD.
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Affiliation(s)
- Tessa Cheng
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
- British Columbia Centre on Substance Use, Providence Health Care, 400-1045 Howe St, Vancouver, BC V6Z 2A9 Canada
| | - Will Small
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
- British Columbia Centre on Substance Use, Providence Health Care, 400-1045 Howe St, Vancouver, BC V6Z 2A9 Canada
- Centre for Applied Research in Mental Health and Addiction, SFU Faculty of Health Sciences, 515 W. Hastings Street, Vancouver, BC V6B 5K3 Canada
| | - Huiru Dong
- British Columbia Centre on Substance Use, Providence Health Care, 400-1045 Howe St, Vancouver, BC V6Z 2A9 Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Ekaterina Nosova
- British Columbia Centre on Substance Use, Providence Health Care, 400-1045 Howe St, Vancouver, BC V6Z 2A9 Canada
| | - Kanna Hayashi
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
- British Columbia Centre on Substance Use, Providence Health Care, 400-1045 Howe St, Vancouver, BC V6Z 2A9 Canada
| | - Kora DeBeck
- British Columbia Centre on Substance Use, Providence Health Care, 400-1045 Howe St, Vancouver, BC V6Z 2A9 Canada
- School of Public Policy, Simon Fraser University, 515 West Hastings Street, Suite 3271, Vancouver, BC V6B 5K3 Canada
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Knighton JS, Stevens-Watkins D, Staton M, Pangburn K. Trends and mental health correlates of nonmedical opioid use among criminal justice-involved African American men. Addict Behav 2018; 85:14-20. [PMID: 29803098 DOI: 10.1016/j.addbeh.2018.04.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Centers for Disease Control and Prevention has deemed nonmedical opioid use (NMOU) an epidemic. Population-based survey data indicate high rates of NMOU among Caucasians, however, these estimates exclude incarcerated samples and may underestimate use among criminal justice-involved African Americans. Despite opioid-associated risks of co-occurring mental illness and mortality, to our knowledge, this is the first study to examine NMOU and mental health among a sample of African American men receiving corrections-based substance use disorder (SUD) treatment in jail, prison, or the community. METHOD We conducted a cross-sectional study examining trends and mental health correlates of NMOU during the year prior to each participant's incarceration, across five cohorts of African American men (N = 4021) enrolled in corrections-based SUD treatment between the years, 2010 and 2014. A series of chi-square, ANOVAs, correlations, and logistic regression models were conducted. RESULTS Over 20% of our sample reported NMOU during the year prior to incarceration. On average, participants were 36-years-old, earned 13 years of education, and were generally unemployed, prior to incarceration. We found a statistically significant positive linear trend between NMOU prior to incarceration and cohort year. The final stepwise multivariate regression model was significant and revealed, older age was associated with lower odds of NMOU. More years of education and frequent mental health symptoms were associated with significantly increased odds of NMOU. DISCUSSION Our findings are unique in that extant literature has primarily described NMOU as a 'White suburban' problem. Culturally-adapted behavioral interventions and medication assisted therapies are discussed.
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Affiliation(s)
| | | | - Michele Staton
- University of Kentucky, 141 Medical Behavioral Science Building, Lexington, KY 40506, United States.
| | - Kevin Pangburn
- Kentucky Department of Corrections, Substance Abuse Division, 275 E Main St., Frankfort, KY 40601, United States.
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13
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Nock NL, Minnes S, Alberts JL. Neurobiology of substance use in adolescents and potential therapeutic effects of exercise for prevention and treatment of substance use disorders. Birth Defects Res 2018; 109:1711-1729. [PMID: 29251846 DOI: 10.1002/bdr2.1182] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/13/2017] [Indexed: 12/17/2022]
Abstract
Substance use (e.g., alcohol, marijuana, opioids, cocaine., etc,) use often initiates during adolescence, a critical period of physiological and social development marked by an increase in risk-taking due, in part, to heightened motivation to obtain arousal from rewards. Substance use during adolescence has been associated with a greater risk of substance use disorders (SUD) in adulthood. Although use rates for most substances have remained relatively stable, the frequency of marijuana use and the perception that regular marijuana use is not harmful has increased in adolescents. Furthermore, the nonmedical use of opioids has increased, particularly in the South, Midwest, and rural low-income communities. Substance use in adolescence has been associated with adverse structural and functional brain changes and, may exacerbate the natural "imbalance" between frontal/regulatory and cortical-subcortical circuits, leading to further heightened impulsive and reward-driven behaviors. Exercise increases growth and brain-derived neurotrophic factors that stimulate endogenous dopaminergic systems that, in turn, enhance general plasticity, learning, and memory. Exercise may help to reinforce the "naïve" or underdeveloped connections between neurological reward and regulatory processes in adolescence from the "bottom up" and "offset" reward seeking from substances, while concomitantly improving cardiovascular health, as well as academic and social achievement. In this review, we provide an overview of the current state of substance use in adolescents and rationale for the utilization of exercise, particularly "assisted" exercise, which we have shown increases neural activity in cortical-subcortical regions and may modulate brain dopamine levels during adolescence, a unique window of heightened reward sensitivity and neural plasticity, for the prevention and adjunctive treatment of SUD.
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Affiliation(s)
- Nora L Nock
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Sonia Minnes
- Jack, Joseph and Morton Mandel School of Applied Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Jay L Alberts
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio
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14
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Abstract
There are inconsistent findings regarding the rates of nonmedical prescription drug use (NMPDU) among Black Americans. The majority of previous studies used pharmaceutical names of drugs and relied on national data that excludes incarcerated populations, in which Black men are overrepresented. Therefore, the current study aimed to describe pre-incarceration rates of NMPDU among Black men in prison using culturally relevant alternative drug names. We recruited 208 incarcerated (adult age 18 or older) Black men nearing community reentry to urban counties from four state prisons in Kentucky. Results indicated the majority of participants engaged in lifetime NMPDU. The most commonly endorsed class of prescription drug was, "Other Sedatives, Hypnotics, and Tranquilizers" and the most commonly endorsed specific prescription drugs were "Syrup," Lortab/Hydrocodone, and Xanax. There were significant age differences in the number of days that drugs were used in the year prior to incarceration. The current study contributes to the dearth of literature on NMPDU among Black Americans. These findings have implications for disease transmission, overdose risk, and culturally relevant data collection methods and interventions aimed at reducing NMPDU among Black men.
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15
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Abstract
We propose a method to decompose the young adult mortality hump by cause of death. This method is based on a flexible shape decomposition of mortality rates that separates cause-of-death contributions to the hump from senescent mortality. We apply the method to U.S. males and females from 1959 to 2015. Results show divergence between time trends of hump and observed deaths, both for all-cause and cause-specific mortality. The study of the hump shape reveals age, period, and cohort effects, suggesting that it is formed by a complex combination of different forces of biological and socioeconomic nature. Male and female humps share some traits in all-cause shape and trend, but they also differ by their overall magnitude and cause-specific contributions. Notably, among males, the contributions of traffic and other accidents were progressively replaced by those of suicides, homicides, and poisonings; among females, traffic accidents remained the major contributor to the hump.
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16
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Xouridas S. Gambling on Electronic Gaming Machines in Germany: An Age-Period-Cohort Analysis. INTERNATIONAL GAMBLING STUDIES 2018. [DOI: 10.1080/14459795.2018.1459776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Stergios Xouridas
- Gambling Research Center, University of Hohenheim, Stuttgart, Germany
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17
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Rose RA, Evans CBR, Smokowski PR, Howard MO, Stalker KL. Polysubstance Use Among Adolescents in a Low Income, Rural Community: Latent Classes for Middle- and High-School Students. J Rural Health 2017; 34:227-235. [PMID: 28921667 DOI: 10.1111/jrh.12268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/26/2017] [Accepted: 07/28/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Rural communities are currently being impacted by a nationwide epidemic of prescription opioid misuse. Rural adolescent substance users may be at substantial risk for later addiction to these and other drugs. METHODS This study uses Latent Class Analysis to identify subtypes of polysubstance users among a sample of 7,074 rural adolescents. Separate models were estimated for middle- and high-school youth. Predictive validity was estimated using cumulative ordinal logistic regression of the classes on a set of youth and family characteristics. FINDINGS We identified a 4-class solution for both middle- and high-school students marked by initiation of an increasing number of substances used at greater frequency. These classes included Substance Nonusers, Primarily Alcohol Users, Initiators-Low Frequency Users, and Initiators-Moderate-to-High Lifetime Frequency Users. About 6%-10% of youth reported using prescription drugs at least once, and in the moderate-to-high frequency class, middle-school youth were more likely to use prescription drugs and inhalants compared to high-school youth in the same class. The 4 classes were associated with race/ethnicity, and in high school with receiving free/reduced price lunch. CONCLUSION In general, younger adolescents have lower overall use rates, but within certain classes identified by this analysis, the observed pattern suggests that younger cohorts are turning to prescription drugs and inhalants. These findings support the implementation of universal substance use prevention programs, targeted programs for youth experiencing risk factors associated with substance use, and improved rural substance abuse treatment options.
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Affiliation(s)
- Roderick A Rose
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Paul R Smokowski
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,School of Social Welfare, University of Kansas, Lawrence, Kansas
| | - Matthew O Howard
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Katie L Stalker
- School of Social Work, Arizona State University, Tucson, Arizona
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18
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Hu MC, Griesler P, Wall M, Kandel DB. Age-related patterns in nonmedical prescription opioid use and disorder in the US population at ages 12-34 from 2002 to 2014. Drug Alcohol Depend 2017; 177. [PMID: 28622626 PMCID: PMC5568606 DOI: 10.1016/j.drugalcdep.2017.03.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To estimate age-related patterns in nonmedical prescription opioid (NMPO) use in the US population and disorder among past-year users at ages 12-34 between 2002 and 2014, controlling for period and birth-cohort effects. METHODS Data are from 13 consecutive cross-sectional National Surveys on Drug Use and Health (N=542,556). Synthetic longitudinal cohorts spanning ages 12-34 were created and an age-period-cohort analysis was implemented based on the Intrinsic Estimator algorithm. RESULTS In every birth cohort, past-year NMPO use increases during adolescence, peaks at ages 18-21, decreases through ages 30-34; disorder among past-year users increases from ages 18-21 through 30-34. Use at ages 12-34 decreased from the 1984-87 birth cohorts to more recently-born cohorts. Peak prevalence of use at ages 18-21 has also decreased, and the rates of increase from ages 14-17 to ages 18-21 are slowing down. Disorder at ages 18-34 increased from the 1976-79 to 1992-95 cohorts, but decreased at ages 12-17 from the 1992-95 to the most recently-born 2000-02 cohorts. The years 2010-2014 were characterized by lower NMPO use but higher disorder than 2002-2009. CONCLUSIONS Increasing NMPO disorder among users aged 18-34 warrants concern. However, declining NMPO use among 12-34 year-olds, a declining rate of increase from adolescence to early adulthood, and a suggestive decline in disorder among the most recent adolescent cohorts may forecast a potential reduction in the public health crisis associated with NMPO drugs.
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Affiliation(s)
- Mei-Chen Hu
- Department of Psychiatry, Columbia University, New York, NY 10032, USA
| | - Pamela Griesler
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Melanie Wall
- Department of Psychiatry, Columbia University, New York, NY 10032, USA,New York State Psychiatric Institute, New York, NY 10032, USA,Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Denise B. Kandel
- Department of Psychiatry, Columbia University, New York, NY 10032, USA,New York State Psychiatric Institute, New York, NY 10032, USA,Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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19
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Thomas F. Young people's use of medicines: Pharmaceuticalised governance and illness management within household and school settings. Soc Sci Med 2016; 165:150-158. [PMID: 27522566 DOI: 10.1016/j.socscimed.2016.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/21/2016] [Accepted: 07/25/2016] [Indexed: 11/25/2022]
Abstract
Recent decades have witnessed a significant rise in the use and 'misuse' of pharmaceutical medicines. Without significant behavioural change, the adverse health and environmental impacts resulting from medicine misuse will be most felt by today's young people. Yet despite real concerns surrounding pharmaceutical sustainability, insights into the ways that understandings of, and expectations to take medicines are communicated to, and taken up by young people remain limited. This paper draws on research focused around everyday home and school settings, to examine how understandings and norms relating to medicine use become embedded within the lives of young people. Between May 2014-January 2015, fifty students (aged 11-14) from one secondary school in England participated in focus groups and forty-three in interviews. Two focus groups were held with parents (n = 10). Findings demonstrate that attitudes towards medicine use were bound up with notions of parental responsibility, risk, peer governance and social acceptability, labour-related expectations, and processes of regulation within the school. Indeed, it was clear that medication use was often a compromised solution in response to wider structural pressures and demands and that such thinking was embedded at an early stage in the life course. The study found that few opportunities arose for open and informed discussion relating to responsible medicine use. Such circumstances demonstrate that any attempts to change medicine-related attitudes and behaviours should be considered within the wider social and structural contexts that govern their use.
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Affiliation(s)
- Felicity Thomas
- Centre for Medical History, University of Exeter, Rennes Drive, Exeter, EX4 4RJ, UK.
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20
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Pulver A, Davison C, Parpia A, Purkey E, Pickett W. Nonmedical Use of Prescription Opioids and Injury Risk Among Youth. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016. [DOI: 10.1080/1067828x.2015.1115795] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ariel Pulver
- University of Toronto, Toronto, Ontario, Canada
- Queen's University, Kingston, Ontario, Canada
| | - Colleen Davison
- Queen's University, Kingston, Ontario, Canada
- Kingston General Hospital Research Centre, Kingston, Ontario, Canada
| | | | - Eva Purkey
- Queen's University, Kingston, Ontario, Canada
| | - William Pickett
- Queen's University, Kingston, Ontario, Canada
- Kingston General Hospital Research Centre, Kingston, Ontario, Canada
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21
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Hall MT, Golder S, Higgins GE, Logan T. Nonmedical prescription opioid use among victimized women on probation and parole. Addict Behav 2016; 53:113-9. [PMID: 26476007 DOI: 10.1016/j.addbeh.2015.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 09/16/2015] [Accepted: 10/03/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Nonmedical prescription opioid use (NPOU) is a major public health concern and few studies have described this phenomenon among victimized women involved in the criminal justice system. OBJECTIVE This study will describe the relationship between victimization, psychological distress, health status and NPOU among the vulnerable population of victimized women on probation and parole. METHODS A sample of 406 women on probation and parole responded to items assessing victimization history, self-reported health status, physical pain, psychological distress, and post-traumatic stress disorder. Multiple logistic regression analysis was utilized to differentiate NPOUs versus nonusers. RESULTS Overall, 169 (41.6%) women reported lifetime NPOU, and 20% reported use in the past year. Compared to women who did not report NPOU, NPOUs were more likely to be White, have poorer general health, and more severe psychological distress across nine symptom domains. In multiple logistic regression models, each year of age reduced the odds of NPOU by 4%; White women were twice as likely as women of other races to report NPOU; each unit increase in the measure for physical pain was associated with a 30% increase in the odds of NPOU; and participants who met diagnostic criteria for PTSD were 60% more likely to report NPOU compared to individuals who did not. CONCLUSION Victimized women on probation and parole report high rates of NPOU and comorbid mental and physical health problems. The criminal justice system should routinely screen for NPOU, as well as untreated or poorly managed physical pain and psychological distress, which may increase risk of NPOU.
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22
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Baumbauer KM, Young EE, Starkweather AR, Guite JW, Russell BS, Manworren RCB. Managing Chronic Pain in Special Populations with Emphasis on Pediatric, Geriatric, and Drug Abuser Populations. Med Clin North Am 2016; 100:183-97. [PMID: 26614727 PMCID: PMC4766002 DOI: 10.1016/j.mcna.2015.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In the adult population chronic pain can lead to loss of productivity and earning potential, and decreased quality of life. There are distinct groups with increased vulnerability for the emergence of chronic pain. These groups may be defined by developmental status and/or life circumstances. Within the pediatric, geriatric, and drug abuser populations, chronic pain represents a significant health issue. This article focuses on known anatomic, physiologic, and genetic mechanisms underlying chronic pain in these populations, and highlights the need for a multimodal approach from multiple health care professionals for management of chronic pain in those with the most risk.
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Affiliation(s)
- Kyle M Baumbauer
- School of Nursing, The Center for Advancing Management of Pain, University of Connecticut, Storrs, CT 06269-4026, USA; Department of Neuroscience, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06030, USA; Institute for Systems Genomics, University of Connecticut Health Center, 400 Farmington Ave, CT 06030, USA
| | - Erin E Young
- School of Nursing, The Center for Advancing Management of Pain, University of Connecticut, Storrs, CT 06269-4026, USA; Institute for Systems Genomics, University of Connecticut Health Center, 400 Farmington Ave, CT 06030, USA; Department of Genetics and Genome Sciences, University of Connecticut Health Center, 400 Farmington Ave, Farmington, CT 06030, USA
| | - Angela R Starkweather
- School of Nursing, The Center for Advancing Management of Pain, University of Connecticut, Storrs, CT 06269-4026, USA
| | - Jessica W Guite
- Department of Pediatrics, University of Connecticut School of Medicine, 236 Farmington Ave, Farmington, CT 06030, USA; Children's Center for Community Research (C3R), 12 Charter Oak Place, Hartford, CT 06106, USA; Pediatric Psychology, Hartford Hospital/The Institute of Living, 100 Retreat, Suite 515, Hartford, CT 06106, USA; Division of Pain and Palliative Medicine, Connecticut Children's Medical Center, 282 Washington St, Hartford, CT 06106, USA
| | - Beth S Russell
- Human Development & Family Studies, University of Connecticut, 368 Mansfield Rd, Storrs, CT 06269-1058, USA
| | - Renee C B Manworren
- School of Nursing, The Center for Advancing Management of Pain, University of Connecticut, Storrs, CT 06269-4026, USA; Department of Pediatrics, University of Connecticut School of Medicine, 236 Farmington Ave, Farmington, CT 06030, USA; Division of Pain and Palliative Medicine, Connecticut Children's Medical Center, 282 Washington St, Hartford, CT 06106, USA.
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23
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Ham LS, Wiersma-Mosley JD, Feldner MT, Melkonian AJ, Milner LA, Lewis SF. Posttraumatic Stress Symptoms and Nonmedical Prescription Drug Use Among College Students With Trauma Exposure. J Dual Diagn 2016; 12:43-54. [PMID: 26829261 DOI: 10.1080/15504263.2016.1146556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Nonmedical prescription drug use, defined as using the drug without a prescription or in ways for which it is not prescribed, and traumatic event exposure are highly prevalent among college students. Despite evidence that posttraumatic stress symptoms could place college students at risk for nonmedical prescription drug problems, no studies have examined this relationship. This study was a preliminary examination of posttraumatic stress symptoms, lifetime nonmedical prescription drug use, hazardous use, and dependence symptoms among college students with trauma exposure. METHODS Participants were students attending a rural college in Virginia, recruited through psychology classes, flyers, LISTSERVs, and announcements at student events. All students who reported experiencing at least one traumatic event were included (N = 119); participants' mean age was 19.7 years (SD = 1.90), about half were women (n = 63, 53%), and most were Caucasian (n = 103, 87%). RESULTS Nearly 60% of participants (n = 71) reported using nonmedical prescription drugs at least once during their lifetime and were more likely than those with no use to report hazardous alcohol use (p < .01) and depressive symptoms (p < .05). There were no other significant differences between those who did and did not report use of nonmedical prescription drugs. Regression analyses showed that posttraumatic stress symptom frequency was positively associated with hazardous nonmedical prescription drug use, after controlling for gender, depressive symptoms, and hazardous alcohol use (p < .001). Posttraumatic stress symptom frequency was higher for those with any nonmedical prescription drug dependence symptoms (p < .001), but was unrelated to whether the student had ever engaged in nonmedical prescription drug use. CONCLUSIONS Findings suggest that consideration of the types of behaviors and problems a college student is experiencing related to nonmedical prescription drug use may be more relevant to posttraumatic stress symptom frequency than dichotomous measures of nonmedical prescription drug use alone. Further, the association between the frequency of posttraumatic stress symptoms and both hazardous nonmedical prescription drug use and dependence symptoms among college students with a trauma history deserves further investigation due to the resulting vulnerability to increasingly negative outcomes.
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Affiliation(s)
- Lindsay S Ham
- a Department of Psychological Science , University of Arkansas , Fayetteville , Arkansas , USA
| | | | - Matthew T Feldner
- a Department of Psychological Science , University of Arkansas , Fayetteville , Arkansas , USA
| | - Alexander J Melkonian
- a Department of Psychological Science , University of Arkansas , Fayetteville , Arkansas , USA
| | - Lauren A Milner
- c Louis Stokes Cleveland VA Medical Center , Cleveland , Ohio , USA
| | - Sarah F Lewis
- d Center for Research, Assessment and Treatment Efficacy , Asheville , North Carolina , USA
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Miech R, Johnston L, O’Malley PM, Keyes KM, Heard K. Prescription Opioids in Adolescence and Future Opioid Misuse. Pediatrics 2015; 136:e1169-77. [PMID: 26504126 PMCID: PMC4834210 DOI: 10.1542/peds.2015-1364] [Citation(s) in RCA: 336] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Legitimate opioid use is associated with an increased risk of long-term opioid use and possibly misuse in adults. The objective of this study was to estimate the risk of future opioid misuse among adolescents who have not yet graduated from high school. METHODS Prospective, panel data come from the Monitoring the Future study. The analysis uses a nationally representative sample of 6220 individuals surveyed in school in 12th grade and then followed up through age 23. Analyses are stratified by predicted future opioid misuse as measured in 12th grade on the basis of known risk factors. The main outcome is nonmedical use of a prescription opioid at ages 19 to 23. Predictors include use of a legitimate prescription by 12th grade, as well as baseline history of drug use and baseline attitudes toward illegal drug use. RESULTS Legitimate opioid use before high school graduation is independently associated with a 33% increase in the risk of future opioid misuse after high school. This association is concentrated among individuals who have little to no history of drug use and, as well, strong disapproval of illegal drug use at baseline. CONCLUSIONS Use of prescribed opioids before the 12th grade is independently associated with future opioid misuse among patients with little drug experience and who disapprove of illegal drug use. Clinic-based education and prevention efforts have substantial potential to reduce future opioid misuse among these individuals, who begin opioid use with strong attitudes against illegal drug use.
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Affiliation(s)
- Richard Miech
- Survey Research Center, University of Michigan, Ann Arbor, Michigan;
| | - Lloyd Johnston
- Survey Research Center, University of Michigan, Ann Arbor, Michigan
| | | | - Katherine M. Keyes
- Mailman School of Public Health, Columbia University, New York, New York; and
| | - Kennon Heard
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado
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25
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Nonmedical prescription drug use among US young adults by educational attainment. Soc Psychiatry Psychiatr Epidemiol 2015; 50:713-24. [PMID: 25427665 PMCID: PMC4405452 DOI: 10.1007/s00127-014-0980-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Little is known about nonmedical use of prescription drugs among non-college-attending young adults in the United States. METHODS Data were drawn from 36,781 young adults (ages 18-22 years) from the 2008-2010 National Survey on Drug Use and Health public use files. The adjusted main effects for current educational attainment, along with its interaction with gender and race/ethnicity, were considered. RESULTS Compared to those attending college, non-college-attending young adults with at least and less than a HS degree had a higher prevalence of past-year nonmedical use of prescription opioids [NMUPO 13.1 and 13.2 %, respectively, vs. 11.3 %, adjusted odds ratios (aORs) 1.21 (1.11-1.33) and 1.25 (1.12-1.40)], yet lower prevalence of prescription stimulant use. Among users, regardless of drug type, non-college-attending youth were more likely to have past-year disorder secondary to use [e.g., NMUPO 17.4 and 19.1 %, respectively, vs. 11.7 %, aORs 1.55 (1.22-1.98) and 1.75 (1.35-2.28)]. Educational attainment interacted with gender and race: (1) among nonmedical users of prescription opioids, females who completed high school but were not enrolled in college had a significantly greater risk of opioid disorder (compared to female college students) than the same comparison for men; and (2) the risk for nonmedical use of prescription opioids was negligible across educational attainment groups for Hispanics, which was significantly different than the increased risk shown for non-Hispanic whites. CONCLUSIONS There is a need for young adult prevention and intervention programs to target nonmedical prescription drug use beyond college campuses.
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26
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Keyes KM, Maslowsky J, Hamilton A, Schulenberg J. The great sleep recession: changes in sleep duration among US adolescents, 1991-2012. Pediatrics 2015; 135:460-8. [PMID: 25687142 PMCID: PMC4338325 DOI: 10.1542/peds.2014-2707] [Citation(s) in RCA: 277] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Average nightly sleep times precipitously decline from childhood through adolescence. There is increasing concern that historical shifts also occur in overall adolescent sleep time. METHODS Data were drawn from Monitoring the Future, a yearly, nationally representative cross-sectional survey of adolescents in the United States from 1991 to 2012 (N = 272 077) representing birth cohorts from 1973 to 2000. Adolescents were asked how often they get ≥7 hours of sleep and how often they get less sleep than they should. Age-period-cohort models were estimated. RESULTS Adolescent sleep generally declined over 20 years; the largest change occurred between 1991-1995 and 1996-2000. Age-period-cohort analyses indicate adolescent sleep is best described across demographic subgroups by an age effect, with sleep decreasing across adolescence, and a period effect, indicating that sleep is consistently decreasing, especially in the late 1990s and early 2000s. There was also a cohort effect among some subgroups, including male subjects, white subjects, and those in urban areas, with the earliest cohorts obtaining more sleep. Girls were less likely to report getting ≥7 hours of sleep compared with boys, as were racial/ethnic minorities, students living in urban areas, and those of low socioeconomic status (SES). However, racial/ethnic minorities and adolescents of low SES were more likely to self-report adequate sleep, compared with white subjects and those of higher SES. CONCLUSIONS Declines in self-reported adolescent sleep across the last 20 years are concerning. Mismatch between perceptions of adequate sleep and actual reported sleep times for racial/ethnic minorities and adolescents of low SES are additionally concerning and suggest that health education and literacy approaches may be warranted.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Columbia University, New York, New York;
| | - Julie Maslowsky
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas; and
| | - Ava Hamilton
- Department of Epidemiology, Columbia University, New York, New York
| | - John Schulenberg
- Institute for Social Research and Department of Psychology and Center for Growth and Human Development, University of Michigan, Ann Arbor, Michigan
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Pulver A, Davison C, Pickett W. Time-use patterns and the recreational use of prescription medications among rural and small town youth. J Rural Health 2015; 31:217-28. [PMID: 25599760 DOI: 10.1111/jrh.12103] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine the relationship between rural and small town adolescents' time-use and an increased risk for recreational use of prescription drugs in rural settings. METHODS Rural students in grades 9 and 10 (n = 2,393) were asked about past-year recreational use of prescription medications and their time-use in structured and unstructured activity contexts in the 2009/2010 Cycle of the Canadian Health Behaviour in School-aged Children survey. Time-use patterns of rural and small town youth from across Canada were examined using multilevel, multivariate Poisson regression analyses to determine whether they may impact the risk of this kind of substance use. FINDINGS Peer time outside school hours and nonparticipation in extracurricular activities were significantly associated with rural youths' recreational use of prescription drugs. Peer drug use, unhappy home lives and frequent binge drinking explained most of these associations. CONCLUSIONS Structured and unstructured activity contexts within rural settings play a role in the nonmedical use of prescription medications. Results support interventions aimed at increasing structured time-use opportunities in addition to focusing on peer contexts and multiple risk-taking behaviors among rural youth.
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Affiliation(s)
- Ariel Pulver
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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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: 90] [Impact Index Per Article: 9.0] [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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Hadland SE, DeBeck K, Kerr T, Feng C, Montaner JS, Wood E. Prescription opioid injection and risk of hepatitis C in relation to traditional drugs of misuse in a prospective cohort of street youth. BMJ Open 2014; 4:e005419. [PMID: 25052173 PMCID: PMC4120401 DOI: 10.1136/bmjopen-2014-005419] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Despite dramatic increases in the misuse of prescription opioids, the extent to which their intravenous injection places drug users at risk of acquiring hepatitis C virus (HCV) remains unclear. We sought to compare risk of HCV acquisition from injection of prescription opioids to that from other street drugs among high-risk street youth. DESIGN Prospective cohort study. SETTING Vancouver, British Columbia, Canada from September 2005 to November 2011. PARTICIPANTS The At-Risk Youth Study (ARYS) is a prospective cohort of drug-using adolescents and young adults aged 14-26 years. Participants were recruited through street-based outreach and snowball sampling. PRIMARY OUTCOME MEASURE HCV antibody seroconversion, measured every 6 months during follow-up. Risk for seroconversion from injection of prescription opioids was compared with injection of other street drugs of misuse, including heroin, cocaine or crystal methamphetamine, using Cox proportional hazards regression controlling for age, gender and syringe sharing. RESULTS Baseline HCV seropositivity was 10.6%. Among 512 HCV-seronegative youth contributing 860.2 person-years of follow-up, 56 (10.9%) seroconverted, resulting in an incidence density of 6.5/100 person-years. In bivariate analyses, prescription opioid injection (HR=3.48; 95% CI 1.57 to 7.70) predicted HCV seroconversion. However, in multivariate modelling, only injection of heroin (adjusted HR=4.56; 95% CI 2.39 to 8.70), cocaine (adjusted HR=1.88; 95% CI 1.00 to 3.54) and crystal methamphetamine (adjusted HR=2.91; 95% CI 1.57 to 5.38) remained independently associated with HCV seroconversion, whereas injection of prescription opioids did not (adjusted HR=0.94; 95% CI 0.40 to 2.21). CONCLUSIONS Although misuse of prescription opioids is on the rise, traditional street drugs still posed the greatest threat of HCV transmission in this setting. Nonetheless, the high prevalence and incidence of HCV among Canadian street youth underscore the need for evidence-based drug prevention, treatment and harm reduction interventions targeting this vulnerable population.
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Affiliation(s)
- Scott E Hadland
- Division of Adolescent & Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Kora DeBeck
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Thomas Kerr
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cindy Feng
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- University of Saskatchewan, School of Public Health, Saskatoon, Saskatchewan, Canada
| | - Julio S Montaner
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Keyes KM, Nicholson R, Kinley J, Raposo S, Stein MB, Goldner EM, Sareen J. Age, period, and cohort effects in psychological distress in the United States and Canada. Am J Epidemiol 2014; 179:1216-27. [PMID: 24692432 DOI: 10.1093/aje/kwu029] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although treatment utilization for depression and anxiety symptoms has increased substantially in the United States and elsewhere, it remains unclear whether the underlying population distribution of psychological distress is changing over time. We estimated age, period, and cohort effects using data from 2 countries over more than 20 years, including National Health Interview Surveys from 1997 to 2010 (n = 447,058) and Canadian Community Health Surveys from 2000 to 2007 (n = 125,306). Psychological distress was measured with the Kessler Psychological Distress Scale. By period, both countries showed the highest levels of psychological distress in 2001 and the lowest levels in 2007. By age, psychological distress was highest in adolescence and during the late 40s and early 50s. By cohort, Canadian Community Health Survey results indicated a decreasing cohort effect among those born in 1922-1925 through 1935-1939 (β = -0.36, 95% confidence interval: -0.45, -0.27) and then a continuously increasing cohort effect during the remainder of the 20th century through 1989-1992 (β = 0.49, 95% confidence interval: 0.38, 0.61). The National Health Interview Survey data captured earlier-born cohorts and indicated an increased cohort effect for the earliest born (for 1912-1914, β = 0.44, 95% confidence interval: 0.26, 0.61). In sum, individuals in the oldest and more recently born birth cohorts have higher mean psychological distress symptoms compared with those born in midcentury, underscoring the importance of a broad, population-level lens for conceptualizing mental health.
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Fotiou A, Kanavou E, Richardson C, Ploumpidis D, Kokkevi A. Misuse of prescription opioid analgesics among adolescents in Greece: The importance of peer use and past prescriptions. DRUGS-EDUCATION PREVENTION AND POLICY 2014. [DOI: 10.3109/09687637.2014.899989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Keyes KM, Miech R. Age, period, and cohort effects in heavy episodic drinking in the US from 1985 to 2009. Drug Alcohol Depend 2013; 132:140-8. [PMID: 23433898 PMCID: PMC4827021 DOI: 10.1016/j.drugalcdep.2013.01.019] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 01/23/2013] [Accepted: 01/24/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Evaluating population-level patterns of heavy episodic drinking by age, period, and cohort is critical to understanding population-level influences on rates over time and to forecasting future trends for public health planning efforts. The present study examined trends in heavy episodic drinking in the US from 1985 through 2009 in a nationally representative sample that included adolescents and adults. METHODS Data are drawn from repeated cross-sectional surveys of US households as part of the National Household Survey on Drug Use and Health conducted in 1985, 1988, and annually from 1990 though 2009, inclusive (N=809,281). Heavy episodic drinking was defined as any instance of consuming five or more drinks in one sitting in the past month. Age-period-cohort models were identified using the Intrinsic Estimator algorithm. RESULTS Heavy episodic drinking is decreasing in the US among adolescents and young adults, with the most recently born cohorts (born in the 1990s) at lower odds of heavy episodic drinking compared with cohorts born in the 1960s, 1970s, and 1980s. Results were consistent across sex and race/ethnicity, with the exception that the decrease is not apparent among Hispanics. CONCLUSIONS These data are promising in that young cohorts appear to be reducing heavy episodic drinking, however the lack of decrease among Hispanics suggests targeted intervention and prevention as well as increased surveillance are necessary.
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Affiliation(s)
- Katherine M. Keyes
- Columbia University, New York, NY, United States,Corresponding author at: Columbia University, Department of Epidemiology, Mailman School of Public Health, 722 West 168th Street, Suite 503, New York, NY 10032, United States. Tel.: +1 212 304 5652; fax: +1 212 543 5913. (K.M. Keyes)
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Miech RA, London AS, Wilmoth JM, Koester S. The effects of the military's antidrug policies over the life course: the case of past-year hallucinogen use. Subst Use Misuse 2013; 48:837-53. [PMID: 23869457 DOI: 10.3109/10826084.2013.800120] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We analyze long-term trends in past-year hallucinogen use among veterans as compared to nonveterans. This topic is theoretically strategic because the military adopted stringent and successful antidrug policies in the mid-1980s, which serves as a natural experiment to examine the potential long-term impact of comprehensive drug policies on illegal drug use. Drawing on self-reported data from the National Survey of Drug Use and Health in years 1985, 1988, and 1990-2010, the analysis uses age-period-cohort analysis to update trends in past-year hallucinogen use and to examine the impact of veteran status. Results are consistent with the hypothesis that a stringent antidrug policy can lead to a life-long reduction in hallucinogen use. Among birth cohorts who were young adults immediately before the implementation of the antidrug policies (those in the 1960-1964 birth cohort) odds of past-year hallucinogen use were twice as high for veterans as compared to nonveterans over the life course. This difference disappeared among birth cohorts that were young adults after the antidrug policies were implemented, when the prevalence of past-year hallucinogen use would be expected to be higher for veterans because of their significantly higher rates of illegal drug use in adolescence. After the drug-testing policies were implemented veterans actually had significantly lower prevalence of past-year hallucinogen use in comparison to nonveterans among the subgroup of respondents who reported a history of illegal drug use before age 18 (OR = .77, p < .01). These trends across veterans and nonveterans were not explained by trends in recruits' tendencies for illegal drug use. These findings point to service in today's armed forces as a turning point that, overall, leads to a lasting, lifelong reduction in substance use.
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Affiliation(s)
- Richard A Miech
- Health and Behavior Sciences, University of Colorado at Denver, Denver, Colorado, USA.
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