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Wells BE, Samrock S, Pawson M, Starks TJ. Pilot Randomized Trial of an Expressive Writing Intervention to Reduce Sexual HIV-Transmission Risk and Substance Use Among Emerging Adult Gay and Bisexual Men. AIDS Behav 2022; 26:584-595. [PMID: 34357477 PMCID: PMC8816814 DOI: 10.1007/s10461-021-03413-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 02/03/2023]
Abstract
This pilot randomized controlled trial evaluated the feasibility, acceptability, and preliminary efficacy of expressive writing to reduce HIV-related sexual risk taking and symptoms of drug dependence among emerging adult gay and bisexual men (EAGBM) through linguistic mechanisms involving use of words associated with cognitive processing (e.g., think, cause), positive emotion (e.g., love, nice), and negative emotion (e.g., hurt, shame). Between 2014 and 2015, EAGBM (n = 78; aged 18-29) completed a baseline survey and were randomized to complete three 15-min expressive writing or equivalent control-group writing sessions and follow-up assessments 2 months post-baseline. EAGBM in the expressive writing condition utilized significantly more positive emotion, negative emotion, and cognitive processing words. Path model results indicated the intervention condition resulted in significant reductions in symptoms of drug dependence and frequency of condomless anal sex (CAS) through paths mediated by positive emotion words, and significant increases in CAS through a path mediated by negative emotion words.
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Affiliation(s)
- Brooke E. Wells
- Center for Human Sexuality Studies, Widener University, Chester, PA. USA,Interdisciplinary Sexuality Research Collaborative, Widener University, Chester, PA. USA
| | - Steven Samrock
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY. USA
| | - Mark Pawson
- Department of Sociology, Purdue University, West Lafayette, IN. USA
| | - Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY. USA,Health Psychology and Clinical Science Doctoral Program, Graduate Center of CUNY, New York, NY. USA
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Drazdowski TK, Schulte M, Wolitzky-Taylor KB, Schaper H, Chapman JE. Motivations for Prescription Drug Misuse Related to Mental Health Problems in Adults. Subst Use Misuse 2022; 57:316-327. [PMID: 34903123 PMCID: PMC8842830 DOI: 10.1080/10826084.2021.2012687] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Prescription drug misuse (PDM) is a significant public health problem associated with mental health symptoms. OBJECTIVES This project investigates the connections between PDM motivations and mental health to inform intervention efforts. METHODS Using nationally representative adult data from the 2016-2018 National Survey on Drug Use and Health (N = 128,205; 53% female) this project investigated which motivations for misuse are related to past-year mental health problems including any mental illness, serious mental illness, major depressive episode, and suicidal thoughts. Complex samples logistic regression models of the main motivation of PDM for each mental health problem were conducted separately for each prescription drug class (i.e., opioids, tranquilizers, sedatives, and stimulants) while controlling for demographic characteristics. RESULTS Adults that reported PDM were more likely than those with no PDM to endorse past year mental health problems. Compared to those that reported PDM of other medications, those misusing prescription opioids and tranquilizers to help with emotions and misusing sedatives to "relax or relieve tension" were more likely to have all categories of mental health problems. Those that misused prescription stimulants to "help study" had lower odds of all mental health problems. CONCLUSIONS While there were differences based on prescription drug class, a range of motivations increased adults' likelihood to have mental health problems and common themes were found across drug classes. While causality is still undetermined, prevention and intervention efforts that are multifaceted and individualized, while broadly providing adults with other ways to cope with negative emotions are likely to help reduce PDM.
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Affiliation(s)
- Tess K Drazdowski
- UCLA Integrated Substance Abuse Programs, Los Angeles, California, USA.,Oregon Social Learning Center, Eugene, Oregon, USA
| | - Marya Schulte
- UCLA Integrated Substance Abuse Programs, Los Angeles, California, USA
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Phaugat P, Nishal S, Dhiman R. Abuse Deterrent Formulations in Constraining the Abuse Potential of Prescription Medicines: A Myth or Truth. Curr Drug Deliv 2021; 19:466-478. [PMID: 34353262 DOI: 10.2174/1567201818666210805145819] [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: 12/19/2020] [Revised: 06/07/2021] [Accepted: 06/16/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diverse pain killers used for the management of varied categories of pain are being misused in order to have extreme pleasant effect by a large number of populations. To overcome the misuse of prescription drugs, regulatory bodies have given stress on development of abuse resistance. METHODS We studied numerous literatures: (1) Research and review papers including the guidelines for pain management, abuse, and abuse deterrence; (2) Description and categorization of pain along with the management approaches; (3) advantages and disadvantages of the abuse deterrent formulations were described. RESULTS Abuse deterrent formulations are the contemporary remedial treatment for pain with reduced prospects of being abused. But these comprise the huge expense in contrast to the generic drugs as well as the non-deterrent branded equivalents. CONCLUSION Many challenges are faced throughout the development of abuse deterrent formulations. These formulations displayed substantial drop in abuse incidences but it may lead to other modes of abuse which may prove more harmful for the users.
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Affiliation(s)
- Parmita Phaugat
- Drug Safety Associate; Pharmacovigilance, Parexel International. India
| | - Suchitra Nishal
- College of Pharmacy, University of Health Sciences Rohtak. India
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Abstract
AIMS Prescription opioid misuse (POM) contributes to a larger opioid crisis in the US and Canada, with over 17 000 US POM-related overdose deaths in 2017. Our aims were to (1) identify specific profiles of respondents based on POM motives using the US National Survey on Drug Use and Health (NSDUH) and (2) compare profile respondents on sociodemographics, substance use and mental and physical health outcomes. METHODS Analyses included 2017-18 NSDUH respondents with data on POM motives (n = 4810). POM was defined as prescription opioid use in a way not intended by the prescriber, including use without a prescription, in larger amounts or more frequently. Nine POM motives for the most recent episode were assessed, including 'to relieve physical pain' and 'to get high'. Latent classes, based on POM motives, were estimated. Classes were compared on sociodemographics, substance use and physical and mental health outcomes. RESULTS Eight latent classes were identified (in order of prevalence): pain relief only, relax-pain relief, sleep-pain relief, multi-motive, high, experimenter, emotional coping and dependent/hooked. Compared to the pain relief only group, the high and multi-motive classes had higher odds of all substance use outcomes, with the dependent/hooked class having higher odds on all but one outcome. Six of the eight classes had higher odds of past-year mental health treatment and suicidal ideation than the pain relief only class. CONCLUSIONS Screening for pain, pain conditions, problematic substance use and psychopathology are recommended in those with any POM. While those in the dependent/hooked, multi-motive and emotional coping classes are most likely to have prescription opioid use disorder (OUD), screening for OUD symptoms in all individuals with POM is also warranted.
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Votaw VR, Geyer R, Rieselbach MM, McHugh RK. The epidemiology of benzodiazepine misuse: A systematic review. Drug Alcohol Depend 2019; 200:95-114. [PMID: 31121495 PMCID: PMC6639084 DOI: 10.1016/j.drugalcdep.2019.02.033] [Citation(s) in RCA: 209] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 02/22/2019] [Accepted: 02/27/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Benzodiazepine misuse is a growing public health problem, with increases in benzodiazepine-related overdose deaths and emergency room visits in recent years. However, relatively little attention has been paid to this emergent problem. We systematically reviewed epidemiological studies on benzodiazepine misuse to identify key findings, limitations, and future directions for research. METHODS PubMed and PsychINFO databases were searched through February 2019 for peer-reviewed publications on benzodiazepine misuse (e.g., use without a prescription; at a higher frequency or dose than prescribed). Eligibility criteria included human studies that focused on the prevalence, trends, correlates, motives, patterns, sources, and consequences of benzodiazepine misuse. RESULTS The search identified 1970 publications, and 351 articles were eligible for data extraction and inclusion. In 2017, benzodiazepines and other tranquilizers were the third most commonly misused illicit or prescription drug in the U.S. (approximately 2.2% of the population). Worldwide rates of misuse appear to be similar to those reported in the U.S. Factors associated with misuse include other substance use, receipt of a benzodiazepine prescription, and psychiatric symptoms and disorders. Benzodiazepine misuse encompasses heterogeneous presentations of motives, patterns, and sources. Moreover, misuse is associated with myriad poor outcomes, including mortality, HIV/HCV risk behaviors, poor self-reported quality of life, criminality, and continued substance use during treatment. CONCLUSIONS Benzodiazepine misuse is a worldwide public health concern that is associated with a number of concerning consequences. Findings from the present review have implications for identifying subgroups who could benefit from prevention and treatment efforts, critical points for intervention, and treatment targets.
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Affiliation(s)
- Victoria R. Votaw
- Department of Psychology, University of New Mexico, MSC 03-2220, Albuquerque, NM, USA,Corresponding author: Victoria R. Votaw, Clinical Psychology Ph.D. Student Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, Albuquerque, NM 87131,
| | - Rachel Geyer
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA, USA
| | - Maya M. Rieselbach
- Department of Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA, USA
| | - R. Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, USA
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Compton WM, Han B, Blanco C, Johnson K, Jones CM. Prevalence and Correlates of Prescription Stimulant Use, Misuse, Use Disorders, and Motivations for Misuse Among Adults in the United States. Am J Psychiatry 2018; 175:741-755. [PMID: 29656665 PMCID: PMC6070393 DOI: 10.1176/appi.ajp.2018.17091048] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to simultaneously examine the prevalence and correlates of prescription stimulant use, misuse, use disorders, and motivations for misuse in the U.S. adult population. METHOD This was a nationally representative household population study of adults age 18 or older from the 2015 and 2016 National Surveys on Drug Use and Health (N=102,000). Measurements included prescription stimulant use, use without misuse, misuse without use disorders, and misuse with use disorders, as well as sociodemographic characteristics, health conditions, and mental health factors. RESULTS Among U.S. adults, 6.6% (annual average) used prescription stimulants overall; 4.5% used without misuse, 1.9% misused without use disorders, and 0.2% had use disorders. Adults with past-year prescription stimulant use disorders did not differ from those with misuse without use disorders in any of the examined sociodemographic characteristics and in many of the examined substance use problems. The most commonly reported motivations for misuse were to help be alert or concentrate (56.3%). The most likely source of misused prescription stimulants was by obtaining them free from friends or relatives (56.9%). More frequent prescription stimulant misuse and use disorder were associated with an increased likelihood of obtaining medications from physicians or from drug dealers or strangers and less likelihood of obtaining them from friends or relatives. CONCLUSIONS Approximately 16.0 million U.S. adults used prescription stimulants in the preceding year (annual average), 5.0 million misused prescription stimulants, and 0.4 million had use disorders. Cognitive enhancement was the most commonly reported reason for misusing prescription stimulants. Patients who are using their medication for cognitive enhancement or diverting their medication to others present a high risk.
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Affiliation(s)
- Wilson M Compton
- From the National Institute on Drug Abuse, Bethesda, Md.; and the Substance Abuse and Mental Health Services Administration, Rockville, Md
| | - Beth Han
- From the National Institute on Drug Abuse, Bethesda, Md.; and the Substance Abuse and Mental Health Services Administration, Rockville, Md
| | - Carlos Blanco
- From the National Institute on Drug Abuse, Bethesda, Md.; and the Substance Abuse and Mental Health Services Administration, Rockville, Md
| | - Kimberly Johnson
- From the National Institute on Drug Abuse, Bethesda, Md.; and the Substance Abuse and Mental Health Services Administration, Rockville, Md
| | - Christopher M Jones
- From the National Institute on Drug Abuse, Bethesda, Md.; and the Substance Abuse and Mental Health Services Administration, Rockville, Md
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Mahmoud KF, Finnell D, Savage CL, Puskar KR, Mitchell AM. A Concept Analysis of Substance Misuse to Inform Contemporary Terminology. Arch Psychiatr Nurs 2017; 31:532-540. [PMID: 29179817 DOI: 10.1016/j.apnu.2017.06.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/11/2017] [Accepted: 06/04/2017] [Indexed: 11/15/2022]
Abstract
Previous diagnostic categories of substance abuse and dependence have given way to the current view that substance use disorders occur on a continuum with a broad range of severity. This current view is featured in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V). In recognizing the role of stigma in preventing persons from seeking substance use treatment, advocates have called attention that particular terminology can fuel such stigma. To mitigate the negative effects of such stigmatizing language, the International Society of Addiction Journal Editors (ISAJE) recommends against using previously-used and possibly pejorative terminology for substance abuse and dependence, unless a particular scientific justification exists. The purpose of this paper is to: (1) present a concept analysis of the term substance misuse and (2) recommend an alternate term for substance misuse that is neither pejorative nor inadvertently stigmatizing: at-risk substance use.
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Affiliation(s)
- Khadejah F Mahmoud
- University of Pittsburgh School of Nursing, 3500 Victoria Street, 415 Victoria Building, Pittsburgh, PA 15261, USA.
| | - Deborah Finnell
- Johns Hopkins University School of Nursing, Department of Acute and Chronic Care, 525 N. Wolfe Street, Baltimore, MD 21205-1730, USA
| | - Christine L Savage
- Johns Hopkins University School of Nursing, Department of Acute and Chronic Care, 525 N. Wolfe Street, Baltimore, MD 21205-1730, USA
| | - Kathryn R Puskar
- University of Pittsburgh School of Nursing, 3500 Victoria Street, 415 Victoria Building, Pittsburgh, PA 15261, USA
| | - Ann M Mitchell
- University of Pittsburgh School of Nursing, 3500 Victoria Street, 415 Victoria Building, Pittsburgh, PA 15261, USA
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LeClair A, Kelly BC, Pawson M, Wells BE, Parsons JT. Motivations for Prescription Drug Misuse among Young Adults: Considering Social and Developmental Contexts. DRUGS-EDUCATION PREVENTION AND POLICY 2015; 22:208-216. [PMID: 26709337 DOI: 10.3109/09687637.2015.1030355] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS As part of a larger study on prescription drug misuse among young adults active in urban nightlife scenes, we examined participants' motivations for misuse. Prescription painkillers, stimulants and sedatives were the primary substances of interest. METHODS Participants were recruited from nightlife venues in New York using time-space sampling. Subjects completed a mixed-methods assessment at project research offices. The data presented here are from a subsample of 70 qualitative interviews conducted during the baseline assessment. FINDINGS We identified experimentation and a "work hard, play hard" ethos as key motivations for misusing prescription drugs and argue that these motivations are specific, though not necessarily unique, to the participants' social location as young adults. These findings highlight the role of life stage and social context in the misuse of prescription drugs. CONCLUSION Future studies of prescription drug misuse should pay attention to the larger social contexts in which users are embedded and, therefore, make decisions about how and why to misuse. Moving beyond the very broad concepts of "recreation" and "self-medication" presently established in the research, policies targeting young adults may want to tailor intervention efforts based on motivations.
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Affiliation(s)
- Amy LeClair
- Institute for Health, Health Care Policy & Aging Research, Rutgers University
| | - Brian C Kelly
- Purdue University ; Center for HIV Educational Studies & Training, CUNY
| | - Mark Pawson
- Center for HIV Educational Studies & Training, CUNY ; Graduate Center, CUNY
| | - Brooke E Wells
- Center for HIV Educational Studies & Training, CUNY ; Hunter College, CUNY
| | - Jeffrey T Parsons
- Center for HIV Educational Studies & Training, CUNY ; Hunter College, CUNY ; Graduate Center, CUNY
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McHugh RK, Nielsen S, Weiss RD. Prescription drug abuse: from epidemiology to public policy. J Subst Abuse Treat 2015; 48:1-7. [PMID: 25239857 PMCID: PMC4250400 DOI: 10.1016/j.jsat.2014.08.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 08/25/2014] [Indexed: 11/26/2022]
Abstract
Prescription drug abuse has reached an epidemic level in the United States. The prevalence of prescription drug abuse escalated rapidly beginning in the late 1990s, requiring a significant increase in research to better understand the nature and treatment of this problem. Since this time, a research literature has begun to develop and has provided important information about how prescription drug abuse is similar to, and different from the abuse of other substances. This introduction to a special issue of the Journal of Substance Abuse Treatment on prescription drug abuse provides an overview of the current status of the research literature in this area. The papers in this special issue include a sampling of the latest research on the epidemiology, clinical correlates, treatment, and public policy considerations of prescription drug abuse. Although much has been learned about prescription drug abuse in recent years, this research remains in early stages, particularly with respect to understanding effective treatments for this population. Future research priorities include studies on the interaction of prescription drugs with other licit and illicit substances, the impact of prescription drug abuse across the lifespan, the optimal treatment for prescription drug abuse and co-occurring conditions, and effective public policy initiatives for reducing prescription drug abuse.
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Affiliation(s)
- R Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
| | - Suzanne Nielsen
- University of New South Wales, National Drug and Alcohol Research Centre, New South Wales, Australia; Drug and Alcohol Services, South Eastern Sydney Local Health District, New South Wales, Australia
| | - Roger D Weiss
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
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