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Freibott CE, Auty SG, Stein MD, Lipson SK. Opioid misuse and mental health in college student populations: A national assessment. J Affect Disord 2024; 363:72-78. [PMID: 39038626 PMCID: PMC11348281 DOI: 10.1016/j.jad.2024.07.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/28/2024] [Accepted: 07/14/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Despite growing concern about opioid misuse and mental health of college students, little is known about this population who are at high risk of co-occurrence and unmet needs. This national study aims to estimate the prevalence of opioid misuse, examine correlates with anxiety and depression symptoms, and quantify help-seeking behaviors among U.S. college students. METHODS Data come from students in the Healthy Minds Study between 2017 and 2020 (n = 176,191). Validated screening tools assessed mental health symptoms (PHQ-9, GAD-7). Marginal effects of logistic regression models estimate the effect of opioid misuse on mental health symptoms, help-seeking and academic performance. RESULTS 782 students indicated past month opioid misuse. Student opioid misuse was associated with 24.1 percentage point increase in the probability of screening positive for anxiety/depression (p < 0.001) and 3.6 percentage point increase in the probability of informal help-seeking (p = 0.017). Less than half of students with opioid misuse and a positive depression/anxiety screen received any treatment in the past year. LIMITATIONS Limitations to this study include: possible non-response bias, as it is unknown whether students with opioid misuse may be differentially-likely to respond to the survey; differing time frame for opioid misuse and mental health questions; and data was collected prior to the COVID-19 pandemic. CONCLUSIONS This large, multi-campus study underlines the need for more partnership between substance use and mental health services on campus. It also highlights that college peers could receive training in ways to best help students who misuse opioids, directing them to on- or off-campus care.
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Affiliation(s)
| | - Samantha G Auty
- 715 Albany Street, Talbot Building, Boston, MA 02118, United States of America
| | - Michael D Stein
- 715 Albany Street, Talbot Building, Boston, MA 02118, United States of America
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Thomas C, Dondaine T, Caron C, Bastien A, Chérot N, Deheul S, Gautier S, Cottencin O, Moreau-Crépeaux S, Bordet R, Carton L. Factors associated with the use of benzodiazepine and opioid prescription drug in the student population: a cross-sectional study. Sci Rep 2024; 14:13040. [PMID: 38844771 PMCID: PMC11156936 DOI: 10.1038/s41598-024-63037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/23/2024] [Indexed: 06/09/2024] Open
Abstract
The misuse of benzodiazepines and opioid medications is frequent in students. To improve our understanding of this behavior, we aimed to identify factors associated with separate and concomitant use of these substances. Anonymous self-reported questionnaires were e-mailed to students enrolled at a French university between March and July 2021, covering: sociodemographic characteristics, academics, psychoactive substance use, ADHD symptomatology (adulthood and childhood), and psychiatric/psychological or addiction follow-up. Factors associated with the use of benzodiazepines and opioid medications included female sex (OR = 1.41 [1.08; 1.86]) and OR = 1.38 [1.06; 1.79], respectively), older age (OR = 1.65 [1.04; 2.6] and OR = 2.17 [1.4; 3.36], respectively), current psychiatric/psychological follow-up (OR = 6.53 [5.18; 8.24] and OR= 1.5 [1.12; 2.0], respectively), ADHD symptomatology (OR= 2.33 [1.71;3.16] and OR= 1.61 [1.15; 2.24], respectively), polyconsumption (tobacco use for benzodiazepine users, OR = 1.38 [1.04; 1.82]; alcohol use OR = 1.67 [1.17; 2.39] and tobacco use OR = 1.62 [1.23; 2.14] for opioid users). These factors were even more strongly associated with the concomitant use of benzodiazepines and opioid medications: older age (OR = 3.64 [2.22; 5.99]), female sex (OR = 1.54 [1.1; 2.14]), grade repetition (OR = 1.7 [1.14; 2.54]), psychiatric/psychological follow-up (OR = 4.51 [3.35;6.06]), ADHD symptomatology (OR = 5.3 [3.69; 7.63]), polyconsumption (tobacco use OR = 2.05 [1.39; 3] and cannabis use, OR = 2.07 [1.97; 4.16]. The factors associated with the use of benzodiazepines and prescription opioids identified in this study could lead to the development of targeted prevention methods.
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Affiliation(s)
- Charlotte Thomas
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France.
| | - Thibaut Dondaine
- University of Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | - Clément Caron
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Axel Bastien
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Nathalie Chérot
- IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Department of Occupational Health, University of Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, 59000, Lille, France
| | - Sylvie Deheul
- CHU Lille, Pharmacology Department, Pharmacovigilance and Addictovigilance center, Lille, France
| | - Sophie Gautier
- University of Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
- CHU Lille, Pharmacology Department, Pharmacovigilance and Addictovigilance center, Lille, France
| | - Olivier Cottencin
- Lille Neuroscience & Cognition Centre (LiNC), Department of Psychiatry and Addiction Medicine, University of Lille, CHU Lille, INSERM U-1172, Plasticity & SubjectivitY (PSY) team, Lille, France
| | | | - Régis Bordet
- University of Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
- CHU Lille, Pharmacology Department, Pharmacovigilance and Addictovigilance center, Lille, France
| | - Louise Carton
- University of Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
- CHU Lille, Pharmacology Department, Pharmacovigilance and Addictovigilance center, Lille, France
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Assini-Meytin LC, Giacomozzi AI, Priolo Filho SR, Lorandi JM, Laurinaitytė I. Adverse Childhood Experiences in Brazilian College Students: Examining Associations with Suicidal Ideation and Risky Behaviors. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:495-505. [PMID: 38938942 PMCID: PMC11199450 DOI: 10.1007/s40653-023-00572-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 06/29/2024]
Abstract
Background The association between adverse childhood experiences (ACEs) and poor health outcomes is well-established in high-income countries. However, the evidence is limited for the association of ACEs, mental health, and risky behaviors for low- and middle-income countries. Moreover, studies often overlook prescription drug misuse and risky driving when examining the association of ACEs with risky behaviors. In our study, we examined the associations between ACEs, suicidal ideation, and risky behaviors (binge drinking, prescription drug misuse, and risky driving) among Brazilian college students. Methods Participants consisted of a convenience sample of students recruited from undergraduate courses primarily in two states in Southern Brazil (93%). Data were collected via an online survey between December 2020 and August 2021. The analytical sample comprised 503 participants, most were female (71%), and the mean age was 24 years. Survey instrument included questions on ten different ACE types, mental health, and risky behaviors. Statistical analyses included univariate descriptive analysis, binary and multivariable regression models. Results Across the ten ACE types assessed, only 14% of participants reported no ACEs, and 29% of participants experienced polyvictimization (i.e., four or more ACES). Multivariable models showed that, compared to those with no ACEs, participants who experienced polyvictimization had significantly increased odds of reporting suicide ideation (AOR = 6.21, p < .001), prescription drug misuse (AOR = 8.78, p < .01), and riding with an impaired driver (AOR = 3.58, p < .01). Conclusions Our findings support the need for psychological support and services available for college students with multiple ACEs.
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Affiliation(s)
- Luciana C. Assini-Meytin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington Street, Baltimore, MD 21231 USA
| | - Andreia Isabel Giacomozzi
- Department of Psychology, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, Trindade, Florianópolis, SC 88040-900 Brasil
| | - Sidnei R. Priolo Filho
- Laboratório de Pesquisa, Prevenção e Intervenção em Psicologia Forense, Universidade Tuiuti do Paraná – Rua Sydney Rangel Santos, Curitiba/PR, 238 Brasil
| | - Joana Milan Lorandi
- Department of Psychology, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, Trindade, Florianópolis, SC 88040-900 Brasil
| | - Ilona Laurinaitytė
- Institute of Psychology, Vilnius University, Universiteto g. 9/1, Vilnius, 01513 Lithuania
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Baumann-Larsen M, Storheim K, Stangeland H, Zwart JA, Wentzel-Larsen T, Skurtveit S, Dyb G, Stensland SØ. Childhood trauma and the use of opioids and other prescription analgesics in adolescence and young adulthood: The HUNT Study. Pain 2024; 165:1317-1326. [PMID: 38126936 PMCID: PMC11090031 DOI: 10.1097/j.pain.0000000000003131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023]
Abstract
ABSTRACT Opioid and nonopioid analgesics are commonly prescribed to young people to alleviate pain. Even short-term prescriptions increase the risk of persistent use and future misuse of potent analgesics, such as opioids. Childhood trauma exposure has been found to be related to pain conditions and to using more prescription analgesics. This large, prospective cohort study aimed to investigate the association of a broad range of childhood trauma exposures with prescription rates for opioid and nonopioid analgesics in adolescence and young adulthood. Self-reported data on childhood trauma exposures from adolescents (aged 13-19 years) who participated in the Young-HUNT3 Study (2006-2008, n = 8199) were linked to data from the Norwegian Prescription Database (NorPD, 2004-2021). We found that exposure to childhood trauma was consistently associated with higher prescription rates for opioids throughout adolescence and young adulthood. The highest incidence rate ratio (IRR) in adolescence was observed for sexual abuse (IRR 1.63, confidence interval [CI] 1.19-2.23). In young adulthood, the highest IRR was observed for physical violence (2.66, CI 2.27-3.12). The same overall pattern was observed for nonopioid analgesics. The more frequent prescriptions of opioid and nonopioid analgesics to participants exposed to childhood trauma suggests a higher symptom load of pain causing them to seek professional help with pain relief. Receiving potent analgesics is not without risk, and the likelihood of misuse may be elevated among trauma-exposed individuals. A trauma-informed approach to pain could be vital for guiding clinicians to the most effective and least harmful treatment for each patient.
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Affiliation(s)
- Monica Baumann-Larsen
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kjersti Storheim
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Helle Stangeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Svetlana Skurtveit
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Grete Dyb
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Synne Øien Stensland
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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Thiesset HF, Barber M, Hall SM, Johnson E, McBride E, Larsen M. Understanding the effects of nutrition and mental health conditions for patients with opioid use disorder (OUD). J Opioid Manag 2024; 20:255-259. [PMID: 39017617 DOI: 10.5055/jom.0843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
BACKGROUND The ravaging effects of the opioid epidemic have affected our communities locally and nationally and are multifaceted in their cause and treatment. It is imperative to locate multiple modalities of treatment options and care for patients with opioid use disorder (OUD) including developing healthy nutrition habits and addressing mental health concerns. Understanding patient perceptions of their personal nutrition habits and mental health status is imperative to providing holistic care in the OUD patient population. METHODS An anonymous 31-question Likert-scale and multiple-choice survey was administered to patients with an International Classification of Disease (ICD-10) code in their electronic medical record of OUD (N = 124). χ2 and Fisher's exact test where appropriate were performed to determine the demographics of survey participants who acknowledged history of OUD compared to those who did not acknowledge a history of OUD. Log-binomial models were used to generate adjusted prevalence ratios. RESULTS Of the 117 patients identified using ICD-10 codes from their medical records as having OUD, only 63 patients acknowledged having a history of OUD, while 54 patients did not. A univariate analysis showed differences in marital status for patients with a self-identified history of OUD. They were also more likely to not be married (divorced or single) (p < 0.01). Patients also tended to be younger than 50 years of age (p < 0.01) and non-White (p < 0.01). There were no differences seen for patients with a history of OUD in the categories of employment (p = 0.31) status or sex (p = 0.51). Patients who acknowledged a history of OUD were significantly more likely to understand the relationship between a healthy diet and reducing the intensity of opioid cravings (p = 0.01) and more likely to consider using nutrition to help combat opioid cravings (p = 0.01). There were no significant differences in overall health or the use of supplements as a part of opioid use treatment. Significant differences were found between those acknowledging a history of OUD having higher rates of depression (p = 0.02) and anxiety (p = 0.02) treatment, despite there not being differences in condition rates for these two conditions (depression, p = 0.08; anxiety, p = 0.27) between the groups. Patients with patient-confirmed OUD were more likely to receive medication treatment (p = 0.03) than those without this acknowledgment. DISCUSSION A similar disease burden of anxiety and depression existed for patients acknowledging OUD as opposed to patients denying OUD. However, significant differences existed between these groups in medication treatment, with those acknowledging OUD having higher rates of being treated for both depression and anxiety. Understanding a patient's mental health condition(s) can be impactful for the treatment of OUD. Multifaceted treatment options should include addressing nutritional deficiencies that impact cravings and long-term healing for patients. CONCLUSION Nutrition and mental health are key parts of a multifaceted treatment modality for patients dealing with OUD. Assisting patients in treatment for depression and anxiety as well as nutrition can change the trajectory of a patient's opioid use recovery.
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Affiliation(s)
- Heather F Thiesset
- Division of Health Sciences, Utah Valley University, Orem; Department of Surgery, University of Utah Health, Salt Lake City; Department of Public Health, Brigham Young University, Provo, Utah. ORCID: https://orcid.org/0000-0002-5484-5303
| | | | - Sarah M Hall
- Department of Public Health, Utah Valley University, Orem, Utah
| | - Emma Johnson
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Elaine McBride
- Department of Public Health, Brigham Young University, Provo, Utah
| | - Merilee Larsen
- Division of Health Sciences, Utah Valley University, Orem, Utah
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Broman MJ, Grekin E, Resko SM, Agius E. Demographic, substance use, and mental well-being correlates of high-intensity drinking among college students and non-college young adults: implications for intervention. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38564777 DOI: 10.1080/07448481.2024.2334071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To assess demographic, substance use, and mental wellbeing factors associated with high-intensity drinking (HID; 10+ drinks on one occasion) among college- and non-college young adults, to inform prevention and intervention efforts. PARTICIPANTS A total of 1,430 young adults (819 in college and 611 not attending college) in a Midwestern state who reported trying alcohol at least once. METHODS Participants were recruited via social media between November 2019 and February 2020 to complete a web-based survey assessing demographics, substance use, and mental well-being. Logistic regression was conducted to assess relationships between these measures and HID among (1) college students and (2) non-college young adults. RESULTS About 14.0% of participants reported past-month HID. Among both college- and non-college young adults, men, those who perceived slight or no risk of harm from binge drinking, and those who used alcohol and marijuana simultaneously in the past year had greater odds of reporting past-month HID. Among students, past-year prescription drug misuse was also associated with HID. CONCLUSIONS High intensity-drinking is concerning given potential adverse consequences. Campus programming should address norms that may promote such drinking and other high-risk substance use associated with HID.
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Affiliation(s)
- Michael J Broman
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
| | - Emily Grekin
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Stella M Resko
- School of Social Work & Merrill, Palmer Skillman Institute, Wayne State University, Detroit, Michigan, USA
| | - Elizabeth Agius
- Center for Social Work Research, Wayne State University, Detroit, Michigan, USA
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Qeadan F, Beaudin S, Reutrakul S, English K. Single use of psychoactive substances and its association with sleep disorders and sleep health in a large US college sample. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-15. [PMID: 38442345 DOI: 10.1080/07448481.2024.2317171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/30/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Estimate the association between single (i.e., exclusive) use of a range of substances and sleep outcomes. PARTICIPANTS College students participated in the 2015-2019 American College-Health Association-National College-Health Assessment survey. METHODS Multivariable logistic and linear regressions were used. RESULTS Single users of sedative, opioid, tobacco, and stimulant drugs were more likely to report a diagnosis of insomnia and other sleep disorder and indicated more days per week of negative sleep health outcomes compared not only to non-users of these substances but also polysubstance users. Single users of alcohol were significantly less likely to report a diagnosis of sleep disorder and indicated having had more days per week of positive sleep health outcomes compared to non-alcohol users and polysubstance users. However, those results are reversed for binge drinking. CONCLUSIONS Support of programs addressing behaviors to reduce the high prevalence of psychoactive substance use and sleep disturbances in college youth is needed.
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Affiliation(s)
- Fares Qeadan
- Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
| | - Stephane Beaudin
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, USA
| | | | - Kevin English
- Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA
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Kouros CD, Papp LM. College Students' prescription drug misuse over time and links with their mental health and well-being. Addict Behav 2024; 149:107895. [PMID: 37924582 PMCID: PMC10842301 DOI: 10.1016/j.addbeh.2023.107895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/24/2023] [Accepted: 10/25/2023] [Indexed: 11/06/2023]
Abstract
Prescription drug misuse (PDM) is a mounting public health concern in the U.S., particularly among college students. The field's reliance on cross-sectional designs and limited controls for other substance use has failed to capture the specific role of misuse for longer-term health. Therefore, the present study tested associations between trajectories of PDM problems and college students' mental health and subjective happiness over time. Participants were 300 students who completed a baseline assessment (T1) and follow-ups every 6 months for two years (T2-T5). Participants self-reported problems associated with PDM and mental health. Results from univariate latent growth models indicated that problems with PDM were initially on an increasing trajectory. Based on parallel process models, problems with PDM were concurrently associated with higher levels of depressive symptoms, disinhibition, callousness/aggression, and lower levels of subjective happiness at T1. Further, we found support for parallel trajectories between PDM problems and both depressive symptoms and general disinhibition. Participants whose PDM problems were on an increasing (worsening) trajectory at baseline showed an increase in depressive symptoms and general disinhibition over the next two years. Participants whose PDM problems accelerated over time (got worse at a faster and faster rate over time) also showed a significant increase in their depressive symptoms over time. Most findings, however, were no longer statistically significant in sensitivity analyses that controlled for alcohol and other drug problems. Findings highlight college as an important time for interventions to prevent substance use and its associated negative consequence on later young adult mental health.
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Affiliation(s)
- Chrystyna D Kouros
- Department of Psychology, Southern Methodist University, PO BOX 750442, Dallas, TX 75275, United States.
| | - Lauren M Papp
- Department of Human Development and Family Studies, University of Wisconsin-Madison, 1300 Linden Drive, Madison, WI 53706, United States.
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Freibott CE, McCann NC, Biondi BE, Lipson SK. Interventions to increase naloxone access for undergraduate students: A systematic review of the literature. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38227912 PMCID: PMC11250916 DOI: 10.1080/07448481.2023.2299404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/26/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE To identify and describe interventions that increase access to naloxone for undergraduate students. METHODS A systematic review across 4 databases identified interventions that expand access to naloxone at colleges in the United States from 2015-2023. Three reviewers extracted the following data to create a narrative synthesis and summary of program elements: setting, rationale for intervention, timeline, intervention components, study size, collaboration, sustainability, outcomes and results. RESULTS Seven articles met inclusion criteria. Institutions' implemented naloxone interventions due to concerns for student safety and/or student overdose fatalities. Three universities collaborated with their School of Pharmacy for program design and/or dissemination, while two partnered with state-based naloxone distribution programs. Most programs combined opioid-overdose/naloxone training; four distributed naloxone kits. Three studies included pre/post-outcomes, and all reported increases in participant knowledge, attitudes, and/or ability to respond to an overdose. CONCLUSIONS Our results indicates an opportunity for wide-scale implementation of undergraduate naloxone programs within US colleges. However, more rigorous implementation research is needed to identify barriers and facilitators to program feasibility, acceptability, and participation.
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Affiliation(s)
- Christina E Freibott
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Nicole C McCann
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Breanne E Biondi
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sarah Ketchen Lipson
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts, USA
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10
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Puri BK, Miari A, Theodoratou M. Predictors of poor psychological functioning of healthcare workers based in Greece during the COVID-19 pandemic. Health Psychol Res 2023; 11:91274. [PMID: 38162540 PMCID: PMC10756858 DOI: 10.52965/001c.91274] [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: 07/27/2023] [Accepted: 10/14/2023] [Indexed: 01/03/2024] Open
Abstract
Background Poor psychological functioning during the COVID-19 pandemic has been reported in several studies of healthcare workers from around the world. Factors that might predict this have yet to be established. Objectives First, to ascertain which factors were associated with poor psychological functioning in a cohort of healthcare workers during the COVID-19 pandemic. Second, to characterize key sociodemographic aspects of this cohort. Third, to determine the degree to which any predictors of poor psychological functioning were associated with each other. Methods A questionnaire-based cross-sectional study was conducted of 144 healthcare workers in Patras, Greece, during the COVID-19 pandemic. The questionnaire consisted of: (1) demographic survey questions; (2) the Psychological Consequences Questionnaire scale; (3) the Kessler Psychological Distress scale; and (4) Toulouse's scale for coping strategies. The data were analyzed using general linear modeling. Results The statistical model (p < 10-10) indicated that smoking or taking drugs to calm anxiety, feeling ashamed, and being overwhelmed by one's feelings were all predictors of poor psychological functioning. Conversely, income was a protective factor. A post hoc network analysis showed that smoking or taking drugs to calm anxiety was relatively strongly associated with feeling ashamed; the latter was also associated with feeling overwhelmed. There was a weak negative association between income and feeling ashamed. Conclusion This study highlights the critical importance of psychological functioning in shaping the mental well-being of healthcare professionals during pandemics. Prioritizing the mental health of frontline workers is crucial for their well-being and for the overall functioning of healthcare systems.
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Affiliation(s)
| | | | - Maria Theodoratou
- Social Sciences Hellenic Open University
- Health Sciences Neapolis University Pafos
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11
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Dabbagh R, Alsulimani A, Alshamrani S, Abuhaimed A, Alzaid W, Aldofyan M, Alqahtani S, Alsharqi A, Rawson R. Prescription opioid misuse in relation to addiction susceptibility among women at a Saudi university. Saudi Pharm J 2023; 31:101764. [PMID: 37693733 PMCID: PMC10491761 DOI: 10.1016/j.jsps.2023.101764] [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: 05/08/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives The trends of prescription opioid misuse are understudied in Arab populations, let alone among university students. Additionally, little is known about the psychological traits that increase susceptibility for such behaviors in this region. Thus, this study aimed to assess the prevalence of prescription opioid misuse and its association with addiction susceptibility, as measured by the Substance Abuse Risk Profile Scale (SURPS). Methods We sampled university students from King Saud University's women's campus. Data on prescription opioid misuse, SURPS traits, and demographic characteristics were collected using an electronic self-administered survey. Results Lifetime prescription opioid misuse was 48.5%, while past-month misuse was 28.9%. On average, SURPS subscale scores for impulsivity (mean = 11.6; SD = 2.8) hopelessness (mean = 12.3; SD = 3.5), sensation seeking (mean = 16.4; SD = 3.8), and anxiety sensitivity (mean = 14.6; SD = 2.6). Anxiety sensitivity composite scores significantly differed between students reporting misuse and those who did not. Moreover, the odds for prescription opioid misuse increased by 7% for every 1 unit increase in anxiety sensitivity (AOR = 1.07; 95% CI = 1.00, 1.14), when controlling for other SURPS measures and student characteristics. Conclusion The prevalence of prescription opioid misuse in our study is higher than what is reported in global student populations. This may reflect unmonitored availability of controlled substances and unsupervised medical prescriptions. Additionally, high levels of anxiety sensitivity may be driving such misuse. Further surveillance of prescription drug misuse among university students and motivators for such behavior is needed for planning prevention and control interventions.
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Affiliation(s)
- Rufaidah Dabbagh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | | | | | - Wejdan Alzaid
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Samar Alqahtani
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Richard Rawson
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, United States
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, United States
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Kerr DCR, Bae H, Cole VT, Hussong AM. Psychosocial functioning associated with prescription stimulant and opioid misuse versus illicit drug use among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1387-1396. [PMID: 34133905 DOI: 10.1080/07448481.2021.1926269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/01/2021] [Accepted: 05/02/2021] [Indexed: 06/12/2023]
Abstract
Objective: College students' prescription stimulant and opioid misuse (PSM and POM) share psychosocial risks with other substance use. We sought to extend a prior study of these issues. Methods: National College Health Assessment (2015-2016) participants ages 18-24 years (n = 79,336) reporting 12-month PSM (defined as use of a drug not prescribed to them), 30-day other illicit drug use (non-cannabis), both, or neither, were compared on other substance use, psychopathology, academic adjustment, attention deficit hyperactivity disorder, and chronic pain. Models were repeated for POM. Results: Relative to those who only misused the prescription drug, those who used other illicit drugs had lower odds of chronic pain and academic problems, but higher odds on nearly every other outcome especially if they also misused the prescription drug. Conclusions: Findings suggest PSM and POM are on a continuum of risk shared with illicit drug use, but also are linked to outcomes specific to these drugs' perceived medical purposes.
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Affiliation(s)
- David C R Kerr
- School of Psychological Science, Oregon State University, Corvallis, Oregon, USA
| | - Harold Bae
- Biostatistics Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Veronica T Cole
- Department of Psychology, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Andrea M Hussong
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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13
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Shelton RC, Goodwin K, McNeil M, Bernitz M, Alexander SP, Parish C, Brotzman L, Lee M, Li WB, Makam S, Ganek N, Foskett D, Warren C, Metsch LR. Application of The Consolidated Framework for Implementation Research to inform understanding of barriers and facilitators to the implementation of opioid and naloxone training on college campuses. Implement Sci Commun 2023; 4:56. [PMID: 37221618 PMCID: PMC10204023 DOI: 10.1186/s43058-023-00438-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/09/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The opioid epidemic in the US continues to worsen. Opioid-only and polysubstance-involved opioid overdose deaths are increasing among adolescents and young adults, who have limited knowledge of opioid overdose prevention, including recognition and response. College campuses have infrastructure to support national-level implementation of evidence-based public health strategies for providing opioid overdose prevention and naloxone training programs among this priority population. However, college campuses are an underutilized, understudied setting for this programming. To address this gap, we conducted research assessing barriers and facilitators to planning and implementing this programming on college campuses. METHODS We held 9 focus groups among purposively selected campus stakeholders whose perceptions were important to understand in planning for the dissemination and implementation of opioid overdose prevention and naloxone training. Focus group scripts were informed by The Consolidated Framework for Implementation Research (CFIR) to query about perceptions of opioid and other substance use, opioid and other substance use-related resources, and naloxone administration training. We used a deductive-inductive, iterative approach to thematic analysis. RESULTS Themes about implementation barriers included (1) the perception that problematic use of other (non-opioid) substances was more prevalent than opioid use on campus and focus on those substances would be a greater priority on college campuses; (2) student schedules were overwhelmed with academic commitments and extracurricular activities, making delivery of additional training challenging; (3) barriers related to the perceived complexity and decentralization of communication on campus, preventing students from knowing how to access substance use-related resources. Themes about implementation facilitators included (1) framing naloxone training as important in becoming a responsible leader on campus and in the broader community and (2) leveraging existing infrastructure, champions within existing campus groups, and tailored messaging to facilitate participation in naloxone training. CONCLUSIONS This is the first study to provide in-depth insights into potential barriers and facilitators to widespread, routine implementation of naloxone/opioid education on undergraduate college campuses. The study captured diverse stakeholder perspectives and was theoretically grounded in CFIR, contributing to the growing literature on the application and refinement of CFIR across diverse community and school contexts.
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Affiliation(s)
- Rachel C Shelton
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA.
| | - Kathleen Goodwin
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michael McNeil
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
- Columbia Health, Columbia University, New York, NY, USA
| | - Melanie Bernitz
- Columbia Health, Columbia University, New York, NY, USA
- Center for Family and Community Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Savannah P Alexander
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Carrigan Parish
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Laura Brotzman
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Matthew Lee
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | | | | | | | | | - Chloe Warren
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
- School of General Studies, Columbia University, New York, NY, USA
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Papp LM, Kouros CD, Witt HK, Curtin JJ, Blumenstock SM, Barringer A. Real-time momentary mood as a predictor of college students' prescription drug misuse in daily life: Direct links and the moderating role of background mental health. Exp Clin Psychopharmacol 2022; 30:787-796. [PMID: 34110882 PMCID: PMC8660934 DOI: 10.1037/pha0000500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The present study addressed calls for research to identify real-time predictors of prescription drug misuse (Schepis et al., 2020) by testing young adults' momentary reports of their negative mood and positive mood as predictors of event-level misuse in daily life. We implemented a 28-day ecological momentary assessment (EMA) procedure that collected individuals' mood and other contextual experiences in moments preceding prescription drug misuse. Consistent with models of problematic substance use as a means to reduce negativity (Khantzian, 1997), results from hierarchical generalized linear modeling (HGLM) indicated within-person links between higher than usual negative mood and greater likelihood of prescription misuse in daily life. Contrary to the hypothesis, misuse was also more likely when preceded by elevated positive mood. We found consistent support for the hypothesized between-person effects, with prescription misuse in daily life associated with higher average levels of negative mood, and lower average levels of positive mood, across the reporting period. We further predicted that individuals reporting greater levels of social anxiety, depression, and externalizing symptoms would evidence stronger links between their momentary negative mood and prescription misuse. Partial support for this moderation hypothesis was found, with the positive within-person link between negative mood and prescription misuse significantly stronger among individuals higher (vs. lower) on social anxiety and depression. Results provide support for intricate connections between young adults' momentary mood, mental health symptoms, and prescription drug misuse. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Schepis TS, McCabe SE, Ford JA. Prescription drug and alcohol simultaneous co-ingestion in U.S. young adults: Prevalence and correlates. Exp Clin Psychopharmacol 2022; 30:797-808. [PMID: 34410796 PMCID: PMC8857307 DOI: 10.1037/pha0000519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Simultaneous co-ingestion of prescription medication (e.g., opioid, tranquilizer/sedative, stimulant) and alcohol is associated with overdose and elevated substance use, but no studies have examined prescription drug misuse (PDM) and alcohol co-ingestion in U.S. young adults (18-25 years), despite the high rates of PDM in this age group. We used the 2015-19 National Survey on Drug Use and Health (young adult N = 69,916) to examine prevalence of past-month PDM-alcohol co-ingestion, PDM characteristics, and sociodemographic, physical health, mental health, and substance use correlates. Logistic regression examined correlates, comparing those without past-year PDM, those with past-year but not past-month PDM, those with past-month PDM without alcohol co-ingestion, and those with past-month PDM and alcohol co-ingestion. An estimated 585,000 young adults engaged in any past-month PDM-alcohol co-ingestion, or between 32.7% (opioids) and 44.6% (tranquilizer/sedatives) of those who were engaged in past-month PDM. Co-ingestion varied by educational status and was more common in males and white or multiracial young adults. All PDM-involved groups had elevated odds of suicidal ideation and other psychopathology, but substance use and substance use disorder (SUD) odds were significantly higher in young adults with co-ingestion, versus all other groups. To illustrate, 41.1% with opioid-alcohol co-ingestion had multiple past-year SUDs, versus 2.0% in those without past-year PDM. Young adults with co-ingestion are particularly likely to have problematic alcohol use and higher rates of SUD. Counseling about the risks of PDM-alcohol co-ingestion and screening for co-ingestion among those at risk are warranted to limit poor outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Ty S. Schepis
- Department of Psychology, Texas State University, San Marcos, Texas
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Jason A. Ford
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan
- Department of Sociology, University of Central Florida, Orlando, Florida
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Rugg CM, Cheah JW, Vomer RP, Lau B. Opiate Use Patterns Among Collegiate Athletes. Cureus 2022; 14:e31152. [PMID: 36483908 PMCID: PMC9724194 DOI: 10.7759/cureus.31152] [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: 11/05/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE/AIM The purpose of this study is to determine the rates of prescribed opiate use and misuse among current collegiate athletes. MATERIALS AND METHODS This was an observational survey study conducted at a single institution; Division I Collegiate Athletics Department. The participants in the study were current Division I Collegiate Student-Athletes. The survey queried athletes' age, gender, and history of injury or orthopedic surgery before and during college. Athletes were asked about prior opiate prescriptions, length of medication use, and reasons for opiate use. RESULTS Of196 student-athlete respondents, the average age was 20.1 years and 62.8% were female. Pre-collegiate orthopedic injuries/surgeries were reported by 45.4% of athletes, of which 40.4% received an opiate prescription. Collegiate orthopedic injuries/surgeries were reported by 28.6% of athletes; 46.4% received an opiate prescription. Fifty-two student-athletes (26.5%) had received an opiate prescription after an orthopedic injury or surgery. The length of opiate use was most commonly 2 weeks or less. Female athletes had a higher rate of collegiate injuries (P<0.05) and a nonsignificant trend towards more opiate prescriptions. Among the 26 student-athletes who received collegiate opiate prescriptions, the reasons for taking opiates were most commonly pain (84.6%) and sleep (46.2%). Opiate use outside of prescribed indication was present in 14 athletes (7.1% of the total); 12 were female. CONCLUSION A quarter of collegiate student-athletes had received an opiate prescription due to orthopedic injury or surgery, with a small subset using opiates for non-analgesic functions. Future research should examine risk factors for opiate misuse among collegiate athletes.
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Affiliation(s)
- Caitlin M Rugg
- Department of Orthopedic Surgery, Kaiser Permanente San Jose Medical Center, San Jose, USA
| | - Jonathan W Cheah
- Department of Orthopedic Surgery, Santa Clara Valley Medical Center, San Jose, USA
| | - Rock P Vomer
- Family and Community Health and Orthopedics, Division of Sports Medicine, Duke University, Durham, USA
| | - Brian Lau
- Orthopedic Surgery, Duke University, Durham, USA
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Abar CC, Combs A, Miley A, Ruffino R, Abar B. Parenting, health, and use of medications among college youth: The PHARMACY survey study. Prev Med Rep 2021; 24:101623. [PMID: 34976678 PMCID: PMC8684000 DOI: 10.1016/j.pmedr.2021.101623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/25/2021] [Accepted: 10/23/2021] [Indexed: 10/25/2022] Open
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Nonmedical Prescription Opioid Use among a Sample of College Students: Prevalence and Predictors. PHARMACY 2021; 9:pharmacy9020106. [PMID: 34071670 PMCID: PMC8167772 DOI: 10.3390/pharmacy9020106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022] Open
Abstract
Nonmedical use of prescription opioid medication (NMPO) in the United States is a public health crisis, resulting in high rates of emergency room visits, morbidity, and mortality. The purpose of this study was to explore prevalence estimates and correlates of NMPO among a convenience sample of college students in the northeast and southeast regions of the US to help generate directions for future research. Motivations for misuse, age of onset, access, concomitant substance use, and individual factors were investigated among a sample of undergraduate students from two universities. Participants (N = 847) completed a battery of various self-report measures. Findings revealed that 7.7% (Southeastern University) and 12.8% of students (Northeastern University) reported lifetime NMPO, whereas past-month NMPO was reported by 0.8% and 0.9% of participants, respectively. Lifetime history of regularly using alcohol, nonmedical use of benzodiazepine medication, nonmedical use of prescription stimulants, symptoms of depression and anxiety, and executive functioning (i.e., metacognition and behavioral regulation) were significantly related to lifetime history of NMPO in this college sample. These findings offer several potential subsequent lines of investigation regarding the associations between various demographic and psychological factors and NMPO. Future research is needed to help identify college students who are at risk of NMPO.
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Aizpurua E, Caravaca-Sánchez F, Taliaferro LA. Suicidality Among College Students in Spain: Prevalence and Associations With Substance Use, Social Support, and Resilience. DEATH STUDIES 2021; 46:2025-2030. [PMID: 33683175 DOI: 10.1080/07481187.2021.1888823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Few studies have examined protective factors associated with reduced risk of suicidality among college students. We sought to address gaps in the literature by conducting a cross-sectional survey of 636 college students from a public university in Spain. We assessed substance use, social support, resilience, severity of suicidal ideation and suicide attempts. Twenty percent of students reported low severity and 27% reported high severity suicidal ideation, while 5% reported attempting suicide during the past year. Higher levels of social support represented a protective factor associated with reduced risk of suicidal ideation and suicide attempts.
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Affiliation(s)
- Eva Aizpurua
- European Social Survey ERIC, City, University of London, London, United Kingdom
- School of Law, Trinity College Dublin, Dublin, Ireland
| | | | - Lindsay A Taliaferro
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
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