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Jian Q, Chihuri S, Andrews HF, Betz ME, DiGuiseppi C, Eby DW, Hill LL, Jones V, Mielenz TJ, Molnar LJ, Strogatz D, Lang BH, Li G. Association between polypharmacy and hard braking events in older adult drivers. ACCIDENT; ANALYSIS AND PREVENTION 2024; 204:107661. [PMID: 38820927 DOI: 10.1016/j.aap.2024.107661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/08/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Polypharmacy (i.e., simultaneous use of two or more medications) poses a serious safety concern for older drivers. This study assesses the association between polypharmacy and hard braking events in older adult drivers. METHODS Data for this study came from a naturalistic driving study of 2990 older adults. Information about medications was collected through the "brown-bag review" method. Primary vehicles of the study participants were instrumented with data recording devices for up to 44 months. Multivariable negative binomial model was used to estimate the adjusted incidence rate ratios (aIRRs) and 95 % confidence intervals (CIs) of hard-braking events (i.e., maneuvers with linear deceleration rates ≥0.4 g) associated with polypharmacy. RESULTS Of the 2990 participants, 2872 (96.1 %) were eligible for this analysis. At the time of enrollment, 157 (5.5 %) drivers were taking fewer than two medications, 904 (31.5 %) were taking 2-5 medications, 895 (31.2 %) were taking 6-9 medications, 571 (19.9 %) were taking 10-13 medications, and 345 (12.0 %) were taking 14 or more medications. Compared to drivers using fewer than two medications, the risk of hard-braking events increased 8 % (aIRR 1.08, 95 % CI 1.04, 1.13) for users of 2-5 medications, 12 % (aIRR 1.12, 95 % CI 1.08, 1.16) for users of 6-9 medications, 19 % (aIRR 1.19, 95 % CI 1.15, 1.24) for users of 10-13 medications, and 34 % (aIRR 1.34, 95 % CI 1.29, 1.40) for users of 14 or more medications. CONCLUSIONS Polypharmacy in older adult drivers is associated with significantly increased incidence of hard-braking events in a dose-response fashion. Effective interventions to reduce polypharmacy use may help improve driving safety in older adults.
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Affiliation(s)
- Qi Jian
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
| | - Stanford Chihuri
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
| | - Howard F Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA; VA Eastern Colorado Geriatric Research Education and Clinical Center, Aurora, CO 80045, USA.
| | - Carolyn DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - David W Eby
- University of Michigan Transportation Research Institute, College of Engineering, Ann Arbor, MI 48109, USA.
| | - Linda L Hill
- School of Public Health, University of California San Diego, La Jolla, CA 92093, USA.
| | - Vanya Jones
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Thelma J Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Columbia Center for Injury Science and Prevention, Columbia University Irving Medical Center, New York, NY 10032, USA.
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, College of Engineering, Ann Arbor, MI 48109, USA.
| | - David Strogatz
- Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY 13326, USA
| | - Barbara H Lang
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
| | - Guohua Li
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
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2
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Choi NG, Marti CN, Choi BY. Perceived Risk of Binge Drinking among Older Alcohol Users: Associations with Alcohol Use Frequency, Binge Drinking, Alcohol Use Disorder, and Alcohol Treatment Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1081. [PMID: 39200690 PMCID: PMC11353946 DOI: 10.3390/ijerph21081081] [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: 07/25/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 09/02/2024]
Abstract
Despite the high prevalence of alcohol use and binge drinking among older adults, little research has been conducted on the association between their alcohol risk perception and alcohol use patterns. Using data on past-year alcohol users aged 50 and older (N = 6693) in the 2022 National Survey on Drug Use and Health, we examined the (1) associations between risk perception of binge alcohol use 1-2 times a week and alcohol use frequency, binge use frequency, and alcohol use disorder (AUD), and (2) the association between alcohol treatment use and risk perception. About 40% of past-year alcohol users perceived great risk of binge alcohol use 1-2 times a week, and 27% of past-year users had binge drinking in the past month. Multivariable analyses showed the negative association between great risk perception and alcohol use frequency (IRR = 0.60, 95%CI = 0.48-0.74 for daily use) and past-month binge alcohol use (IRR = 0.33, 95%CI = 0.19-0.57 for 6-19 days of binge use). The odds of great risk perception were also lower among those with mild AUD. Risk perception was not significantly associated with alcohol treatment. The lower likelihood of risk perception among problematic alcohol users and low treatment use is concerning. Education and interventions to reduce harm from alcohol are needed.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, USA;
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, USA;
| | - Bryan Y. Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine and BayHealth, Dover, DE 19901, USA;
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Klein H, Washington TA. The Relationship of Anti-Transgender Discrimination, Harassment, and Violence to Binge Drinking among Transgender Adults. Subst Use Misuse 2024; 59:583-590. [PMID: 38105183 DOI: 10.1080/10826084.2023.2293731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Purpose: Using a minority stress paradigm, this paper examines the relationship between anti-transgender discrimination, harassment, and violence among transgender adults. Methods: Data from the 2015 U.S. National Transgender Survey were used to examine twenty types of anti-transgender experiences/problems (e.g., harassment at work, problems with police officials, verbal and physical assaults) in a sample of 27,715 transgender Americans aged 18 or older. Binge drinking during the previous month was the dependent variable, and eight control measures were examined in the multivariate analysis. Results: Experiencing any of the twenty types of anti-transgender discrimination, harassment, or violence increased the odds of binge drinking by 48%. Experiencing many such problems increased the odds of binge drinking by 104%. Multivariate analysis showed that anti-transgender discrimination, harassment, and violence remains a predictor of binge drinking even when other key measures are taken into account. Younger people, racial minority group members, and persons who were not married or "involved" were at particularly great risk. Conclusions: Consistent with the minority stress paradigm, the more different types of anti-transgender experiences people had, the more likely they were to engage in binge drinking. Targeted intervention needs to help transgender persons to avoid anti-transgender discrimination, harassment, and violence to the greatest extent possible, and to develop resiliency skills whenever they are victimized. This is particularly true for transgender persons who are younger, minority, and not "involved" in a relationship.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Silver Spring, Maryland, USA
- School of Social Work, California State University-Long Beach, Long Beach, California, USA
| | - Thomas Alex Washington
- School of Social Work, California State University-Long Beach, Long Beach, California, USA
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de Aquino ÉC, de Morais OL. Uber use after alcohol consumption among car/motorcycle drivers in ten Brazilian capitals. Rev Saude Publica 2023; 57:86. [PMID: 37971180 PMCID: PMC10631747 DOI: 10.11606/s1518-8787.2023057005147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 06/20/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE This study aimed to measure the proportion of Uber use instead of drinking and driving in ten Brazilian capitals, in 2019. METHODS A cross-sectional survey was developed in ten Brazilian capitals. Data were collected in agglomeration points (AP) and sobriety checkpoints (SC). Based on responses to a standardized questionnaire, the proportion of drivers who used Uber instead of drinking and driving was measured for total sample of each methodology and stratified by municipality, age group, gender, education level, and type of vehicle. Fisher's exact test was used to make comparisons between the strata. RESULTS A total of 8,864 drivers were interviewed. The most used means of transport to replace driving after drinking alcohol was the Uber system (AP: 54.6%; 95%CI: 51.2-58.0. SC: 58.6%; 95%CI: 55.2-61.9). Most of these users were aged from 18 to 29 years, women, with at least one higher education degree. According to the AP methodology, the highest magnitude of this indicator was found in Vitória (ES) (71.0%; 95%CI: 63.5-77.5), whereas the lowest was observed in Teresina (PI) (33.1%; 95%CI: 22.7-45.5). According to the SC methodology, the highest magnitude of the indicator was also found in Vitória (ES) (78.3%; 95%CI: 68.8-85.5), whereas the lowest was observed in Boa Vista (RR) (36.6%; 95%CI: 26.8-47.7). CONCLUSION In Brazilian capitals, the study showed higher proportions of Uber use instead of drinking and driving. This type of scientific evidence on factors associated with road traffic injuries presents the potential to guide public health interventions.
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Affiliation(s)
- Érika Carvalho de Aquino
- Universidade Federal de GoiásInstituto de Patologia Tropical e Saúde PúblicaDepartamento de EpidemiologiaGoiâniaGOBrasil Universidade Federal de Goiás . Instituto de Patologia Tropical e Saúde Pública . Departamento de Epidemiologia . Goiânia , GO , Brasil
| | - Otaliba Libânio de Morais
- Universidade Federal de GoiásInstituto de Patologia Tropical e Saúde PúblicaDepartamento de EpidemiologiaGoiâniaGOBrasil Universidade Federal de Goiás . Instituto de Patologia Tropical e Saúde Pública . Departamento de Epidemiologia . Goiânia , GO , Brasil
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Davis S, Betz ME, Hill LL, Eby DW, Jones VC, Mielenz TJ, Molnar LJ, Strogatz D, Clancy K, Li G, DiGuiseppi CG. Associations of cannabis use with motor vehicle crashes and traffic stops among older drivers: AAA LongROAD study. TRAFFIC INJURY PREVENTION 2023; 24:307-314. [PMID: 36939676 DOI: 10.1080/15389588.2023.2180736] [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: 11/28/2022] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Acute cannabis use is associated with a higher risk of motor vehicle crashes (MVC). This study aimed to determine if self-reported past-year cannabis use is associated with MVC or traffic stops among older drivers. METHODS This cross-sectional analysis used data from a multi-center study enrolling active drivers aged 65-79 years. Data regarding cannabis use, MVC, and traffic stops (i.e., being pulled over by police, whether ticketed or not) within the previous 12 months were collected through participant interviews. Log-binomial regression models examined associations of past-year cannabis use with MVC and traffic stops, adjusting for site and sociodemographic and mental health characteristics. RESULTS Of 2,095 participating older drivers, 186 (8.88%) used cannabis in the past year but only 10 (<0.5%) within an hour before driving in the last 30 days; 11.41% reported an MVC and 9.45% reported a traffic stop. Past-year cannabis users had a higher prevalence of MVC (adjusted prevalence ratio [aPR] = 1.38; 95%CI: 0.96, 2.00; p = 0.086) and traffic stops (aPR = 1.58; 1.06, 2.35; p = 0.024). CONCLUSIONS Past-year cannabis use was associated with increased traffic stops, which are correlated modestly with increased MVC in past studies and may indicate impaired driving performance. We did not find a statistically significant association of past-year cannabis use with MVC, which may indicate limited sustained effects on driving performance from periodic use among older adults, who report rarely driving immediately after use.
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Affiliation(s)
- Shelby Davis
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Marian E Betz
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), Veterans Health Administration, Aurora, Colorado
| | - Linda L Hill
- School of Public Health, University of California San Diego, La Jolla, California
| | - David W Eby
- University of Michigan Transportation Research Institute, College of Engineering, University of Michigan, Ann Arbor, Michigan
| | - Vanya C Jones
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Thelma J Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia University Center for Injury Science and Prevention, Columbia University, New York, New York
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, College of Engineering, University of Michigan, Ann Arbor, Michigan
| | - David Strogatz
- Bassett Research Institute, Bassett Healthcare Network, Cooperstown, New York
| | - Kate Clancy
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia University Center for Injury Science and Prevention, Columbia University, New York, New York
- Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, New York
| | - Carolyn G DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Zamba PT, Rossheim ME. Are state minimum jail laws associated with less frequent drunk-driving? TRAFFIC INJURY PREVENTION 2022; 23:459-464. [PMID: 36178871 DOI: 10.1080/15389588.2022.2117984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES The current study investigated associations between minimum jail sentences included in state DUI laws and self-reported drunk-driving in the US. Scant existing research has been conducted on this topic. The current study is the first to use Behavioral Risk Factor Surveillance System (BRFSS) data to investigate associations between minimum jail sentences and frequency of self-reported drunk-driving among adults who report drunk-driving. METHODS 2020 BRFSS data were used. Analyses were limited to participants aged 18 years and older who reported at least one episode of drunk-driving during the past 30-days. Participants missing data on age, gender, race, income, binge-drinking, or state of residence were excluded from analyses. The final sample size was 3,732. Websites from official state legislatures and/or data from state motor vehicle departments were used to gather current information on DUI minimum jail penalties. A dichotomous variable was created that categorized all 50 states and Washington D.C. as either (i) having a minimum jail sentence for first time DUI offense or (ii) having no minimum jail sentence for first time DUI offense. Multivariable negative binomial regression analyses were conducted using SAS® v9.4. The dependent variable was the number of self-reported drunk-driving episodes. RESULTS Among the sample of adults who reported drunk-driving, residents of states with no minimum jail sentence for a first-time DUI offense had a 32% higher incidence rate of drunk-driving episodes [RR = 1.32,95% CI:0.98-1.77] compared to their counterparts residing in states with a minimum jail sentence for first time DUI offenses. Similar findings were observed in multiple sensitivity analyses conducted. CONCLUSION There was a marginally significant [p = 0.07] higher incidence rate of drunk-driving episodes among residents of states with no minimum jail sentence compared to those in states with a minimum jail sentence for the first time DUI. This was the first study to use BRFSS 2020 data to investigate this association and only among participants who self-reported drunk-driving. We therefore provide an important contribution to the literature on this association by using the most up to date data and among a valid sample of drunk drivers. Further studies that provide stronger causal inference are needed.
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Affiliation(s)
- Patrick T Zamba
- School of Public Health, The University of North Texas Health Science Center (UNTHSC), Fort Worth, Texas
| | - Matthew E Rossheim
- School of Public Health, The University of North Texas Health Science Center (UNTHSC), Fort Worth, Texas
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Zolopa C, Høj SB, Minoyan N, Bruneau J, Makarenko I, Larney S. Ageing and older people who use illicit opioids, cocaine or methamphetamine: a scoping review and literature map. Addiction 2022; 117:2168-2188. [PMID: 35072313 PMCID: PMC9544522 DOI: 10.1111/add.15813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 01/06/2022] [Indexed: 11/26/2022]
Abstract
AIMS To provide an overview of research literature on ageing and older people who use illicit opioids and stimulants by documenting the conceptual frameworks used and content areas that have been investigated. METHODS We conducted a scoping review of literature relating to ageing and older people who use illicit stimulants and opioids, defining 'older' as 40 years and above. Primary studies, secondary studies and editorials were included. Searches were conducted in PubMed and Embase in July 2020 and March 2021; the Cochrane library was searched in November 2021. Charted data included methodological details, any conceptual frameworks explicitly applied by authors and the content areas that were the focus of the publication. We developed a hierarchy of content areas and mapped this to provide a visual guide to the research area. RESULTS Of the 164 publications included in this review, only 16 explicitly applied a conceptual framework. Seven core content areas were identified, with most publications contributing to multiple content areas: acknowledgement of drug use among older people (n = 64), health status (n = 129), health services (n = 109), drug use practices and patterns (n = 84), social environments (n = 74), the criminal legal system (n = 28) and quality of life (n = 15). CONCLUSIONS The literature regarding older people who use illicit drugs remains under-theorized. Conceptual frameworks are rarely applied and few have been purposely adapted to this population. Health status and health services access and use are among the most frequently researched topics in this area.
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Affiliation(s)
- Camille Zolopa
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada
| | - Stine B Høj
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada
| | - Nanor Minoyan
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Social and Preventative Medicine, School of Public Health, Université de Montréal, Montreal, Québec, Canada
| | - Julie Bruneau
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Iuliia Makarenko
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Family Medicine, McGill University, Montreal, Québec, Canada
| | - Sarah Larney
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Québec, Canada
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Phillips KT, Pedula KL, Choi NG, Tawara KAK, Simiola V, Satre DD, Owen-Smith A, Lynch FF, Dickerson J. Chronic health conditions, acute health events, and healthcare utilization among adults over age 50 in Hawai'i who use cannabis: A matched cohort study. Drug Alcohol Depend 2022; 234:109387. [PMID: 35279458 DOI: 10.1016/j.drugalcdep.2022.109387] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/14/2022] [Accepted: 02/28/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Research on cannabis-related health outcomes in diverse older adults is limited. The current study utilized a matched cohort study design to compare older adults in Hawai'i with identified cannabis diagnoses and matched controls on chronic health conditions, acute health events, and healthcare utilization from 2016 to 2020. METHOD Patients age 50 + were identified using ICD-10 diagnostic codes for cannabis use, abuse, and dependence using electronic health record data from an integrated health system (Kaiser Permanente Hawai'i). Those with cannabis diagnoses (n = 275) were compared to matched non-using controls (n = 275; based on age, sex) on chronic health conditions (coronary heart disease, hypertension, COPD, chronic non-cancer pain), acute health events (myocardial infarction, respiratory symptoms, stroke, persistent or cyclic vomiting, injuries), and healthcare utilization (outpatient, inpatient, and emergency department visits) following case identification for two years. RESULTS Participants were 19.3% Native Hawaiian/Pacific Islander, 24.4% Asian, 47.8% White, and 8.5% Other/Unknown, with an average age of 62.8 years (SD=7.3). Adjusting for covariates as possible, participants with a cannabis diagnosis had significantly greater risk of coronary heart disease, chronic non-cancer pain, stroke, myocardial infarction, cyclic vomiting, and injuries, over time, compared to controls. Cannabis use was associated with any and greater frequency of outpatient, inpatient, and emergency department visits. CONCLUSIONS In a diverse sample, older adults who used cannabis had worse health conditions and events and used more health services over a two-year period. Future studies should evaluate cannabis-related health outcomes, effects of cannabis problem severity, as well as implications for healthcare in aging populations.
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Affiliation(s)
- Kristina T Phillips
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI, USA.
| | - Kathryn L Pedula
- Hawai'i Permanente Medical Group, Kaiser Permanente Hawai'i, Honolulu, HI, USA
| | - Namkee G Choi
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Kylee-Ann K Tawara
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI, USA; School of Public Health, University of Washington, Seattle, WA, USA
| | - Vanessa Simiola
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI, USA
| | - Derek D Satre
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA; Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Ashli Owen-Smith
- School of Public Health, Georgia State University, Atlanta, GA, USA; Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA, USA
| | - Frances F Lynch
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA; OCHIN Research, Portland, OR, USA
| | - John Dickerson
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
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Substance Misuse and the Older Offender. Clin Geriatr Med 2021; 38:159-167. [PMID: 34794699 DOI: 10.1016/j.cger.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Substance misuse is prevalent among older adults involved in the criminal justice system. The different classes of older offenders, primarily defined as individuals 50 years and older, as well as their offending behaviors vary in their association with substance misuse. Most prison health care systems do not adequately integrate substance use services. Screening for and treatment of substance misuse should be part of comprehensive mental health programs tailored to older offenders. This article reviews different types of offenses among older offenders, their association with substance misuse, and available treatment services.
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Asmar S, Nelson A, Anand T, Hammad A, Obaid O, Ditillo M, Saljuqi T, Tang A, Joseph B. Marijuana and thromboembolic events in geriatric trauma patients: The cannabinoids clots correlation! Am J Surg 2021; 223:798-803. [PMID: 34334193 DOI: 10.1016/j.amjsurg.2021.07.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/12/2021] [Accepted: 07/20/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Tetrahydrocannabinol (THC) can alter the coagulation cascade resulting in hypercoagulability. The aim of our study is to evaluate the impact of THC use on thromboembolic complications (TEC) in geriatric trauma patients (GTP). METHODS This is a 2017 analysis of the TQIP database including all GTP (age ≥65 years). Patients were stratified based on THC use. Propensity score matching (1:2 ratio) was performed. RESULTS A total of 2,835 patients were matched (THC+: 945 and THC-: 1,890). Mean age was 70 ± 6 years, 94% sustained blunt injuries, and median ISS was 22[12-27]. Sixty-two percent of patients received thromboprophylaxis, with median time to initiation of 27 h from admission. Overall, the rate of TEC was 2.1% and mortality was 6.0%. THC + patients had significantly higher rates of TEC compared to THC- patients (3.0% vs. 1.7%; p = 0.01). Rates of DVT (2.2% vs 0.6%, p < 0.01) and PE (1.4% vs 0.4%, p < 0.01) were higher in the THC + group. CONCLUSION THC exposure increases the risk of TEC in GTP. Incorporation of THC use into risk assessment protocols merits serious consideration in GTP.
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Affiliation(s)
- Samer Asmar
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Adam Nelson
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Tanya Anand
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Ahmad Hammad
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Omar Obaid
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Michael Ditillo
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Tawab Saljuqi
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Andrew Tang
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Bellal Joseph
- Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
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11
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Rudisill TM, Smith GS. Risk factors associated with driving under the influence of drugs in the USA. Inj Prev 2020; 27:514-520. [PMID: 33303559 DOI: 10.1136/injuryprev-2020-044015] [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: 09/30/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Driving under the influence of drugs (DUID) is a burgeoning public health concern in the USA. Because little is known about individuals who engage in DUID, the purpose of this study was to analyse potential sociodemographic characteristics and behavioural risk factors associated with the behaviour. METHODS Self-reported data from drivers ≥18 years of age who ever used drugs and participated in the 2018 National Survey on Drug Use and Health were used. Characteristics of those who reported to engage and not engage in DUID were compared via frequencies, percentages and logistic regression analyses, which accounted for the multistage survey design. RESULTS Among eligible respondents, 10.4% (weighted n=117 275 154) reported DUID. DUID was higher among those aged 18-25 year (34%), males (65%), unmarried individuals (61%), lesbian/gay/bisexuals (13%), those whom abused or were drug dependent (45%), engaged in numerous risky lifestyle behaviours (12%) and those taking medication for a mental health issue (22%). Nearly 20% and 6% of respondents engaged in DUID abused or were dependent on marijuana or methamphetamine, respectively. The adjusted odds of DUID were greatest among those 18-25 years of age (OR 3.7; 95% CI 2.8 to 5.0), those never/not married (OR 1.8; 95% CI 1.5 to 2.2), those who abused or were drug dependent (OR 4.0; 95% CI 3.5 to 4.7), exhibited riskier lifestyle behaviours (OR 8.0; 95% CI 5.9 to 11.0), were employed (OR 1.3; 95% CI 1.1 to 1.6) or lesbian/gay/bisexuals (OR 1.4; 95% CI 1.1 to 1.7). CONCLUSIONS DUID was common among some population sub-groups who may benefit from intervention.
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Affiliation(s)
| | - Gordon S Smith
- Epidemiology, West Virginia University, Morgantown, West Virginia, USA
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Vichitkunakorn P, Intusoma U, Assanangkornchai S. Binge Drinking and Drunk Driving Among Current Drinkers in Thailand: Analysis of Cigarette Smoking and Alcohol Drinking Behavior Surveys From 2007 to 2017. Asia Pac J Public Health 2020; 33:234-241. [PMID: 33147987 DOI: 10.1177/1010539520971178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to evaluate the association between binge drinking and drunk driving among the Thai population. Data in 2007, 2011, and 2017 of the Thai National surveys on Tobacco and Alcohol Consumption were analyzed. The household surveys collected information from the population, aged >15 years, using a face-to-face interview. There were 89 002 current drinkers from the 3 waves of surveys. About 40% reported drunk driving in the past 12 months. Binge drinking accounted for 17.3%, 17.8%, and 42.8% of the current drinkers in 2007, 2011, and 2017, respectively. The prevalence of drunk driving also increased from 36.6% to 57.7% over the 10-year period. Both occasional binge drinkers and regular binge drinkers showed about twice the risk of drunk driving (range of odds ratios [ORs] from 1.81; 95% confidence interval [95% CI] = 1.71-1.92 to OR 2.96; 95% CI = 2.64-3.31), compared with non-binge drinkers, and these OR increased by drinking frequency.
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Affiliation(s)
- Polathep Vichitkunakorn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Utcharee Intusoma
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Sawitri Assanangkornchai
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Hill LL, Andrews H, Li G, DiGuiseppi CG, Betz ME, Strogatz D, Pepa P, Eby DW, Merle D, Kelley-Baker T, Jones V, Pitts S. Medication use and driving patterns in older drivers: preliminary findings from the LongROAD study. Inj Epidemiol 2020; 7:38. [PMID: 32741358 PMCID: PMC7397667 DOI: 10.1186/s40621-020-00265-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 06/10/2020] [Indexed: 12/30/2022] Open
Abstract
Background The potential for impaired driving due to medication use can occur at any age, though older adults are more likely to take multiple prescribed medications and experience side effects that may affect driving ability. The purpose of this study was to characterize the relationship between medications and driving safety behaviors. Methods Data for this study came from the five-site Longitudinal Research on Aging Drivers (LongROAD) project. Participants were active drivers, age 65–79 years at enrollment, and patients at one of the 5 participating sites. Medication names and doses were obtained at baseline based on the “brown-bag review” method. Medications were coded using the American Hospital Formulary Service system. Driving data were collected by a GPS accelerometer installed in the study participants’ main vehicles. Results Medication data were available for 2949 (98.6%) of the 2990 participants, and 2898 (96.9% of all participants) had both medication data and at least 30 recorded days of driving. The median number of medications taken per study participant was seven, with a range of 0–51. Total number of medications was significantly associated with a higher rapid deceleration rate. Certain medication classes were significantly associated with other driving outcomes, including central nervous system agents (more speeding events), hormones and gastrointestinal medications (more rapid decelerations), electrolytes (fewer rapid decelerations), and antihistamines (greater right to left turn ratio). Conclusions Older adult drivers are taking large quantities of prescription and non-prescription medications that may affect their driving safety. Certain medication classes are associated with potentially adverse driving patterns, such as speeding and rapid decelerations, while others are associated with potentially protective maneuvers, such as right hand turning. Further research is warranted to identify and mitigate potential adverse effects of such medications on driving safety in older adults.
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Affiliation(s)
- Linda L Hill
- Department of Family Medicine and Public Health, University of California, 200 W Arbor Dr., MC 0811, San Diego, CA, 92103, USA.
| | - Howard Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University, 1051 Riverside Dr. Unit 47, New York, NY, 10032, USA
| | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St. Rm 524, New York, NY, 10032, USA.,Center for Injury Epidemiology and Prevention, Columbia University Medical Center, 722 W 168th St. Rm 524, New York, NY, 10032, USA.,Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, 722 W 168th St. Rm 524, New York, NY, 10032, USA
| | - Carolyn G DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, 13001 E. 17th Place, Mail Stop B119, Bldg. 500, Rm. W3138, Aurora, CO, 80045, USA
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Leprino Building, Campus Box B215, 12401 East 17th Ave, Aurora, CO, 80045, USA
| | - David Strogatz
- Bassett Research Institute, Bassett Healthcare Network, 1 Atwell Rd, Cooperstown, NY, 13326, USA
| | - Patricia Pepa
- Department of Ambulatory Care Clinical Pharmacy, Kaiser Permanente, Oakland, USA
| | - David W Eby
- Transportation Research Institute, University of Michigan, 2901 Baxter Rd, Ann Arbor, MI, 48109, USA
| | - David Merle
- Department of Biostatistics, Mailman School of Public Health, Columbia University, 1051 Riverside Dr. Unit 47, New York, NY, 10032, USA
| | - Tara Kelley-Baker
- AAA Foundation for Traffic Safety, 607 14th St. NW, Ste. 201, Washington, DC, 20005, USA
| | - Vanya Jones
- Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Hampton House, Baltimore, MD, 21205, USA
| | - Samantha Pitts
- Department of Medicine, School of Medicine, Johns Hopkins University, 733 North Broadway, Baltimore, MD, 21205, USA
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Sommer JL, El-Gabalawy R, Contractor AA, Weiss NH, Mota N. PTSD's risky behavior criterion: Associated risky and unhealthy behaviors and psychiatric correlates in a nationally representative sample. J Anxiety Disord 2020; 73:102247. [PMID: 32502805 DOI: 10.1016/j.janxdis.2020.102247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 02/06/2023]
Abstract
Criterion E2 ("reckless or self-destructive behavior") was added to the DSM-5 posttraumatic stress disorder (PTSD) criteria to reflect the established association between PTSD and risky and unhealthy behaviors (RUBs); however, previous research has questioned its clinical significance. To determine whether criterion E2 adequately captures reckless/self-destructive behavior, we examined the prevalence and associations of RUBs (e.g., substance misuse, risky sexual behaviors) with criterion E2 endorsement. Further, we examined associations between criterion E2 and psychiatric conditions (e.g., depressive disorders, anxiety disorders) in a population-based sample of trauma-exposed adults. We analyzed data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 36,309). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 assessed lifetime DSM-5 psychiatric conditions and self-reported RUBs. Among trauma-exposed adults (n = 23,936), multiple logistic regressions examined criterion E2's associations with RUBs and psychiatric conditions. After adjusting for covariates, all RUBs were associated with E2 endorsement (AOR range: 1.58-3.97; most prevalent RUB among those who endorsed E2: greater substance use than intended [57.0 %]) except binge eating, and E2 endorsement was associated with increased odds of PTSD, bipolar disorder, substance use disorders, and schizotypal, borderline, and antisocial personality disorders (AOR range: 1.65-2.75), and decreased odds of major depressive disorder (AOR = 0.76). Results support the clinical significance of criterion E2 through identifying associated RUBs and distinct correlates. These results may inform screening and intervention strategies for at-risk populations.
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Affiliation(s)
- Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, 671 William Avenue, Winnipeg, Manitoba, R3E 0Z2, Canada; Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba, R3T 2N2, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, 671 William Avenue, Winnipeg, Manitoba, R3E 0Z2, Canada; Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba, R3T 2N2, Canada; Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4, Canada; Department of Psychiatry, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4, Canada
| | - Ateka A Contractor
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, TX, 76203, United States
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, 142 Flagg Road, Kingston, RI, 02881, United States
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4, Canada; Department of Psychiatry, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4, Canada.
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Guimarães RA, Morais Neto OL. Prevalence and Factors Associated with Driving Under the Influence of Alcohol in Brazil: An Analysis by Macroregion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030767. [PMID: 31991757 PMCID: PMC7037342 DOI: 10.3390/ijerph17030767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/14/2020] [Accepted: 01/18/2020] [Indexed: 11/16/2022]
Abstract
Objective: To analyze the prevalence and factors associated with driving under the influence of alcohol (DUIA) in Brazil, according to macroregion. Methods: A cross-sectional study was conducted using data from individuals aged 18 years or older who participated in the 2013 National Health Survey in Brazil. Subjects were selected by probabilistic sampling and interviewed through home visits. Prevalence of DUIA was estimated according to the number of drivers and/or motorcyclists who reported consuming alcohol in the previous 30 days (n = 9537). Poisson regression was used to analyze the factors associated with DUIA to Brazil and in each macroregion of the country. Results: The prevalence of DUIA was 27.5%, 29.4%, 29.6%, 22.9%, and 20.8% in the North, Northeast, Central-West, South, and Southeast macroregions, respectively. The overall prevalence of Brazil was 24.3%. In most macroregions, the main predictors of DUIA were male sex, high educational level, living in outside the capital or metropolitan regions (other regions), and binge drinking in the previous 30 days. Depression was a predictor in Brazil and two macroregions. Conclusion: A high prevalence of DUIA was observed in Brazil, especially in the Central-West, Northeast and, North macro-regions. Factors associated with DUIA can be incorporated to develop effective interventions to reduce this behavior in Brazil.
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DiGuiseppi CG, Smith AA, Betz ME, Hill L, Lum HD, Andrews H, Leu CS, Hyde HA, Eby DW, Li G. Cannabis use in older drivers in Colorado: The LongROAD Study. ACCIDENT; ANALYSIS AND PREVENTION 2019; 132:105273. [PMID: 31521874 PMCID: PMC7428847 DOI: 10.1016/j.aap.2019.105273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 02/08/2019] [Accepted: 08/15/2019] [Indexed: 05/30/2023]
Abstract
This study examined cannabis use and driving outcomes among older drivers in Colorado, which has legalized medical and recreational use. The associations of self-reported past-year cannabis use with diverse driving outcomes were assessed in 598 drivers aged 65-79 (51% female, 70% with postsecondary education), using regression analysis to adjust for health and sociodemographic characteristics. Two hundred forty four (40.8%) drivers reported ever using cannabis. Fifty-four drivers (9.0%) reported past-year use, ranging from more than once a day (13.0%) to less than once a month (50.0%). Of past-year users, 9.3% reported cannabis use within 1 h of driving in the past year. Past-year users were younger, less highly educated, lower income, and reported significantly worse mental, emotional, social and cognitive health status than drivers without past-year use. Past-year users were four times as likely to report having driven when they may have been over the legal blood-alcohol limit (adjusted OR [aOR] = 4.18; 95% CI: 2.11, 8.25) but were not more likely to report having had a crash or citation (aOR = 1.36; 95% CI: 0.70, 2.66) in the past year. Users and non-users had similar scores on self-rated abilities for safe driving (adjusted beta=-0.04; 95% CI: -0.23, 0.15) and on driving-related lapses, errors and violations in the past year (adjusted beta = 0.04; 95% CI: -0.04, 0.12). Further study is needed to establish driving risks and behaviours related to cannabis use, independent of other associated risk factors, among older adults.
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Affiliation(s)
| | - Alexandra A Smith
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Linda Hill
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Hillary D Lum
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA; Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Howard Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Cheng-Shiun Leu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hailey A Hyde
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - David W Eby
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA
| | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia University, Center for Injury Epidemiology and Prevention, Columbia University Medical Center, Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Choi NG, Dinitto DM, Arndt S. Potential Harms of Marijuana Use Among Older Adults. ACTA ACUST UNITED AC 2019. [DOI: 10.1093/ppar/prz011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, The University of Texas at Austin
| | - Diana M Dinitto
- Steve Hicks School of Social Work, The University of Texas at Austin
| | - Stephan Arndt
- Department of Psychiatry, University of Iowa, Iowa City
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Beck KH, Zanjani F, Allen HK. Social context of drinking among older adults: Relationship to alcohol and traffic risk behaviors. TRANSPORTATION RESEARCH. PART F, TRAFFIC PSYCHOLOGY AND BEHAVIOUR 2019; 64:161-170. [PMID: 33162781 PMCID: PMC7643866 DOI: 10.1016/j.trf.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Alcohol use among older adults is a major public health concern given potentially negative effects to health and functioning in this population. Little is known about context in which alcohol use among older adults occurs, or how context of use is associated with risk behaviors. METHOD Invitation letters were mailed to licensed drivers 65 years and older in Maryland. A total of 825 participants completed an online survey that assessed demographic characteristics, alcohol use, social context of drinking, and driving behaviors. RESULTS The analytic sample consisted of 604 older adult current drinkers (55% male). A factor analysis revealed three separate contexts of drinking: social facilitation, emotional comfort, and relaxation. Drinking in the context of social facilitation was associated with driving after drinking. Drinking in the context of emotional comfort was associated with getting drunk, driving after drinking, and running a stop sign or red light. Drinking in the context of relaxation was associated with traffic risk behaviors, including running a stop sign or red light and getting in a near crash or collision. CONCLUSIONS Understanding the social context of alcohol use among older adults may be useful for targeting and attempting to modify risky alcohol use and driving behaviors.
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Affiliation(s)
- Kenneth H. Beck
- University of Maryland College Park, School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
| | - Faika Zanjani
- Virginia Commonwealth University, College of Health Professions, 1200 E. Broad Street, Box 980233, Richmond, VA 23298, USA
| | - Hannah K. Allen
- University of Maryland College Park, School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA
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Older marijuana users' marijuana risk perceptions: associations with marijuana use patterns and marijuana and other substance use disorders. Int Psychogeriatr 2018; 30:1311-1322. [PMID: 29223184 DOI: 10.1017/s1041610217002794] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
UNLABELLED ABSTRACTBackground:Compared to their non-using age peers, older marijuana users are known to have lower marijuana risk perceptions. We examined associations of older marijuana users' risk perceptions with their marijuana use patterns and substance use disorders. METHODS Data are from 2013 to 2015 National Survey of Drug Use and Health (N = 24,057 respondents aged 50+ years). Bivariate logistic regression was used to compare risk perceptions among never users, former users, and past-year users aged 50+ years. Multivariable logistic regression was used to test associations between risk perception and marijuana use status and between risk perception and marijuana use patterns. RESULTS Among the total sample, former (AOR = 0.30, 95% CI = 0.27-0.32) and past-year (AOR = 0.05, 95% CI = 0.04-0.06) marijuana users had significantly lower odds of moderate/great risk perception (as opposed to no/slight risk perception) than never users. Among past-year users, odds of moderate/great risk perception were lower among those who used marijuana more frequently (AOR = 0.14, 95% CI = 0.07-0.28 for 300+ days of use compared to 1-11 days of use) and who reported any medical marijuana use (AOR = 0.27, 95% CI = 0.14-0.51). However, those who had marijuana use disorder were 3.5 times more likely to report moderate/great risk perception (AOR = 3.50, 95% CI = 1.62-7.58). Those who had a college education, had higher incomes, and resided in states with medical marijuana laws also had lower risk perceptions. CONCLUSIONS Public health education on scientific evidence about marijuana's benefits and harms and age-appropriate treatment for older adults with substance use problems are needed. Research on risk perception formation using longitudinal data among older adults is also needed.
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Lloyd SL, Striley CW. Marijuana Use Among Adults 50 Years or Older in the 21st Century. Gerontol Geriatr Med 2018; 4:2333721418781668. [PMID: 29977980 PMCID: PMC6024284 DOI: 10.1177/2333721418781668] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/25/2018] [Accepted: 05/15/2018] [Indexed: 02/04/2023] Open
Abstract
Background: Marijuana is the most commonly used illicit drug among older adults. As an older population grows in the United States that has a tolerant attitude toward marijuana use, the dynamics of marijuana use and the effects of marijuana on personal, social, and health outcomes among older adults require attention. Objectives: This review summarizes epidemiological literature on marijuana use among older adults. Method: A literature search was conducted using PubMed, AgeLine, and an online search engine from January 2000 to December 2017, resulting in 18 articles. Results: The greatest increase in marijuana use was observed among those in the older adult population 50 years or older, and those 65 years or older had the greatest increase in marijuana use in the older adult population. Common correlates of marijuana use among those in the older population included being male, being unmarried, having multiple chronic diseases, having psychological stress, and using other substances such as alcohol, tobacco, other illicit drugs, and prescription drugs. Conclusion: The increased use of marijuana in older populations requires surveillance and additional research to understand the use and effects of marijuana in older populations to avoid negative health outcomes.
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Alcañiz M, Guillen M, Santolino M. Prevalence of drug use among drivers based on mandatory, random tests in a roadside survey. PLoS One 2018; 13:e0199302. [PMID: 29920542 PMCID: PMC6007923 DOI: 10.1371/journal.pone.0199302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 06/05/2018] [Indexed: 11/18/2022] Open
Abstract
Background In the context of road safety, this study aims to examine the prevalence of drug use in a random sample of drivers. Methods A stratified probabilistic sample was designed to represent vehicles circulating on non-urban roads. Random drug tests were performed during autumn 2014 on 521 drivers in Catalonia (Spain). Participation was mandatory. The prevalence of drug driving for cannabis, methamphetamines, amphetamines, cocaine, opiates and benzodiazepines was assessed. Results The overall prevalence of drug use is 16.4% (95% CI: 13.9; 18.9) and affects primarily younger male drivers. Drug use is similarly prevalent during weekdays and on weekends, but increases with the number of occupants. The likelihood of being positive for methamphetamines is significantly higher for drivers of vans and lorries. Conclusions Different patterns of use are detected depending on the drug considered. Preventive drug tests should not only be conducted on weekends and at night-time, and need to be reinforced for drivers of commercial vehicles. Active educational campaigns should focus on the youngest age-group of male drivers.
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Affiliation(s)
- Manuela Alcañiz
- Department of Econometrics, Riskcenter-IREA, University of Barcelona, Barcelona, Spain
| | - Montserrat Guillen
- Department of Econometrics, Riskcenter-IREA, University of Barcelona, Barcelona, Spain
| | - Miguel Santolino
- Department of Econometrics, Riskcenter-IREA, University of Barcelona, Barcelona, Spain
- * E-mail:
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Choi NG, DiNitto DM, Marti CN. Older Adults Driving Under the Influence: Associations With Marijuana Use, Marijuana Use Disorder, and Risk Perceptions. J Appl Gerontol 2017; 38:1687-1707. [DOI: 10.1177/0733464817745379] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite increasing marijuana use among the 50+ age group, little research has been done on marijuana’s impact on older adults’ driving under the influence (DUI). Using the 2013 to 2014 National Survey on Drug Use and Health data, this study examined the association of older adults’ self-reported DUI with marijuana use, marijuana abuse/dependence, and marijuana risk perception. The findings show that one third of past-year marijuana users aged 50+ reported past-year DUI, two thirds of which involved drugs. Those with marijuana abuse/dependence were 2.6 times more likely than those without the disorder to report DUI, controlling for alcohol abuse/dependence, other illicit drug use, and sociodemographic and health/mental health statuses. As safe driving is key to prolonging independence in late life, clinicians need to educate older adults about the risk of marijuana use, alone and with other substances, on their driving capacity and provide age-appropriate treatment for marijuana use disorder.
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Choi NG, Marti CN, DiNitto DM, Choi BY. Older adults’ marijuana use, injuries, and emergency department visits. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 44:215-223. [DOI: 10.1080/00952990.2017.1318891] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Namkee G. Choi
- University of Texas at Austin School of Social Work, Austin, TX, USA
| | - C. Nathan Marti
- University of Texas at Austin School of Social Work, Austin, TX, USA
| | - Diana M. DiNitto
- University of Texas at Austin School of Social Work, Austin, TX, USA
| | - Bryan Y. Choi
- Warren Alpert Medical School, Department of Emergency Medicine, Brown University, Providence, RI, USA
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Hasin DS, Saha TD, Kerridge BT, Goldstein RB, Chou SP, Zhang H, Jung J, Pickering RP, Ruan WJ, Smith SM, Huang B, Grant BF. Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013. JAMA Psychiatry 2015; 72:1235-42. [PMID: 26502112 PMCID: PMC5037576 DOI: 10.1001/jamapsychiatry.2015.1858] [Citation(s) in RCA: 716] [Impact Index Per Article: 79.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
IMPORTANCE Laws and attitudes toward marijuana in the United States are becoming more permissive but little is known about whether the prevalence rates of marijuana use and marijuana use disorders have changed in the 21st century. OBJECTIVE To present nationally representative information on the past-year prevalence rates of marijuana use, marijuana use disorder, and marijuana use disorder among marijuana users in the US adult general population and whether this has changed between 2001-2002 and 2012-2013. DESIGN, SETTING, AND PARTICIPANTS Face-to-face interviews conducted in surveys of 2 nationally representative samples of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions (data collected April 2001-April 2002; N = 43,093) and the National Epidemiologic Survey on Alcohol and Related Conditions-III (data collected April 2012-June 2013; N = 36,309). Data were analyzed March through May 2015. MAIN OUTCOMES AND MEASURES Past-year marijuana use and DSM-IV marijuana use disorder (abuse or dependence). RESULTS The past-year prevalence of marijuana use was 4.1% (SE, 0.15) in 2001-2002 and 9.5% (SE, 0.27) in 2012-2013, a significant increase (P < .05). Significant increases were also found across demographic subgroups (sex, age, race/ethnicity, education, marital status, income, urban/rural, and region). The past-year prevalence of DSM-IV marijuana use disorder was 1.5% (0.08) in 2001-2002 and 2.9% (SE, 0.13) in 2012-2013 (P < .05). With few exceptions, increases in the prevalence of marijuana use disorder between 2001-2002 and 2012-2013 were also statistically significant (P < .05) across demographic subgroups. However, the prevalence of marijuana use disorder among marijuana users decreased significantly from 2001-2002 (35.6%; SE, 1.37) to 2012-2013 (30.6%; SE, 1.04). CONCLUSIONS AND RELEVANCE The prevalence of marijuana use more than doubled between 2001-2002 and 2012-2013, and there was a large increase in marijuana use disorders during that time. While not all marijuana users experience problems, nearly 3 of 10 marijuana users manifested a marijuana use disorder in 2012-2013. Because the risk for marijuana use disorder did not increase among users, the increase in prevalence of marijuana use disorder is owing to an increase in prevalence of users in the US adult population. Given changing laws and attitudes toward marijuana, a balanced presentation of the likelihood of adverse consequences of marijuana use to policy makers, professionals, and the public is needed.
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Affiliation(s)
- Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York2Mailman School of Public Health, Columbia University, New York, New York3New York State Psychiatric Institute, New York
| | - Tulshi D Saha
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Bradley T Kerridge
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Risë B Goldstein
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - S Patricia Chou
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Haitao Zhang
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Jeesun Jung
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Roger P Pickering
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - W June Ruan
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Sharon M Smith
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Boji Huang
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Bridget F Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
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