Non-medical prescription drug use (NMPDU) and poor quality of life in the Swedish general population

Factors associated with non-medical use of prescription drugs among individuals with a legitimate prescription for medical purposes: A population-based study

Background:

Psychoactive prescription drugs are known to have abuse potential. This study was aimed at studying the non-medical use of prescription drugs (NMUPD) among individuals with prescriptions for anxiolytics, sedatives, or strong analgesics. We examined the association of socio-demographics, binge drinking, the number of drug prescriptions, and drug types prescribed for medical purposes with NMUPD among the general Finnish population.

Methods:

Data were derived from population-based (ages 15–69 years) Drug Surveys conducted in Finland in 2006, 2010, and 2014. The response rates varied between 48% and 55%. Individuals with prescriptions for one or more prescription drugs in the last 12 months were included (n = 1,602) and divided into three groups: medical use only, NMUPD, and NMUPD with illicit drug use (ILLICIT USE). Multinomial logistic regression was used.

Results:

Among individuals with a prescription for at least one prescription drug, 5.7% reported NMUPD. Living alone and being outside the labour force were associated with NMUPD. Younger age, living in a large city, living alone, and unemployment were associated with ILLICIT USE. Frequent binge drinking and a high number of drug prescriptions were associated with both NMUPD and ILLICIT USE. Those reporting ILLICIT USE were more likely to have a prescription for sedatives.

Conclusions:

Although NMUPD is on a rather low level among those who have a prescription for legitimate purposes, having multiple prescriptions increased the likelihood of NMUPD. Low socio-economic position and binge drinking are associated with NMUPD and this should be taken into account when planning interventions and preventive actions.

How Does Substance Use Affect Personality Development? Disentangling Between- and Within-Person Effects

Little is known about the effects of substance use on changes in broad personality traits. This 10-year longitudinal study sought to fill this void using a large, representative sample of the Dutch population ( N = 10,872), which provided annual assessments of drug use (tobacco, alcohol, sedatives, soft drugs, ecstasy, hallucinogens, and hard drugs), Big Five personality traits, life satisfaction, and self-esteem. Using multilevel models, we examined the longitudinal associations between drug use and personality both between and within persons. Results indicated that individuals with low levels of conscientiousness, life satisfaction, and self-esteem, as well as high levels of neuroticism, used more drugs on average (between-person effects). In contrast, we found little evidence for personality change following substance use (within-person effects). We discuss these findings in the context of previous empirical and theoretical work and highlight opportunities for future research.

Medical use, non-medical use and use disorders of benzodiazepines and prescription opioids in adults: Differences by insurance status

OBJECTIVES

To report and analyze prevalence's of Benzodiazepines (BZDs) and Prescription Opioids (POs) use by insurance status and to investigate associations between insurance status and BZDs, POs and concurrent medical/non-medical use and use disorders.

METHODS

This study included 81,133 adults ages 18 and older from 2015 and 2016 National Survey on Drug Use and Health. Participants' self-reported past- year medical use, non-medical use and use disorders of BZDs and POs were assessed, along with their insurance status (Private/Military, Medicare, Medicaid, and Uninsured) and demographic characteristics.

RESULTS

In 2015-2016, 12.6% of adults reported using BZDs and 36.9% reported using POs in the past year. Among adults, 8.3% reported past-year use of both BZDs and POs; also, 1.9% and 3.8% reported non-medical use of BZDs and POs, respectively, and 0.9% reported non-medical use of both BZDs and POs. Medicaid-covered respondents had higher risk of BZDs (aRRR = 1.59, 95%CI = [1.45, 1.74]), POs (aRRR = 1.66, 95%CI = [1.54, 1.79]) and concurrent past-year medical use (aRRR = 2.11, 95%CI = [1.87, 2.38]), higher risk of BZDs non-medical use (aRRR = 1.40, 95%CI = [1.17, 1.68]) and BZD Use Disorders (aRRR = 2.60, 95%CI = [1.82, 3.72]), POs non-medical use (aRRR = 1.67, 95%CI = [1.45, 1.92]), PO use Disorders (aRRR = 4.12, 95%CI = [3.33, 5.11]) and concurrent non-medical use (aRRR = 1.52, 95%CI = [1.20, 1.92]) and Use Disorders (aRRR = 3.68, 95%CI = [1.93, 6.78]), compared to those with private insurance.

CONCLUSIONS

Future health policies should focus on reducing individual and co-prescription of BZDs and POs and providing different strategies of pain management.

The epidemiology of benzodiazepine misuse: A systematic review

BACKGROUND

Benzodiazepine misuse is a growing public health problem, with increases in benzodiazepine-related overdose deaths and emergency room visits in recent years. However, relatively little attention has been paid to this emergent problem. We systematically reviewed epidemiological studies on benzodiazepine misuse to identify key findings, limitations, and future directions for research.

METHODS

PubMed and PsychINFO databases were searched through February 2019 for peer-reviewed publications on benzodiazepine misuse (e.g., use without a prescription; at a higher frequency or dose than prescribed). Eligibility criteria included human studies that focused on the prevalence, trends, correlates, motives, patterns, sources, and consequences of benzodiazepine misuse.

RESULTS

The search identified 1970 publications, and 351 articles were eligible for data extraction and inclusion. In 2017, benzodiazepines and other tranquilizers were the third most commonly misused illicit or prescription drug in the U.S. (approximately 2.2% of the population). Worldwide rates of misuse appear to be similar to those reported in the U.S. Factors associated with misuse include other substance use, receipt of a benzodiazepine prescription, and psychiatric symptoms and disorders. Benzodiazepine misuse encompasses heterogeneous presentations of motives, patterns, and sources. Moreover, misuse is associated with myriad poor outcomes, including mortality, HIV/HCV risk behaviors, poor self-reported quality of life, criminality, and continued substance use during treatment.

CONCLUSIONS

Benzodiazepine misuse is a worldwide public health concern that is associated with a number of concerning consequences. Findings from the present review have implications for identifying subgroups who could benefit from prevention and treatment efforts, critical points for intervention, and treatment targets.