Depressant medication use by older persons in the broader social context relating to use of psychoactive substances

Prescription drug abuse in Canada and the diversion of prescription drugs into the illicit drug market

Prescription drug abuse has received considerable attention in media reports in recent years. The purpose of this article is to describe the Canadian situation and context with regards to prescription drug abuse and the diversion of psychotropic prescription drugs into the illicit drug market, with a focus on the need for more data and interventions. Canada ranks within the top 10% of countries in the use of benzodiazepines, opioid prescriptions and stimulants. There are many ways that prescription drugs are diverted into the illicit market and varied reasons for use and abuse. Prescription drug abuse is further related to a number of negative consequences, including overdose. While seniors and women have been the primary focus for research in Canada on prescription drug abuse, adolescents and young adults have received less attention. Systematic epidemiological data specifically on prescription drug abuse in the Canada context are lacking and are needed in order to more clearly understand the reasons for the phenomenon and to develop and implement appropriate interventions.

Factors associated with psychotropic drug use among community-dwelling older persons: A review of empirical studies

BACKGROUND: In the many descriptive studies on prescribed psychotropic drug use by community-dwelling older persons, several sociodemographic and other factors associated with drug use receive inconsistent support. METHOD: Empirical reports with data on at least benzodiazepine or antidepressant drug use in samples of older persons published between 1990 and 2001 (n = 32) were identified from major databases and analyzed to determine which factors are most frequently associated with psychotropic drug use in multivariate analyses. Methodological aspects were also examined. RESULTS: Most reports used probability samples of users and non-users and employed cross-sectional designs. Among variables considered in 5 or more reports, race, proximity to health centers, medical consultations, sleep complaints, and health perception were virtually always associated to drug use. Gender, mental health, and physical health status were associated in about two-thirds of reports. Associations with age, marital status, medication coverage, socioeconomic status, and social support were usually not observed. CONCLUSIONS: The large variety of methods to operationalize drug use, mental health status, and social support probably affected the magnitude of observed relationships. Employing longitudinal designs and distinguishing short-term from long-term use, focusing on samples of drug users exclusively, defining drug use and drug classes more uniformly, and utilizing measures of psychological well-being rather than only of distress, might clarify the nature of observed associations and the direction of causality. Few studies tested specific hypotheses. Most studies focused on individual characteristics of respondents, neglecting the potential contribution of health care professionals to the phenomenon of psychotropic drug use among seniors.

Concordance of use of alcohol and other substances among older adult couples

This study used data from a community survey of 826 older adults to examine the level of concordance of substance use among married couples and the extent to which demographic, social and health factors were associated with concordant drinking patterns. Results showed significant concordance for use of alcohol, caffeine, tobacco and depressant medications, with very high concordance on frequency of drinking and overall volume of consumption of alcohol. Drinking spouses were also very accurate in reporting each other's usual frequency and quantity of alcohol consumption. Education and religiosity were associated with concordance on drinking status (drinker/abstainer), but few other variables were significantly associated with drinking status or drinking level. In particular, marital happiness did not appear to be affected by discordant drinking. The results also indicated that having a drinking spouse (versus an abstinent spouse) was associated with higher levels of drinking. These findings suggest that spousal influence on drinking is an important aspect of drinking among older persons and may have implications for understanding the effects of gender and widowhood on the development of late-onset problem drinking.