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Veskimäe L, Vorobjov S, Pärna K. Tranquilisers and sedatives misuse and associated factors among adolescents in Estonia: findings from cross-sectional ESPAD surveys, 2003-2019. BMJ Open 2024; 14:e077899. [PMID: 38777588 PMCID: PMC11116880 DOI: 10.1136/bmjopen-2023-077899] [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: 07/18/2023] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES This study aimed to (1) to describe trends of tranquilliser and sedative (TS) misuse in Estonia during 2003-2019 and (2) to analyse the associations between TS misuse and explanatory factors (perceived access to TS, medical use of TS, family-related, friends-related, school-related factors, risk behaviour and leisure time physical activity). DESIGN A cross-sectional study. SETTING Data were collected from the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 2003 to 2019 in Estonia. PARTICIPANTS Estonian schoolchildren aged 15-16 years old (n=11 328), 48.6% were boys. OUTCOME MEASURES Prevalence, crude and adjusted ORs with 95% CIs for TS misuse. RESULTS The prevalence of lifetime TS misuse significantly increased from 2003 (5.0% of boys and 12.6% of girls) to 2019 (11.3% and 17.5%, respectively) (p<0.001). Among boys, TS misuse increased significantly among those reporting medical use of TS from 21.1% to 41.4% in 2003-2019 (p=0.006). Medical use of TS multiplied the odds of misuse by 6.89 (95% CI 5.15 to 9.24) for boys and by 4.53 (95% CI 3.58 to 5.73) for girls. Perceived easy access to TS increased the odds of misuse by 6.57 (95% CI 4.13 to 10.46) times for boys and by 4.66 (95% CI 3.25 to 6.70) times for girls. Having many friends who misuse TS increased the odds of misuse by 3.27 (95% CI 2.16 to 4.95) times for boys and by 5.07 (95% CI 3.79 to 6.77) times for girls. Furthermore, higher odds of TS misuse were observed among adolescents who smoked cigarettes and engaged in less sports. CONCLUSIONS TS misuse prevalence among Estonian adolescents increased significantly from 2003 to 2019. Misuse was strongly associated with medical use, perceived easy access and friends' TS misuse. These findings emphasise the need for targeted prevention strategies, including improving prescription practices, limiting TS access and promoting healthy behaviours and positive peer relationships among adolescents.
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Affiliation(s)
- Liina Veskimäe
- Department of Risk Behaviour Studies, National Institute for Health Development, Tallinn, Estonia
- Institute of Family Medicine and Public Health, University of Tartu Faculty of Medicine, Tartu, Estonia
| | - Sigrid Vorobjov
- Department of Risk Behaviour Studies, National Institute for Health Development, Tallinn, Estonia
- Institute of Family Medicine and Public Health, University of Tartu Faculty of Medicine, Tartu, Estonia
| | - Kersti Pärna
- Institute of Family Medicine and Public Health, University of Tartu Faculty of Medicine, Tartu, Estonia
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Caron C, Dondaine T, Bastien A, Chérot N, Deheul S, Gautier S, Cottencin O, Moreau-Crépeaux S, Bordet R, Carton L. Could psychostimulant drug use among university students be related to ADHD symptoms? A preliminary study. Psychiatry Res 2024; 331:115630. [PMID: 38043409 DOI: 10.1016/j.psychres.2023.115630] [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] [Received: 09/20/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 12/05/2023]
Abstract
We aimed to explore if psychostimulant use among student could be linked to attention deficit-hyperactivity disorder (ADHD) symptoms using a self-administered questionnaire sent by email to French students in 2021. Participants were asked about their psychostimulant use and the presence of ADHD symptoms using the Wender Utah Rating Scale and the Adult Self-Report Scale. Among the 4431 respondents, the prevalence of psychostimulant use was concerning and significantly associated with ADHD symptoms. This association could be related to undiagnosed ADHD or to psychobehavioral impairments induced by psychostimulant use underlining the need of ADHD screening and targeted prevention measures.
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Affiliation(s)
- Clément Caron
- Pharmacology Department, Psychiatry and Addiction Medicine Department, CHU Lille, Addictovigilance Center, Lille F-59000, France
| | - Thibaut Dondaine
- Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, Pharmacology Department, University of Lille, Inserm, CHU Lille, UMR-S1172, Lille F-59000, France
| | - Axel Bastien
- Psychiatry and Addiction Medicine Department, CHU Lille, Lille F-59000, France
| | - Nathalie Chérot
- University of Lille, CHU Lille, Institut Pasteur de Lille, EA 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Lille F-59000, France
| | - Sylvie Deheul
- Pharmacology Department, CHU Lille, Addictovigilance Center, France
| | - Sophie Gautier
- Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, Pharmacology Department, University of Lille, Inserm, CHU Lille, UMR-S1172, Lille F-59000, France
| | - Olivier Cottencin
- Department of Psychiatry and Addiction Medicine, Plasticity & SubjectivitY (PSY) team, Lille Neuroscience & Cognition Centre (LiNC), CHU Lille, INSERM U-1172, France
| | | | - Régis Bordet
- Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, Pharmacology Department, University of Lille, Inserm, CHU Lille, UMR-S1172, Lille F-59000, France
| | - Louise Carton
- Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, Pharmacology Department, University of Lille, Inserm, CHU Lille, UMR-S1172, Lille F-59000, France.
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Tam CC, Smout SA, Wall CSJ, Mason KL, Benotsch EG. Behavioral Intervention for Nonmedical Use of Prescription Drugs Among Adolescents and Young Adults: A Narrative Review. Pediatr Clin North Am 2022; 69:807-818. [PMID: 35934501 DOI: 10.1016/j.pcl.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The nonmedical use of prescription drugs (NMUPD) is a public health crisis. In 2020, more Americans died of drug overdose than in any prior year, and the nonmedical use of opioids and other prescription drugs contributed significantly to that total. Young adults and adolescents report the highest rates of NMUPD, relative to other age groups. This article provides a narrative review of interventions for young adults and adolescents to prevent NMUPD, including interventions directed at the individual, family or other small group, and community. The interventions reviewed included those that were delivered in person and via technology.
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Affiliation(s)
- Cheuk Chi Tam
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Green Street, Columbia, SC 29208, USA
| | - Shelby A Smout
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA 23284-2018, USA
| | - Catherine S J Wall
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA 23284-2018, USA
| | - Kyle Liam Mason
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA 23284-2018, USA
| | - Eric G Benotsch
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Box 842018, Richmond, VA 23284-2018, USA.
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Validation of the Arabic and French Versions of a Knowledge, Attitudes and Practices (KAP) Questionnaire on Tranquilizer Misuse. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111144. [PMID: 34769663 PMCID: PMC8582760 DOI: 10.3390/ijerph182111144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
Abstract
Tranquilizer misuse is an emerging international public health concern. The psychosocial determinants of this misuse remain understudied. Instruments to measure the Knowledge, Attitudes and Practices (KAP) of tranquilizer misuse are unavailable, except for a recently published questionnaire validated in the Spanish language. We translated the KAP questionnaire into Arabic and French, adapted it and undertook a complete validation procedure in the general adult population in Lebanon. The content validity indicators were good: item content validity index ranged between 0.89 and 1.00, the content validity index scale average was ≥0.95 and the modified Kappa statistic for each of the KAP items was equal to I-CVI. The intra-class correlation coefficient values (n = 100) were ≥0.62 for all Knowledge and Attitudes items, demonstrating the item reliability. Confirmatory factorial analysis (n = 1450) showed that the selected model of Knowledge and Attitude constructs has adequate fit indicators and encompassed three factors that showed acceptable internal reliability: Knowledge (Cronbach’s alpha = 0.72), personal Attitudes towards tranquilizers (Cronbach’s alpha = 0.79) and Attitudes towards healthcare providers (Cronbach’s alpha = 0.65). The Arabic/French questionnaire was highly accepted, with a response rate of 95.72% and item non-response rate ≤3.6%. The availability of a cross-cultural adapted and multilingual validated questionnaire would stimulate research on tranquilizer misuse.
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Comparison of Longitudinal and Cross-Sectional Approaches in Studies on Knowledge, Attitude and Practices Related to Non-Medical Tranquilizer Use. J Clin Med 2021; 10:jcm10214827. [PMID: 34768347 PMCID: PMC8584824 DOI: 10.3390/jcm10214827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
Research about the association of knowledge and attitudes with practices (KAP) of non-medical tranquilizer use is scarce. We compared findings from cross-sectional and longitudinal approaches in a KAP-based study on non-medical tranquilizer use in Spain using data collected from the same population. Eight-hundred forty-seven participants completed a validated KAP questionnaire at baseline and were then followed-up bimonthly for one year for episodes of non-medical tranquilizer use. Non-medical use was defined as unprescribed use, non-adherence to treatment, storage/sharing of tranquilizers, or a combination of those practices. Adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated using logistic regression from cross-sectional data and generalized linear mixed models for repeated measures in the longitudinal approach. Only the longitudinal approach showed that limited knowledge about the effect of tranquilizers on behaviour [OR: 3.24 (95% CI: 1.12–9.38)] and about the negative effect of their excessive consumption [OR: 4.12 (95% CI: 1.5–11.33)] is associated with storing/sharing tranquilizers. Both cross-sectional and longitudinal analyses indicated that personal attitudes towards tranquilizers and attitudes towards healthcare providers are associated with non-medical tranquilizer use, yet with different magnitude of associations. Differences between the two approaches were also observed for individual types of non-medical use. Certain discrepancies exist between findings from longitudinal and cross-sectional approaches on KAP of non-medical tranquilizer use. KAP studies are the backbone for designing and evaluating prevention programs on non-medical tranquilizer use, and hence choosing a proper study design, scrutinizing the associated biases, and carefully interpreting findings from those studies are required.
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Mallah N, Rodríguez-Cano R, Figueiras A, Takkouche B. Development and validation of a knowledge, attitude and practice questionnaire of personal use of tranquilizers. Drug Alcohol Depend 2021; 224:108730. [PMID: 33930642 DOI: 10.1016/j.drugalcdep.2021.108730] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Tranquilizer misuse is insufficiently acknowledged as a public health problem despite its alarming consequences. Instruments to measure psychosocial factors related to tranquilizer misuse are lacking. We aimed to develop and validate a Knowledge, Attitude and Practice questionnaire of tranquilizer misuse by adults in Spain. METHODS The questionnaire was designed after an extensive literature review and several meetings with experts. We assessed face and content validity, and pilot tested the questionnaire. We examined its reliability by test-retest analysis in a sample of 145 adults. We distributed the questionnaire to 879 individuals, tested the construct validity through Confirmatory Factor Analysis (CFA), measured its overall reliability and determined its acceptability. RESULTS The Item Content Validity Index (I-CVI from 0.78 to 1.00), the Scale Content Validity Index, using the averaging method (S-CVI/Ave = 0.95) and the fact that the modified Kappa statistic for each of the Knowledge, Attitude and Practice items was equal to I-CVI demonstrated the content validity of the questionnaire. The Intra-Class Correlation coefficients for Knowledge and Attitude items were > 0.5, establishing their reliability. The Knowledge and Attitude construct was modeled using CFA and the model showed a good fit, thus establishing its validity. The overall reliability of the construct was revealed by Cronbach՚s alpha values > 0.6. The questionnaire was highly accepted (response rate = 95 % and item non-response ≤ 4%). CONCLUSIONS The validity of the developed questionnaire was established. Its availability will stimulate the initiation of research on tranquilizer misuse and will consequently help in designing related public health interventions.
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Affiliation(s)
- Narmeen Mallah
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | | | - Adolfo Figueiras
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
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