Dataset Information

Trends in older adult nonmedical prescription drug use prevalence: Results from the 2002-2003 and 2012-2013 National Survey on Drug Use and Health.

ABSTRACT: BACKGROUND:Based on projections of increasing older adult nonmedical prescription drug use (NMPDU) prevalence, we investigated whether increases had occurred in opioid, tranquilizer and stimulant NMPDU in older adults from 2002-2003 to 2012-2013, using the National Survey on Drug Use and Health (NSDUH). METHODS:The NSDUH is a nationally representative survey of the US population, with assessments of lifetime, past-year and past 30-day NMPDU from opioids, tranquilizers and stimulants. Weighted cross-tabulations were used to compute prevalence rates, and design-based logistic regressions were used to examine change in NMPDU. Regressions controlled for gender, race/ethnicity and population density of respondent residence. RESULTS:Across medication classes, lifetime NMPDU rates increased in all older adults and two sub-groups: those aged 50 to 64 and those 65years and older. Rates of past year opioid NMPDU also increased from 2002-2003 to 2012-2013 in all examined age ranges. Trend-level results were also found for the past-30day opioid NMPDU and past-year tranquilizer NMPDU in adults aged 50years and older. CONCLUSIONS:The results support projections of increasing older adult NMPDU rates. As NMPDU in older adults may impart greater risk for adverse events, public health efforts are needed to reverse the increases in older adult NMPDU.

SUBMITTER: Schepis TS

PROVIDER: S-EPMC4884514 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Trends in older adult nonmedical prescription drug use prevalence: Results from the 2002-2003 and 2012-2013 National Survey on Drug Use and Health.

Schepis Ty S TS McCabe Sean Esteban SE

Addictive behaviors 20160422

<h4>Background</h4>Based on projections of increasing older adult nonmedical prescription drug use (NMPDU) prevalence, we investigated whether increases had occurred in opioid, tranquilizer and stimulant NMPDU in older adults from 2002-2003 to 2012-2013, using the National Survey on Drug Use and Health (NSDUH).<h4>Methods</h4>The NSDUH is a nationally representative survey of the US population, with assessments of lifetime, past-year and past 30-day NMPDU from opioids, tranquilizers and stimulan ...[more]

PMID: 27163188

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Project description:It is important to document patterns of prescription drug use to inform both clinical practice and research.To evaluate trends in prescription drug use among adults living in the United States.Temporal trends in prescription drug use were evaluated using nationally representative data from the National Health and Nutrition Examination Survey (NHANES). Participants included 37,959 noninstitutionalized US adults, aged 20 years and older. Seven NHANES cycles were included (1999-2000 to 2011-2012), and the sample size per cycle ranged from 4861 to 6212.Calendar year, as represented by continuous NHANES cycle.Within each NHANES cycle, use of prescription drugs in the prior 30 days was assessed overall and by drug class. Temporal trends across cycles were evaluated. Analyses were weighted to represent the US adult population.Results indicate an increase in overall use of prescription drugs among US adults between 1999-2000 and 2011-2012 with an estimated 51% of US adults reporting use of any prescription drugs in 1999-2000 and an estimated 59% reporting use of any prescription drugs in 2011-2012 (difference, 8% [95% CI, 3.8%-12%]; P for trend <.001). The prevalence of polypharmacy (use of ?5 prescription drugs) increased from an estimated 8.2% in 1999-2000 to 15% in 2011-2012 (difference, 6.6% [95% CI, 4.4%-8.2%]; P for trend <.001). These trends remained statistically significant with age adjustment. Among the 18 drug classes used by more than 2.5% of the population at any point over the study period, the prevalence of use increased in 11 drug classes including antihyperlipidemic agents, antidepressants, prescription proton-pump inhibitors, and muscle relaxants.In this nationally representative survey, significant increases in overall prescription drug use and polypharmacy were observed. These increases persisted after accounting for changes in the age distribution of the population. The prevalence of prescription drug use increased in the majority of, but not all, drug classes.

Project description:BACKGROUND:Nonmedical prescription psychiatric drug use (NMPDU) is an increasing global health problem, with recent concern focusing on darknet cryptomarkets as sources of procurement. There is a shortage of evidence regarding comparative worldwide NMPDU trends, due in part to data collection difficulties. This problem is particularly marked for non-opioid drugs, particularly those psychiatric drugs which act on the central nervous system (CNS) and have high misuse potential and are associated with high levels of dependency and fatal overdose. This paper therefore has two goals: 1) to report on the kinds of psychiatric prescription drugs available on cryptomarkets, and 2) to use this data to uncover temporal and geographical trends in sales of these products, potentially informing policy regarding NMPDU more generally. METHOD:Digital trace data collected from 31 cryptomarkets in operation between September 2013 and July 2016 was analysed by country of origin descriptively and for trends in the sales for 7 psychiatric drug groupings, based on their main indication or intended use in psychiatric practice. RESULTS:Sedatives (such as diazepam and alprazolam) and CNS stimulants (mainly Adderall, modafinil and methylphenidate) had the greatest share of sales, but usage and trends varied by location. The UK has high and rising levels of sedative sales, whilst the USA has the greatest stimulant sales and increasing sedative rates. Sales of drugs used in the treatment of opioid dependency are also substantial in the USA. The picture is less clear in mainland Europe with high sales levels reported in unexpected Central and Northern European countries. There is evidence of a move towards the more potent sedative alprazolam - already implicated as a source of problematic NMPDU in the USA - in Australia and the UK. Sales of drugs such as antidepressants, antipsychotics, mood stabilisers and antidementia drugs - all drugs with limited abuse potential - were negligible, indicating minimal levels of online cryptomarket procurement for self-medicating mental health problems. CONCLUSION:Predominantly, psychiatric drugs with potent sedative, stimulant or euphoriant effects are sold on cryptomarkets and this varies by country. With some caveats regarding the limitations of cryptomarket digital trace data taken into account, the study of trends of these products sold online over time may offer a novel and increasingly important window onto wider drug purchasing habits.

Dataset Information

Trends in older adult nonmedical prescription drug use prevalence: Results from the 2002-2003 and 2012-2013 National Survey on Drug Use and Health.

Publications

Trends in older adult nonmedical prescription drug use prevalence: Results from the 2002-2003 and 2012-2013 National Survey on Drug Use and Health.

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