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Prescription drug use, misuse and related substance use disorder symptoms vary by educational status and attainment in U.S. adolescents and young adults.

ABSTRACT: BACKGROUND:Prescription drug misuse (PDM) rates are highest in adolescents and young adults. Little research in these high-risk groups has examined PDM differences by educational status or attainment. This investigation attempted to further our understanding of adolescent and young adult prescription drug use and misuse through examining PDM type (i.e., nonmedical misuse, medical misuse and mixed misuse) and substance use disorder (SUD) symptoms from PDM by educational status/attainment. METHODS:Data were from the 2015 National Survey on Drug Use and Health, with 13,585 adolescent and 14,553 young adult respondents. Participants were categorized by educational status separately in adolescents and young adults. Outcomes were rates of past-year prescription drug use, PDM, PDM type, and SUD symptoms, with analyses performed separately by age group and for opioids, stimulants and sedatives/tranquilizers. Analyses used logistic regression and controlled for age, race/ethnicity and sex. RESULTS:In adolescents and across medication classes, the highest rates of any use, PDM, medical misuse, nonmedical misuse and presence of two or more SUD symptoms were seen in those with poor school adjustment or not in school. In young adults, opioid-PDM and related outcomes were more prevalent in those not in school, especially high school dropouts. For stimulants, rates were highest in full-time college students and college graduates. CONCLUSIONS:These results further suggest the importance of assessing educational status in adolescent and educational attainment in young adult PDM investigations. Adolescents poorly engaged in school or not in school appear especially in need of interventions to limit PDM and associated SUD symptoms.

SUBMITTER: Schepis TS

PROVIDER: S-EPMC6487647 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Prescription drug use, misuse and related substance use disorder symptoms vary by educational status and attainment in U.S. adolescents and young adults.

Schepis Ty S TS Teter Christian J CJ McCabe Sean Esteban SE

Drug and alcohol dependence 20180621

<h4>Background</h4>Prescription drug misuse (PDM) rates are highest in adolescents and young adults. Little research in these high-risk groups has examined PDM differences by educational status or attainment. This investigation attempted to further our understanding of adolescent and young adult prescription drug use and misuse through examining PDM type (i.e., nonmedical misuse, medical misuse and mixed misuse) and substance use disorder (SUD) symptoms from PDM by educational status/attainment. ...[more]

PMID: 29960204

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Project description:ObjectivesThis study explored adolescents' awareness about prescription opioid misuse, sources of medication information, and educational preferences.DesignAn online survey explored adolescents' understanding and perceptions of prescription opioids and opioid misuse and safety, medication information sources, and educational preferences.Setting and participantsEligible participants included students from 3 Wisconsin high schools who could speak and understand English. Participants were recruited through "backpack mail" and completed surveys online at school.Outcome measursSurvey responses were compared across demographic information of the study participants. Binary response items were compared across demographic strata by Fisher exact tests, and Likert responses were analyzed by Kruskal-Wallis tests.ResultsA total of 190 students (53% female, 53% white, 32% Hispanic) were surveyed. Most (83.5%) considered using someone else's opioid medication to be misuse, 85.2% identified using opioids at a higher dose or frequency than prescribed as misuse, and 67.6% considered using an opioid prescription after its expiration date to be misuse. Approximately 90% of students perceived that opioid misuse causes some, quite a bit, or a great deal of harm to a person's physical and mental health and school ability. Many students were able to correctly identify examples and consequences of misuse, however 24.7% believed that flushing opioids down the drain was dangerous. The most common source for finding information about opioids was Google or other search engines (67.6%), followed by talking with parents (56.7%), talking with a doctor or nurse (54.9%), and online videos (42.3%).ConclusionAdolescents have some opioid safety knowledge, but there is a clear opportunity to increase knowledge and understanding of risks. Adolescents could benefit from opioid safety education, particularly on safe storage and disposal, harms of misuse, and strategies for discouraging peer opioid misuse.

Project description:IntroductionBenzodiazepines are commonly prescribed in the U.S. but entail safety concerns, including dependency. In pediatrics, many indications lack trial data. Authors aimed to describe youth initiating prescription benzodiazepine treatment, identify potential indications and prescribing concerns, estimate the duration of treatment by potential indication, and identify factors that predict long-term use.MethodsThe study cohort included children (aged 3-12 years) and adolescents (aged 13-17 years) initiating prescription benzodiazepine treatment (≥3 days' supply) from January 2010 to September 2015 in a U.S. commercial claims database. Potential indications included selected ICD-9-CM diagnoses (≤30 days prior). Long-term (≥6 months) benzodiazepine treatment was estimated with Kaplan-Meier estimation and modified Poisson regression identified independent predictors of long-term benzodiazepine treatment (analysis completed in 2018).ResultsOf 24,504 children and 61,046 adolescents initiating benzodiazepines, 62% of the children and 68% of the adolescents had a potential indication. Anxiety disorders were the most common indication, with mental health indications more common among adolescents (45%) than children (23%) and epilepsy and movement disorders higher in children. Recent opioid prescriptions were common before benzodiazepine initiation (children, 22%; adolescents, 21%). Six percent of the initiators became long-term benzodiazepine users. Potential indication, provider contact, psychotropic medication, and chronic conditions independently predicted long-term benzodiazepine treatment in adolescents and children.ConclusionsU.S. children and adolescents are prescribed benzodiazepines for various mental health and other medical conditions, many lacking evidence of pediatric efficacy. Long-term benzodiazepine treatment, concurrent opioid prescriptions, psychotropic use, and prior substance use disorder diagnoses suggest safety risks among some youth prescribed benzodiazepines.

Project description:BackgroundMedicaid presently insures about one-fourth of the US population and disproportionately insures about 38 % of non-elderly adults with an opioid use disorder (OUD). Owing to Medicaid's prominent role insuring persons with an OUD and that Medicaid coverage includes pharmaceutical benefits, there has been considerable interest in studying potential prescription opioid misuse among Medicaid beneficiaries and identifying subpopulations at higher risk for misuse and possible progression to an OUD.MethodsThe study goals were to explore the associations among prescription opioid misuse, OUD, and co-occurring mental health and other substance use disorders (SUD). We analyzed Illinois Medicaid 2018 claims data for 1102479 adult beneficiaries 18 to 64 years of age. Using algorithms based on previous studies, we first determined either the presence or absence of nine SUDS (including OUD), nine mental health disorders and likely prescription opioid misuse. Then, we subdivided the beneficiary sample into five groups: those who were prescribed opioids and evidenced either no, possible, or probable misuse; those evidencing an OUD; and those evidencing no opioid use or misuse.ResultsBivariate analyses, upset plots, and multinomial logistic regressions were used to compare the five subgroups on the prevalence of co-occurring SUDS and mental health disorders. Those with an OUD or with probable prescription opioid misuse had the highest prevalence of most co-occurring conditions with beneficiaries with an OUD the most likely to evidence co-occurring SUDS, particularly tobacco use disorder, whereas those with probable misuse had elevated prevalence rates of co-occurring mental health disorders comparable to those with an OUD.ConclusionThe medical complexity of persons with an OUD or misusing prescription opioids are considered in light of recent attempts to expand buprenorphine provision as a medication for OUD among Medicaid beneficiaries. Additionally, we consider the possibility of gender, co-occurring mental health disorders, and tobacco use disorder as important risk factors for progressing to prescription opioid misuse and an OUD.

Dataset Information

Prescription drug use, misuse and related substance use disorder symptoms vary by educational status and attainment in U.S. adolescents and young adults.

Publications

Prescription drug use, misuse and related substance use disorder symptoms vary by educational status and attainment in U.S. adolescents and young adults.

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