Patterns of concurrent substance use among prescription stimulant misusers: Results from the national survey on drug use and health

Abstract

s / Drug and Alcohol Dependence 146 (2015) e202–e284 e245 Patterns of concurrent substance use among prescription stimulant misusers: Results from the national survey on drug use and health Lian-Yu Chen1, R. Crum1,2,3, Christopher N. Kaufmann1, Silvia S. Martins4, Eric C. Strain2, R. Mojtabai1,2 1 Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States 2 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States 3 Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States 4 Epidemiology, Mailman School of Public Health, New York, NY, United States Aims: To examine patterns of concurrent substance use among adults who used prescription stimulants non-medically. Methods: We used latent class analysis (LCA) to examine patterns of past-year problematic substance (i.e. had any criteria of abuse or dependence) in a sample of 6244 adult participants of NSDUH 2006–2011 who reported past-year non-medical use of prescription stimulants. Multivariate latent regression was used to determine the association of socio-demographics, mental health and deviant behavior characteristics with the latent classes. Results: A four-class model had the best model fit. The largest class was comprised of individuals with low probabilities of any problematic substance use (low substance users, 49.1%); the smallest class was comprised of individuals with high probabilities of problematic use of multiple drugs and alcohol (polysubstance users, 5.3%). A third class was comprised of those who were problematic users of all types of prescription drugs (prescription drug users, 11.8%). A fourth class included participants with high probabilities of problematic alcohol and marijuana use (33.8%). Regression results showed that prescription drug users and polysubstance usersweremore likely to report past-yearmental health problems, deviant behaviors, and mental or substance treatment use, while alcohol/marijuana users reported more deviant behaviors andsubstance treatmentuse, compared to lowsubstanceusers. Conclusions: Nonmedical users of prescription stimulants are a heterogeneous group, with a large subgroup rarely having any substance problems. These sub-groups have distinct patterns of mental health comorbidity, behavior problems and service use, which can offer implications for prevention and treatment of nonmedical stimulant use. Financial support: DA023186. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.132 Statistical assessment for abuse deterrent formulation in clinical abuse potential studies