Lifetime Nonmedical Prescription Drug Use Research Articles

Sexual enhancement expectancy, non-medical use of prescription drugs, and sexual risk behaviors in college students

Background: American young adults have a high risk of sexually transmitted infections. Sexual risk behaviors may be influenced by psycho-behavioral factors, including substance use and sexual enhancement expectancy. Existing research suggested that substance use may mediate the relationship between sexual enhancement expectancy and sexual risk behaviors. The substance use literature also suggested that non-medical use of prescription drugs (NMUPD) was highly prevalent in college students and was associated with sexual risk. However, limited studies have examined NMUPD-related sexual enhancement expectancy. The current study examined the relationship among sexual enhancement expectancy, NMUPD, and sexual risk behaviors in college students. Methods: Online data were collected in 2016 from 453 US college students with lifetime NMUPD. All participants reported their (1) past-three-month NMUPD, (2) NMUPD sexual enhancement expectancy, and (3) sexual risk behaviors. Structural equation modeling was employed for data analysis. Results: Findings suggested significant associations of NMUPD with sexual enhancement expectancy and sexual risk behaviors. Sexual enhancement expectancy was indirectly associated with sexual risk behaviors through NMUPD. Conclusions: College students’ sexual risk behaviors appear to be indirectly influenced by sexual enhancement expectancy through NMUPD. Future sexual risk reduction interventions should attend to sexual enhancement expectancy and NMUPD.

Peer Substance Use Norms and Nonmedical Use of Prescription Drugs among a National Sample of African American Adolescents

The purpose of this study was to examine the relationship between peer substance use norms and lifetime and past year nonmedical use of prescription drugs (NMUPD) among African American adolescents. A secondary analysis of the 2013 National Survey on Drug Use and Health was conducted (N = 2,420). We performed multivariable logistic regression analyses to examine the associations between peer norms and lifetime and past year NMUPD. For lifetime NMUPD, results revealed that participants who reported that most/all of their peers used substances were significantly more likely to report lifetime use. Similar results were found for past year NMUPD. Recommendations are included.

Non-medical use of prescription drugs and cultural orientation among college students in China

BackgroundDue to a dramatic increase in the past 20 years, the non-medical use of prescription drugs (NMUPD) has become a global public health issue. College students have high prevalence of NMUPD in the United States. However, limited studies have been conducted among Chinese students. The purposes of this study were to examine the prevalence of NMUPD among college students in two urban centers (Beijing and Macau) in China and assess its relationships with cultural orientation (collectivism - primary focus on the group and individualism - primary focus on the individual). MethodsIn January–April 2017, 849 undergraduates (72.2% female) from Beijing and Macau, with an average age of 20 completed online surveys about their demographics, NMUPD, and cultural orientation. ResultsOverall, 62.9% (lifetime) and 33.4% (past three-months) of students in Beijing reported NMUPD, while 35.9% (lifetime) and 21.8% (past three-months) of students in Macau reported NMUPD. The most commonly non-medically used class of medicine (lifetime) was analgesics (62.9% Beijing; 35.5% Macau), followed by sedatives (4.0% Beijing; 0.9% Macau), anxiolytics (2.7% Beijing; 0.6% Macau), and stimulants (1.0% Beijing; 0.2% Macau). Multivariate analyses suggested a positive association of individualism with lifetime NMUPD (OR = 1.78, 95% CI = 1.15, 2.75, p < .01 in Beijing; OR = 1.53, 95% CI = 1.16, 2.02, p < .01 in Macau). ConclusionNMUPD in Chinese college students appears to be common. More discussion is needed in China about regulation of prescription drugs. Future culturally-tailored NMUPD-risk reduction intervention programs may be beneficial to Chinese college students.

Pre-Incarceration Rates of Nonmedical Use of Prescription Drugs among Black Men from Urban Counties.

There are inconsistent findings regarding the rates of nonmedical prescription drug use (NMPDU) among Black Americans. The majority of previous studies used pharmaceutical names of drugs and relied on national data that excludes incarcerated populations, in which Black men are overrepresented. Therefore, the current study aimed to describe pre-incarceration rates of NMPDU among Black men in prison using culturally relevant alternative drug names. We recruited 208 incarcerated (adult age 18 or older) Black men nearing community reentry to urban counties from four state prisons in Kentucky. Results indicated the majority of participants engaged in lifetime NMPDU. The most commonly endorsed class of prescription drug was, "Other Sedatives, Hypnotics, and Tranquilizers" and the most commonly endorsed specific prescription drugs were "Syrup," Lortab/Hydrocodone, and Xanax. There were significant age differences in the number of days that drugs were used in the year prior to incarceration. The current study contributes to the dearth of literature on NMPDU among Black Americans. These findings have implications for disease transmission, overdose risk, and culturally relevant data collection methods and interventions aimed at reducing NMPDU among Black men.

Sexual attraction and the nonmedical use of opioids and sedative drugs among Chinese adolescents

ObjectiveThe nonmedical use of prescription drugs (NMUPD) is attracting public attention. We aimed to explore the association between sexual attraction and NMUPD among Chinese adolescents. MethodA school-based survey was conducted in seven Chinese provinces, and a multi-stage stratified cluster sampling method was used in this study. A total of 150,822 students from seven Chinese provinces completed the questionnaire; the response rate was 95.93%. All data were collected between November 2014 and January 2015. ResultsOverall, 8.8%, 4.4%, and 2.2% of the students reported lifetime, past-year, and past-month NMUPD, respectively. Compared with heterosexual students (8.2%), sexual minority and unsure students were more likely to report lifetime NMUPD (14.4% and 10.0%, respectively; χ2 = 244.34, P < 0.001). In addition, sexual minority and unsure students were more likely to admit past-year and past-month use of NMUPD. After adjusting for social demographics and lifestyle covariates, sexual minority and unsure students were at an increased risk of lifetime NMUPD (adjusted odds ratio [AOR] = 1.68, 95% confidence interval [CI] = 1.54-1.83 and AOR = 1.33, 95% CI = 1.26-1.41, respectively). ConclusionsOur study suggested that sexual minority and unsure adolescents have a higher risk of NMUPD. Moreover, our study suggested that sexual minority and unsure students are more likely to both try and continue to use prescription drugs. Further studies focusing on the mechanism of substance abuse and appropriate interventions among sexual minority and unsure adolescents are warranted.

Adolescent Dating Violence and Nonmedical Prescription Drug Use.

* Abbreviations: DV — : dating violence NMUPD — : nonmedical use of prescription drugs In this issue of Pediatrics , Clayton et al1 report on the associations between adolescent dating violence (DV) victimization and the nonmedical use of prescription drugs (NMUPD) using the Youth Risk Behavior Surveillance System. Given our national focus on the opioid epidemic, studies on associations of NMUPD with other health risk exposures among adolescents, such as DV victimization, are timely. Because most researchers conducting studies on NMUPD among adolescents have relied on emergency department samples or limited geographic areas, researchers conducting a study using nationally representative data to estimate prevalence ratios add needed perspective. With a sample of 10 443 male- and female-identified US high school students who had dated in the past 12 months, Clayton et al1 provide sex-stratified analyses revealing that experiencing both physical and sexual DV victimization is associated with NMUPD for both sex categories. Stratifying by sex category identifies some subtle but important differences. Among boys, there is an association of lifetime NMUPD with sexual violence victimization, whereas among girls, lifetime NMUPD is associated with physical DV victimization. Among girls, NMUPD is associated with a higher frequency of sexual violence victimization … Address correspondence to Elizabeth Miller, MD, PhD, Division of Adolescent and Young Adult Medicine, Oakland Medical Building, 3420 Fifth Ave, Pittsburgh, PA 15213. E-mail: elizabeth.miller{at}chp.edu

Physical and Sexual Dating Violence and Nonmedical Use of Prescription Drugs.

Little information is available on the associations between nonmedical use of prescription drugs (NMUPD) and dating violence victimization (DVV) among high school students and how associations vary by sex. We used data from the 2015 national Youth Risk Behavior Survey, a cross-sectional survey of a nationally representative sample of students in grades 9 to 12. The sample was restricted to students who dated during the 12 months before the survey, resulting in a sample of 5136 boys and 5307 girls. Sex-stratified logistic regression models estimated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between lifetime NMUPD and DVV. In our analyses, we examined a 4-level DVV measure: no DVV, physical only, sexual only, and both physical and sexual. Male students had a significantly lower prevalence of DVV compared with female students. By using the 4-level measure of DVV, after adjusting for covariates, sexual DVV only (aPR = 1.61, 95% CI: 1.21-2.12) and both physical and sexual DVV (aPR = 1.65, 95% CI: 1.26-2.17) were positively associated with NUMPD among boys, whereas among girls, physical DVV only (aPR = 1.42, 95% CI: 1.16-1.75) and both physical and sexual DVV (aPR = 1.43, 95% CI: 1.03-1.99) were positively associated with NMUPD. NMUPD was associated with experiences of DVV among both male and female students. Community- or school-based adolescent violence and substance use prevention efforts would be enhanced by considering the association between DVV and substance use, particularly NMUPD among both male and female adolescents, to address these public health problems.

Unhealthy Weight Management Practices and Non-medical Use of Prescription Drugs.

Non-medical use of prescription drugs (NMUPD) has reached epidemic proportions in the U.S. With approximately one in five high school students engaging in NMUPD, it is important to understand behavioral correlates. Data were combined from the 2011 and 2013 cycles of the Youth Risk Behavior Survey, a nationally representative, cross-sectional survey. After restricting the analytic sample to students who reported a weight loss goal of either staying the same weight or losing weight, logistic regression models were used to estimate adjusted prevalence ratios and 95% CIs for associations between unhealthy weight management practices (UWMPs) and lifetime NMUPD. Individual UWMPs-fasting; taking diet pills, powders, or liquids without a doctor's advice; and vomiting or taking laxatives-and total number of UWMPs were examined. Data were analyzed in 2016. UWMPs were more prevalent among female students (21.1% vs 10.7% for fasting; 7.5% vs 5.2% for taking diet pills, powders, or liquids; and 7.6% vs 3.2% for vomiting or taking laxatives). Significant associations between individual UWMPs and NMUPD and between the number of UWMPs and NMUPD were observed. UWMPs were associated with NMUPD. Health educators in the school setting, as well as other health professionals who provide services to an adolescent population, can focus on healthy weight management strategies, and other substance-specific messages. The association between UWMPs and NMUPD may reflect a constellation of problem behaviors exhibited among some adolescents.

Posttraumatic Stress Symptoms and Nonmedical Prescription Drug Use Among College Students With Trauma Exposure

abstractObjective: Nonmedical prescription drug use, defined as using the drug without a prescription or in ways for which it is not prescribed, and traumatic event exposure are highly prevalent among college students. Despite evidence that posttraumatic stress symptoms could place college students at risk for nonmedical prescription drug problems, no studies have examined this relationship. This study was a preliminary examination of posttraumatic stress symptoms, lifetime nonmedical prescription drug use, hazardous use, and dependence symptoms among college students with trauma exposure. Methods: Participants were students attending a rural college in Virginia, recruited through psychology classes, flyers, LISTSERVs, and announcements at student events. All students who reported experiencing at least one traumatic event were included (N = 119); participants' mean age was 19.7 years (SD = 1.90), about half were women (n = 63, 53%), and most were Caucasian (n = 103, 87%). Results: Nearly 60% of participants (n = 71) reported using nonmedical prescription drugs at least once during their lifetime and were more likely than those with no use to report hazardous alcohol use (p < .01) and depressive symptoms (p < .05). There were no other significant differences between those who did and did not report use of nonmedical prescription drugs. Regression analyses showed that posttraumatic stress symptom frequency was positively associated with hazardous nonmedical prescription drug use, after controlling for gender, depressive symptoms, and hazardous alcohol use (p < .001). Posttraumatic stress symptom frequency was higher for those with any nonmedical prescription drug dependence symptoms (p < .001), but was unrelated to whether the student had ever engaged in nonmedical prescription drug use. Conclusions: Findings suggest that consideration of the types of behaviors and problems a college student is experiencing related to nonmedical prescription drug use may be more relevant to posttraumatic stress symptom frequency than dichotomous measures of nonmedical prescription drug use alone. Further, the association between the frequency of posttraumatic stress symptoms and both hazardous nonmedical prescription drug use and dependence symptoms among college students with a trauma history deserves further investigation due to the resulting vulnerability to increasingly negative outcomes.

A survey of nonmedical use of tranquilizers, stimulants, and pain relievers among college students: Patterns of use among users and factors related to abstinence in non-users

BackgroundThis study examined lifetime non-medical prescription drug use among college students at a small liberal arts college in the Northeast. We assessed the motives, frequency of use, sources, and perceived emotional/physical risks of nonmedical prescription drugs. Specifically, we examined the non-medical use of prescription pain relievers, stimulants, and anti-anxiety medication. MethodsWe sent an internet-based survey to 1/3 of the student body and 303 students completed the survey. ResultsWe found that 36.8% of the sample reported using prescription drugs for non-medical purposes. First-year students were less likely to have used the drugs than those in other class years. Of those reporting use, 48% reported non-medical use of pain relievers, 72.8% reported using stimulants, and 39.8% reported using anti-anxiety medication. The most commonly used pain relievers were Vicodin (hydrocodone/acetaminophen), OxyContin (oxycodone), and codeine (acetaminophen/codeine). The most commonly used stimulants were Adderall (amphetamine/dextroamphetamine) and Ritalin (methylphenidate), while the most commonly used anti-anxiety medication was Xanax (alprazolam). When non-users were asked what factors influenced their choice not to abuse prescription drugs, 82% cited a lack of interest, 61% responded it was due to a fear of damaging their physical health, and 60.1% responded fear of damaging their mental health. ConclusionThis study supports recent findings that show widespread non-medical use of prescription drugs among college students. Our report brings a more detailed understanding of the patterns of drug usage, and the factors influencing both drug use in those who use them and abstinence in those who choose not to use them.

Sex and Grade Level Differences in Lifetime Nonmedical Prescription Drug Use Among Youth

Nonmedical prescription drug (NMPD) use is a significant health issue among youth. The purpose of this study was to examine NMPD use among students in 7th through 12th grades. A total of 54,631 students participated in the study, which utilized the PRIDE Questionnaire. A total of 13.6 % of youth reported lifetime NMPD use. Hispanic youth were more likely than white or African American youth to report use of NMPDs. Engaging in high levels of pro-social behaviors and having high levels of parent and teacher/school protective factors decreased the odds of use among males, females, 7th and 8th grade students and 9th through 12th grade students. Conversely, engaging in risky behaviors and having friends who used other substances increased the odds for use. Study findings highlight the increasing problem of prescription drug use. Prevention professionals may benefit from findings that can be used to tailor educational initiatives to students.

Social Determinants to Nonmedical Prescription Drug Use among Multiracial Youth

Background: The prevalence of Nonmedical prescription drug (NMPD) use, which is defined as using prescription drugs without a doctor’s prescription, is increasing among youth. The present study examined Nonmedical prescription drug (NMPD) use among Multiracial students in 7th through 12th grades. Method: A total of 2,134 students completed the PRIDE Questionnaire, which examines alcohol and drug use among youth. Results: A total of 14.8% of students reported using NMPDs in their lifetime. No significant differences were found based on sex. High school students were significantly more likely than junior high school students to use NMPDs. Results indicated that friends’ involvement in tobacco, alcohol, and marijuana was associated with significantly greater odds of lifetime Nonmedical prescription drug use. Involvement in risky behaviors also increased the odds of use. Conclusions: NMPD use is a significant issue among Multiracial youth. Specific prevention efforts should be implemented. Findings from this study may be used to develop prevention programs for Multiracial youth.

Nonmedical Use of Prescription Drugs and HIV Risk Behavior in Gay and Bisexual Men

Previous research has demonstrated associations between substance use and sexual risk behavior in men who have sex with men (MSM). Recent trends in substance use show increasing use of prescription medications (e.g., Vicodin) without a physician's prescription, yet associations between the nonmedical use of prescription drugs (NMUPD) and HIV risk behavior have not been well examined in MSM. MSM attending a gay pride festival completed a self-report measure assessing NMUPD, motivations for use, use of traditional recreational drugs, and HIV risk behavior. More than one-third of the sample (38%) reported lifetime NMUPD and 17% reported NMUPD in the previous 3 months. The most common class of medications used was prescription analgesics. Men reporting NMUPD also reported higher rates of the use of marijuana, poppers, ecstasy, cocaine, methamphetamine, GHB, ketamine, heroin, and rohypnol, and had significantly higher rates of HIV risk behaviors, including more sexual partners and more unprotected sex. A significant minority of MSM are using prescription medications without a doctor's consent. Men who do so are risking negative consequences of such use, including the potential for addiction, potentially dangerous interactions between prescription and recreational drugs, and greater risk for contracting HIV.

Nonmedical Prescription Drug Use Among US College Students at a Midwest University: A Partial Test of Social Learning Theory

We estimate the prevalence of nonmedical prescription drug (NMPD) use and test social learning theory as an explanation for NMPD use based upon data from a large pilot study. Data were collected from 465 college students at a Midwestern university in the USA using a self-administered questionnaire. The sample was predominantly white (88%), 43% were female and the mean age was 22. Most participants (80%) were not members of social fraternities or sororities. A majority of students did not report NMPD use: 39.4% of respondents reported lifetime NMPD use, 31% reported past-year use, and 14.4% reported past-month use. Multivariate regression results partially supported social learning theory as an explanation for lifetime NMPD use. Limitations and suggestions for future research are suggested.