Motivations For Misuse Research Articles

Motivations for prescription drug misuse among young adults: Considering social and developmental contexts

Aims: This study aimed to explore motivations for prescription drug (i.e. prescription pain killers, stimulants and sedatives) misuse among young adults active in urban nightlife scenes in New York City. Prior research has established “recreation” and “self-medication” as the primary motivations among this age group, but, as prescription drug misuse continues to be a major public health concern in the US and rates of misuse are highest among young adults, a more nuanced analysis is necessary for developing meaningful interventions. As part of a larger study on prescription drug misuse among young adults active in urban nightlife scenes, we examined participants’ motivations for misuse. Prescription painkillers, stimulants and sedatives were the primary substances of interest. Methods: Participants were recruited from nightlife venues in New York using time-space sampling. Subjects completed a mixed-methods assessment at project research offices. The data presented here are from a subsample of 70 qualitative interviews conducted during the baseline assessment. Findings: We identified experimentation and a “work hard, play hard” ethos as key motivations for misusing prescription drugs and argue that these motivations are specific, though not necessarily unique, to the participants’ social location as young adults. These findings highlight the role of life stage and social context in the misuse of prescription drugs. Conclusion: Future studies of prescription drug misuse should pay attention to the larger social contexts in which users are embedded and, therefore, make decisions about how and why to misuse. Moving beyond the very broad concepts of “recreation” and “self-medication” presently established in the research, policies targeting young adults should include educational components focused on denormalising prescription drugs, and interventions should be tailored to transitional contexts and the associated motivations those contexts foster.

Motivations for prescription drug misuse among young men who have sex with men (YMSM) in Philadelphia

BackgroundPrescription drug misuse (i.e. opioids, tranquilizers and stimulants) has become the fastest growing area of substance abuse among young adults. Limited studies focus on prescription drug misuse among young men who have sex with men (YMSM, aged 18–29 years). Furthermore, little is known about YMSM's motivations for misuse. The purpose of this study was to explore personal motivations for prescription drug misuse among YMSM, including the possible connection between misuse and sexual behaviors. MethodsAs part of a larger mixed methods study of 191 YMSM recruited in Philadelphia during 2012–2013, we conducted semi-structured qualitative interviews with 25 of these participants to gather additional contextual information about their prescription drug misuse. We conducted thematic analysis of qualitative data. ResultsWhile our results corroborated previous literature on motives for misuse of prescription drugs, our data yielded some distinct motivations specific among YMSM. These motives included social/recreational motives, facilitating sex with other men (including motives such as use of opioids for less painful anal receptive sex), and psychological motives such as depression, stress management, coping with everyday hardships (opioids and tranquilizers) or feeling more energized (stimulants). Prescription drugs were commonly misused within the broader contexts of participants’ polysubstance use, adding to the significance of this problem. ConclusionsOur findings offer insights into YMSM's motivations for prescription drug misuse, and point to the importance of recognizing and addressing them. While substance use is likely related to various psychosocial issues impacting YMSM, it also may lead to significant health consequences. Results support the need to include prescription drugs and polysubstance use in harm reduction messages and treatment approaches aimed at substance using YMSM.

Factors associated with the inappropriate use of antimicrobials.

Antimicrobial resistance continues to grow and antimicrobial use in food animal production and to a lesser extent in human patients is under fire. Much of the criticism has to do with the misapplication of these drugs in both settings. Research indicates that patients, food animal producers, physicians and veterinarians have all played a part in misusing antimicrobials, often because of mistaken beliefs. This paper reviews this research and introduces a theoretical perspective, the Theory of Planned Behavior (TPB), which broadens our understanding of the motivations for misuse. In particular this approach shows that individuals making decisions about antimicrobial use take into account social pressures from and a sense of obligation to significant others in their social networks. Our own work summarized in this paper indicates that both feedlot veterinarians and feedlot managers' antimicrobial decisions are influenced by both expectations from and obligations to a variety of actors in the feedlot network (other veterinarians, feedlot clients, consumers, pharmaceutical companies, and regulatory bodies). Generally across 4 circumstances of antimicrobial use (for acutely sick cattle, chronically-sick cattle, at-risk cattle, high-risk cattle), it is largely the perception that peers and clients expect feedlot veterinarians to use antimicrobials and feedlot veterinarians sense of obligation to these groups that have the most influence on their decisions to recommend antimicrobials. Based on these findings, the question of engaging in changing the choices made by those working with food animals must start with those who influence the decision to proscribe or use antimicrobials. As our data come from the United States and may be unique relative to other countries, these efforts should begin by ascertaining who influences these decisions. The next step is to then change the beliefs of these significant others.

Characteristics and consequences of prescription drug misuse among university students in the United Kingdom

Introduction: Prescription drug misuse is associated with various problems relating to physical health, psychological disorders, social relationships, as well as broader societal and economic problems. Research in the United States has shown that university students are a high-risk group for involvement in prescription drug misuse. There has been almost no research on prescription drug misuse among university students outside of the United States. Methods: The study was based on an online survey of students currently registered at a university in north Wales. Respondents completed a structured questionnaire covering topics relating to the characteristics and consequences of prescription drug misuse. The analysis was based on those students reporting prescription drug misuse. Results: The most common medications misused were prescribed pain relievers, tranquillisers and sedatives. The main motives for misuse were to obtain the therapeutic benefits of the drug, recreational purposes and mood enhancement. The main problems associated with prescription drug misuse were addiction, physiological and psychological disorders and relationships. Conclusion: The study revealed a wide range of problems experienced by students who misuse prescription drugs. More could be done to tackle prescription drug misuse among students through campus-based drug prevention programmes.

The Effect of Inmate Populations on Estimates of DSM-IV Alcohol and Drug Use Disorders in the United States

To The Editor: Most national estimates of adult DSM-IV substance use disorder (e.g., National Epidemiologic Survey on Alcohol and Related Conditions [1], and National Survey on Drug Use and Health [2]) are based on household samples that exclude prison and jail inmates, populations known to have high rates of substance use disorders. To estimate the effect of excluding inmates, we present estimates of alcohol and drug use disorders for household and inmate populations and calculate the change in the overall prevalence of substance use disorder when these two populations are pooled. Prevalence estimates for the combined U.S. household and inmate population are weighted averages of the survey-weighted prevalence estimates for the household population, state prison population, federal prison population, and jail population (1, 3–5). As seen in Table 1, details about interviewing and how weighted averages and standard errors were calculated are reported (also see the data supplement accompanying the online version of this letter). Table 1 Effect of Adding the Inmate Population to Household Prevalence and Population Estimates of the Prevalence of Past 12 Month DSM-IV Alcohol and Drug Use Disorders in U.S. Adults Including inmates increased overall projected estimates of the number of persons in the United States aged ≥18 years with an alcohol use disorder by 877,000, from 17,580,000 to 18,457,000, a 5.0% increase over the base. Estimates of the number with an illicit drug use disorder increased by 1,043,000, from 4,159,000 to 5,202,000, a 25.1% increase. Overall prevalence of the specific alcohol abuse and dependence disorders increased over the base by 4.2% and 5.9% respectively, and illicit drug abuse and dependence increased by 12.0% and 53.8%. High rates of DSM-IV substance use disorders among inmates combined with a large inmate population means that many persons with alcohol and drug use disorders are missed by major U.S. national general population surveys. The undercount for both alcohol and illicit drug disorders is significant, but proportionately the undercount for alcohol disorders is modest while the proportionate undercount for illicit drug disorders, particularly illicit drug dependence (i.e., addiction), is large. These results likely would be accentuated for substances such as cocaine, methamphetamine, and heroin, which are rare in the household population (2) but common among inmates (4–5). In addition, prevalence rates may be particularly underestimated for men and for those minority populations that are overrepresented in the inmate population. To improve accuracy and cover the full range of cases, the U.S. surveillance system may need to be modified. In addition, further investigation of the effect of incarceration on estimates for specific subpopulations is warranted.