Prescription Medication Misuse Research Articles

Electronic survey investigating UK veterinarians’ perceptions of the potential for veterinary prescription medication misuse or abuse

ObjectiveTo investigate veterinarians’ experience and perception of the risk of veterinary prescription medication (VPM) misuse and abuse by the public and veterinary professionals and to determine the clinical context in which respondent veterinarians prescribed certain VPMs. Study designAnonymous online voluntary survey. PopulationA total of 361 of 7126 veterinarians registered as practicing in the UK, who provided e-mail contact details to the Royal College of Veterinary Surgeons Knowledge for participation in research. Respondents included general practitioners, with or without further qualifications, and European specialists, covering charity, private or academic small, large or mixed animal practice. MethodsThe anonymous online survey, open from September to December 2021, posed 27 questions regarding personal experience and perception of VPM misuse or abuse, including which VPMs were considered most at risk of abuse by clients or veterinary staff. Thematic analysis was performed on free-text sections. ResultsThe participation rate was 5% (361/7126), and the completion rate 60% (216/361 respondents). Of these, 88% of respondents somewhat agreed, agreed or strongly agreed that some VPMs were at risk of abuse. A third (29.9%; 107/358) had suspected an owner of taking VPMs, and one fifth (20.1%; 72/358) had suspected veterinary staff. Perceptions regarding the likelihood of public VPM abuse ranged from not suspecting a problem to having first-hand experience. Drugs considered most at risk of owner abuse were opioids, benzodiazepines and gabapentin, and those for veterinary staff were opioids, benzodiazepines and ketamine. Numerous ‘red flags’ prompting suspicion of VPM abuse were identified alongside ways of mitigating risk. Conclusions and clinical relevanceVeterinarians in the UK reported varied experiences with, awareness of, and attitudes towards VPM abuse by the public and veterinary staff. Although not quantified, the UK veterinary industry could be a source of abusable drugs.

Specificity in genetic and environmental risk for prescription opioid misuse and heroin use.

Many studies aggregate prescription opioid misuse (POM) and heroin use into a single phenotype, but emerging evidence suggests that their genetic and environmental influences may be partially distinct. In total, 7164 individual twins (84.12% complete pairs; 59.81% female; mean age = 30.58 years) from the Australian Twin Registry reported their lifetime misuse of prescription opioids, stimulants, and sedatives, and lifetime use of heroin, cannabis, cocaine/crack, illicit stimulants, hallucinogens, inhalants, solvents, and dissociatives via telephone interview. Independent pathway models (IPMs) and common pathway models (CPMs) partitioned the variance of drug use phenotypes into general and drug-specific genetic (a), common environmental (c), and unique environmental factors (e). An IPM with one general a and one general e factor and a one-factor CPM provided comparable fit to the data. General factors accounted for 55% (a = 14%, e = 41%) and 79% (a = 64%, e = 15%) of the respective variation in POM and heroin use in the IPM, and 25% (a = 12%, c = 8%, e = 5%) and 80% (a = 38%, c = 27%, e = 15%) of the respective variation in POM and heroin use in the CPM. Across both models, POM emerged with substantial drug-specific genetic influence (26-39% of total phenotypic variance; 69-74% of genetic variance); heroin use did not (0% of total phenotypic variance; 0% of genetic variance in both models). Prescription sedative misuse also demonstrated significant drug-specific genetic variance. Genetic variation in POM, but not heroin use, is predominantly drug-specific. Misuse of prescription medications that reduce experiences of subjective distress may be partially influenced by sources of genetic variation separate from illicit drug use.

Psychological distress, non-medical use of prescription medications, and perceived unmet mental health care needs: a cross-sectional study of Ontario students.

The non-medical use of prescription medications among adolescents has become a concerning public health issue. This study assessed the prevalence of the non-medical use of prescription medications in Ontario high school students, and explored the moderating effect of this use on the relationship between psychological distress and unmet mental health needs. Cross-sectional data for 4896 students, age 14-18, were drawn from the 2019 Ontario Student Drug Use and Health Survey. Psychological distress was measured using the Kessler-6 Distress Scale, unmet mental health needs were defined by self-report (yes/no), and non-prescription medication use was defined by self-reported frequency of use. Using logistic regression, we explored the effect of the non-medical use of prescription medications on the relationship between psychological distress and unmet mental health needs. High proportions of Ontario students reported serious psychological distress (22%), some degree of unmet mental health need (38%), and/or non-medical use of prescription medications (13%). While there were strong associations between psychological distress and unmet mental health need, this association was weaker among those reporting non-medical use of prescription medications (OR = 3.3, 95% CI 1.9-5.7) compared to non-users (OR = 5.6, 95% CI 4.5-7.1). Our findings suggest that Ontario students experiencing distress and using non-prescribed medications are less likely to identify a need for mental health support, highlighting the consequences of apparent self-medication through misuse of prescription medications. To assist in the redirection of adolescent perceptions of healthy coping strategies, population-based educational programming, with targeted promotion of both formal and informal mental health care resources, should be considered.

Prescription drug abuse in migrants from Middle Eastern and North African countries: a review

IntroductionIn recent years, there has been a rise in misuse of low-cost prescription pills across Middle Eastern and North African (MENA) countries. In Algeria, Tunisia and Morocco, for example, the consumption of prescription medications has dramatically increased, particularly amongst young and marginalized groups. Drugs such as clonazepam and pregabalin are extremely popular in these regions, as they are relatively inexpensive and perceived as safe. With the migration of MENA citizens to Europe, it is likely that mental health services will come across substance use disorders related to these medications.ObjectivesThe authors aim to analyse prescription medication misuse reports from MENA countries, specifically pregabalin and clonazepam, and review the pharmacological, neurobiological and social factors that contribute to their potential for abuse.MethodsNarrative review of articles referenced on PubMed and Google Scholar.ResultsPregabalin and clonazepam are widely used in psychiatry and neurology. Pregabalin is an alpha 2 omega ligand with supposed GABA-mimetic properties. Anecdotal reports suggest that pregabalin, used recreationally in amounts up to 3-20 times the therapeutic doses, possesses both sedative and psychedelic effects. Experimenters are mainly individuals with a history of recreational polydrug use, who are aware that pregabalin is not included in standard drug monitoring tests, with this molecule being used in some instances as a legal substitute of common illegal drugs. Clonazepam is a benzodiazepine that combines high potency and a long duration of action and is said to cause euphoria at doses over 8mg. It is very popular and affordable, placing consistently in the top three of benzodiazepines sales across the globe. Clonazepam has potential for tolerance build up and severe withdrawal symptoms. These medications are frequently used together and in combination with other substances such as alcohol and opiates, increasing the risk for respiratory failure and death.ConclusionsPrescription medications such as pregabalin and clonazepam are extremely accessible, inexpensive and highly addictive substances, whose abuse is well disseminated across MENA countries. With migratory flows from this region, the prevalence of misuse of these drugs in Europe is expected to increase. Therefore, physicians should be aware of their potential for abuse and carefully evaluate patients’ previous history before prescribing these medications.Disclosure of InterestNone Declared

Behaviors associated with HIV transmission risk among rural sexual and gender minority and majority residents

ABSTRACT Multiple rural states and communities experience elevated rates of human immunodeficiency virus (HIV), often associated with diminished healthcare access and increased drug use. Though a substantial proportion of rural populations are sexual and gender minorities (SGM), little is known of this group regarding substance use, healthcare utilization, and HIV transmission behaviors. During May–July 2021, we surveyed 398 individuals across 22 rural Illinois counties. Participants included cisgender heterosexual males (CHm) and females (CHf) (n = 110); cisgender non-heterosexual males and females (C-MSM and C-WSW; n = 264); and transgender individuals (TG; n = 24). C-MSM participants were more likely to report daily-to-weekly alcohol and illicit drug use prescription medication misuse (versus CHf; aOR = 5.64 [2.37–13.41], 4.42 [1.56–12.53], and 29.13 [3.80–223.20], respectively), and C-MSM participants more frequently reported traveling to meet with romantic/sex partners. Further, more C-MSM and TG than C-WSW reported healthcare avoidance and denial due to their orientation/identity (p < 0.001 and p = 0.011, respectively); 47.6% of C-MSM and 58.3% of TG had not informed their provider about their orientation/identity; and only 8.6% of C-MSM reported ever receiving a pre-exposure prophylaxis (PrEP) recommendation. More work is needed to explore the substance use and sexual behaviors of rural SGM, as well as their healthcare interactions, to better target health and PrEP engagement campaigns.

‘It's a horrible situation for everyone’: The impact of over the counter and prescription medication misuse on friends and family

Introduction Over the counter and prescription-only medication misuse is of concern. Little is known about the impact on friends/family who provide individuals with support. It is important to increase understanding to identify how substance misuse services (SMS) and others can better meet their needs. The aim is to explore the impact of over the counter and prescription-only medication misuse on friends/family and improve an understanding of how this may be reduced. Methods Ethical approval was obtained and confidential semi-structured interviews were undertaken with a modified grounded theory approach. Participants were recruited from community adult SMS in England. Verbatim transcripts underwent thematic analysis using NVIVO, and findings are reported in line with COREQ. Results Eight telephone interviews (62.5% female) included a variety of different friend/relative relationships. Data saturation was felt to have been achieved, and identified that friends/family were significantly impacted, in long-standing and varying negative ways. Five themes were identified: impact on finances; impact of managing side-effects/withdrawal symptoms; impact on relationships; treatment interventions and personal support. Especially due to the psychological burden, friends/family benefit from holistic support, including improved awareness of over the counter and prescription-only medication misuse and interventions from healthcare/SMS providers, social services, affected others and their personal support network. Relationships where honesty and openness are encouraged, enable friends/family to provide more support and advocacy. Conclusions Care providers should include friends/family when delivering holistic interventions. They should be vigilant for safeguarding issues and the impact on children, and improve approaches to withdrawal symptom/side-effect management, medicines optimisation and service responsiveness. Future research should include more participants and other SMS.

152. The association of opioid use disorder on perioperative outcomes following lumbar spine laminectomy

<h3>BACKGROUND CONTEXT</h3> Opioid use disorder (OUD) is characterized by a pattern of excessive, chronic opioid use leading to problems or distress, which can involve misuse of prescription medication, use of diverted medication or illegally obtained heroin. Studies have reported the prevalence of patients who consume opioids prior to spine surgery to be as high as 72%. Additionally, chronic opioid use and misuse have been linked to several complications following spine surgery. <h3>PURPOSE</h3> The purpose of this study was to determine the association of OUD on perioperative. outcomes following lumbar spine laminectomy. Specifically, we investigated the impact of OUD on: 1) in-hospital LOS, 2) readmission rates, 3) medical complications and 4) health care expenditures. <h3>STUDY DESIGN/SETTING</h3> A retrospective analysis from January 1st, 2005 to March 31st, 2014, of the 100% Medicare Standard Analytical Files (SAF) was performed from the for-fee based PearlDiver (PearlDiver Technologies, Fort Wayne, Indiana, United States) database. <h3>PATIENT SAMPLE</h3> The dataset was initially queried for all patients who underwent lumbar spine laminectomy using the following CPT codes: 63005, 63012, 63017 and 63047. Patients who had OUD were identified using ICD-9 diagnostic codes 304.01, 304.02, 305.51 and 305.52. These procedural and diagnostic codes were utilized as they have been used in previously published studies. A total of 131,635 patients who underwent lumbar spine laminectomy were identified for analysis following the inclusion/exclusion criteria. Of these cases, 3,515 (2.67%) had OUD while 128,120 (97.3%) served as the comparison cohort. <h3>OUTCOME MEASURES</h3> Primary endpoints of the study were to compare in-hospital LOS, readmission rates, medical complications, and healthcare expenditures. Readmission rates and medical complications were those which occurred within the 90-day episode of care interval. Complications analyzed included: acute kidney injuries, cerebrovascular accidents, deep vein thromboses, ileus episodes, myocardial infarctions, pneumoniae, pulmonary emboli, respiratory failures, transfusion of blood products, urinary tract infections, and venous thromboemboli. For health care expenditures, day of surgery and total global 90-day episode of care interval costs were analyzed using reimbursement data. Reimbursements were chosen as they are a more accurate predictor of what providers are paid from the insurance companies. <h3>METHODS</h3> Baseline demographics of the two cohorts were analyzed using Pearson's Chi-Square Analyses or Fischer's Exact test for categorical variables. For continuous variables, Welch's t-tests were used to assess for significance for LOS, healthcare expenditures, and mean Elixhauser Comorbidity Index scores between the two cohorts. A multivariate binomial logistic regression model was constructed to determine the association of OUD on readmission rates and medical complications. The model was adjusted for age, sex, alcohol use disorder, chronic obstructive pulmonary disease (COPD), diabetes mellitus, general anxiety disorder, hyperlipidemia, hypertension, obesity - defined as a body mass index (BMI) greater than 30 kilograms per meter squared (kg/m²) and tobacco use. These comorbid conditions were entered into the regression model as studies have shown OUD to be associated with these comorbid conditions. Incidency and Odds Ratios (OR) are reported. To reduce the probability of a type I error, a Bonferroni-correction was performed, and a p-value less than 0.001 was considered to be statistically significant. <h3>RESULTS</h3> Patients with an OUD undergoing lumbar laminectomy had significantly longer in-hospital LOS (3.68 days vs. 1.13 days, p<0.0001). Readmission rates were significantly higher (14.57% vs 7.39%, OR: 1.73, p < 0.0001) of 90-day medical complications including transfusion of blood products (0.54% vs 0.15%, OR: 5.12, 95% CI: 2.92 -8.48, p < 0.0001), in patients who had an OUD. The study cohort was found to have higher incidence and odds (32.36% vs 9.76%, OR: 3.53, p<0.0001), pneumoniae (6.29% vs 1.23%, OR: 5.23, 95% CI: 3.57 - 4.99, p<0.0001), respiratory failures (0.54% vs 0.12%, OR: 4.07, 95% CI: 2.29 - 6.87, p<0.0001), urinary tract infections (14.54% vs 4.49%, OR: 3.57, 95% CI: 3.19 - 3.97, p<0.0001), acute kidney injuries (4.84% vs 1.36%, OR: 3.31, 95% CI: 2.75 - 3.95, p<0.0001), in addition to other medical complications compared to patients without OUD. Patients with OUD had higher total global 90-day episode of care reimbursement rates ($13,635.81 vs $8,131.20, p<0.0001) compared to their counterparts. <h3>CONCLUSIONS</h3> Patients with an OUD are at a significant risk for increased in-hospital LOS, readmission rates, medical complications and health care expenditures following lumbar decompression surgery. Spine surgeons should seek to identify patients with an OUD and determine strategies to optimize patient care in the perioperative course of lumbar surgery. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Misuse of Prescription Medications among Individuals with Mobility Disability

Background The ability of walking a quarter mile is predictive of subsequent disability, mortality, and health care costs. Individuals with mobility disability are at increased risk of chronic conditions and unmet care needs. Thus they may misuse prescription medications to self-medicate. Objectives We aimed to explore the difference of misuse of four types of prescription medications (sedatives, tranquilizers, painkillers, depression medications) and overall misuse by mobility status and identify the correlates of overall misuse. Methods A national probability sample from the survey Midlife in the United States (MIDUS) was used to assess the difference in misuse by mobility status during 2011–2014. To assess the correlates of misuse, mobility status, usual source of care, unmet care needs, insurance coverage, sociodemographic variables, and clinical conditions were added to a survey weighted logistic regression model with backward selection. Results Compared to those without mobility disability, individuals with mobility disability had higher risk of misuse in most types of medications and in overall misuse. Mobility disability, lower education, unmarried status, the emergency room or public health clinic as the most often used care, pain, and depressed affect were identified as correlates of overall misuse of studied medications. Conclusions Individuals with mobility disability are a vulnerable group susceptible to medication misuse, which warrants the urgent need for interventions to ameliorate misuse and reduce risks in this population.

Survey of noncontrolled medication misuse patterns.

IntroductionThe abuse potential of opioids and other controlled substances is well-known; however, reports of noncontrolled prescription medication (NCPM) misuse deserves further attention. Whereas several studies investigate patterns, motivations, and biochemical mechanisms underlying the misuse potential of NCPM, the clinical significance of NCPM misuse is not well-understood. The primary objectives of this project were to identify prescriber perceptions of NCPM misuse and evaluate patient reported patterns of misuse through survey responses.MethodsAdult patients admitted to psychiatry services and prescribers working in psychiatry or on a general medicine service during the study time frame were invited to participate. Surveys were collected anonymously for both patients and prescribers.ResultsNCPM misuse was reported by 38.4% of patients. Trazodone (35%) and quetiapine (30%) were most commonly reported as being misused. Opioid (24.1% vs 4.3%; P = .023) and cannabis use disorders (13.8% vs 0%; P = .019) were reported more frequently in patients who misuse NCPM, whereas no difference was seen for other SUDs (P > .05). There was no difference between psychiatric and general medicine prescribers regarding familiarity with NCPM misuse (n = 21 [87.5%] vs n = 13 [81.3%]; P = .668).DiscussionHigh rates of NCPM misuse were seen in this patient population. Our findings confirm previous reports of quetiapine misuse and also reveal that trazodone is frequently misused. Based on the observations in this study, the misuse of NCPM is identified as prevalent and noteworthy at our institution, warranting provider education and future studies.

The relationship between health behaviors and emergency department visits and hospitalizations after traumatic spinal cord injury.

Cross-sectional study. To identify demographic, injury, and behavioral predictors of emergency department (ED) visits and ED-related hospitalizations among individuals with chronic traumatic spinal cord injury (SCI). An academic medical center in the Southeastern United States. 4057 participants who were at least 18 years of age and 1 year post traumatic SCI with residual neurologic impairment were identified from three cohorts: a rehabilitation specialty hospital in the Southeastern USA and two SCI Surveillance System Registries, one in the Midwestern and one in the Southeastern USA. The participants completed a self-reported assessment on ED visits and ED hospitalizations (yes/no) in the past 12 months. Logistic regression models were used to examine the relationship between ED visits/hospitalizations and eight behavioral indicators, including body weight, healthy diet, drinking, smoking, non-medical substance usage, prescription medication usage, prescription medication misuse, and the planned exercise. During the study period, 41% of participants reported having at least one ED visit and 21% participants reported hospitalization after ED visit in the past 12 months. High frequency of prescription medication usage, prescription medication misuse, and lack of planned exercise were associated with greater odds of at least one ED visit and at least one ED-related hospitalization, while smoking was only associated with ED visits. Health care professionals should be aware that ED visit and related hospitalization prevalence remain high among people with chronic SCI, and there is significant need for intervention of managing risk behaviors and promoting healthy behaviors after SCI.

182. The Impact of the COVID-19 Pandemic on Adolescent Social Media Use, Substance Use, and Depressive Symptoms: A Scoping Review

We conducted a scoping review of published, peer-reviewed literature in order to characterize and synthesize the existing literature on the impact of COVID-19 on adolescent social media use, substance use (i.e. alcohol, cannabis, electronic vapor products, and prescription medication misuse), and depressive symptoms in the United States.

Staying Pressure Injury Free: The Role of Modifiable Behaviors

ObjectiveTo investigate the association of behavioral factors with retrospective reports of staying free from pressure injuries (PIs) during a 12-month period for people with chronic spinal cord injury (SCI). DesignCross-sectional survey. SettingData collection was completed at an academic medical center in the Southeastern United States in collaboration with a specialized treatment center and 2 public health registries that use population-based approaches to identify all incident cases of SCI within the state. ParticipantsThe participant cohort was composed of 3817 adults (N=3817) with traumatic SCI of at least 1-year duration. InterventionsNot applicable. Main Outcome MeasuresSelf-reported recall of staying PI-free for 12 months vs having 1 or more PIs. ResultsAmong the 3817 participants, 74% were male, 76% were non-Hispanic White, and mean age was 48 years, with an average of 12 years post SCI. Based on self-report assessment, 67% reported being PI-free in the past year. After controlling for the demographic and injury characteristics, we found that those in the clinical cohort and those who reported healthy diets and planned exercise at least once a week were more likely to be PI-free; being underweight and high frequency of prescription medication use for spasticity, pain, and depression were negatively associated with being PI-free. Smoking, alcohol use, nonmedical substance use, and prescription medication misuse were not statistically significant in the multivariate model. ConclusionsThere are several significant behavioral predictors of being PI-free, and consideration of these factors may be used to develop tailored strategies to promote healthy skin maintenance and the prevention of multiple, severe, and recurrent PI.

Associations between having been threatened or injured with a weapon and substance use and mental health among high school students in the United States

Being threatened or injured with a weapon is a serious form of physical bullying. Little is known about the effects of being threatened or injured with a weapon on substance use and mental health among adolescents. A secondary analysis of 2017 Youth Risk Behavior Survey data assessed the associations between having been threatened or injured with a weapon and substance use (binge drinking, marijuana, tobacco use, prescription medication misuse) and mental health (feeling sad or hopeless, considering suicide). Multiple logistic regression models with complex survey weights were used, controlling for potential confounders. Approximately 6.0% of students reported having been threatened/injured with a weapon. After adjusting for covariates, having been threatened/injured with a weapon was associated with binge drinking (AOR = 2.5; 95% CI: 1.9–3.4), marijuana (AOR = 2.1; 95% CI: 1.6–2.7), tobacco use (AOR = 2.6; 95% CI: 2.0–3.5), and misuse of prescription medication (AOR = 2.2; 95% CI: 1.6–3.0) compared with students who have not been threatened/injured. Having been threatened/injured with a weapon was associated with 1.6 times the odds (95% CI: 1.2–2.2) of feeling sad/hopeless and 1.7 times the odds (95% CI: 1.3–2.3) of considering suicide. Having been threatened or injured with a weapon is an important public health issue associated with negative mental health and substance use.

Racial-ethnic Differences in Reasons for Misuse of Prescription Medications Among US Adults.

This study aims to investigate racial-ethnic differences in reasons for misuse of prescription medications among a nationally representative sample of US adults. We analyzed data from the 2015-2019 National Surveys on Drug Use and Health. The study population includes US adults (18-49 years old) who reported misuse of 3 types of prescription drugs (stimulants [n = 6139], sedatives and tranquilizers [n = 5643], and pain relievers [n = 8780]) for 3 reasons: medical-only (eg, to help with pain), recreational-only (eg, to get high), or combined medical and recreational reasons. Multinomial logistic regressions assessed the association between reasons of misuse of prescription medications and self-identified race-ethnicity. Misuse of the 4 types of prescription medications was primarily motivated by medical reasons (63%-80%). Compared to non-Hispanic Whites, non-Hispanic Blacks (nHB), and Hispanics (H) were less likely to report misuse of pain relievers for combined (nHB: adjusted relative risk ratio [aRRR] = 0.6, 95% confidence interval [CI]: 0.4, 0.7; H; aRRR = 0.7, 95% CI: 0.5, 0.9) or recreational reasons (nHB: aRRR = 0.8, 95% CI: 0.6, 1.0; H; aRRR = 0.7, 95% CI: 0.6, 0.9) rather than medical-only reasons. The odds of misuse of sedatives and tranquilizers for recreational-only reasons as opposed to medical-only reasons were higher among nHB (aRRR = 1.9, 95% CI: 1.3, 2.7) and H (aRRR = 1.9, 95% CI: 1.4, 2.4) than among non-Hispanic Whites. The increased misuse of prescription pain relievers for medical reasons among racial-ethnic minority groups demonstrates a continued need to investigate underlying structural factors driving these behaviors. The higher odds of sedative and tranquilizer misuse for recreational purposes among racial-ethnic minority groups warrant further investigation.

Self-poisoning as a cause of admission in a medical intensive care unit and a question of misuse of prescription medications

BackgroundSelf-poisoning accounts for between 3 and 17% of intensive care unit (ICU) admissions. ObjectivesTo display the misused substances, intention, and outcome of patients admitted to the ICU due to self-poisoning. MethodsA retrospective review of ICU admissions using an electronic patient database was performed. ResultsA total of 149 patients were admitted, accounting for 4.6% of ICU admissions.Self-poisoning with self-harm was more frequent than without self-harm intent (62.4% vs. 37.6%). 64.4% of ingested substances were misused prescribed drugs. Females used antipsychotics (X2 = 15, p< 0.05) and benzodiazepines (X2 =11.52, p< 0.05), and males ingested antipsychotics (X2 = 12, p< 0.05) with a self-harm intent. Antipsychotics were always used with a self-harm intent. Illicit drugs (X2 =9.14, p< 0.05) and ethanol (X2 =7.34, p< 0.05) were mostly used without self-harm intent. 102 patients (68.5%) continued treatment in a psychiatric clinic, more often women (X2 (1,N = 145)=7.94, p< 0.005). The readmission rate was low. Mortality was 2.6%. ConclusionSelf-poisoning is an infrequent cause of ICU admission. Prescribed psychotropic medications, including benzodiazepines, antipsychotics, and antidepressants were the most frequently misused substances. Psychiatric consultation before the ICU discharge and subsequent psychiatric treatment might lower the repetition and readmission rate.

Parenting, health, and use of medications among college youth: The PHARMACY survey study

Prescription medication misuse represents a major public health concern, with high rates of negative consequences observed among youth. The current study examines the potential roles parents can play in mitigating youth prescription-related harm, with a particular focus on opioid and antibiotic safety. A sample of 167 students from a mid-sized college in the Northeast U.S. were surveyed on their prescription medication knowledge, comfort, and behaviors and perceptions of their parents’ behaviors. Results showed that parenting behaviors like targeted discussions on prescription medication safety (e.g., proper disposal of excess medication) were associated with greater medication-related comfort, which, in turn, was associated with safer prescription medication behaviors.

Prescription medication misuse among students in Lithuanian universities

Abstract Background Prescription drug misuse (PDM) is a known problem in Lithuania. However little information is known regarding the characteristics of prescription drug misusers and the extent of this problem among students of Lithuanian universities. This study attempted to further understand PDM by examining prevalence, PDM type, and students' attitudes towards PDM. Methods Survey data was collected in December 2020 - January 2021 via an online survey. 974 students from 8 State Universities of Lithuania completed the survey. Results include lifetime, past-year, past-month prevalence of PDM with analysis performed separately for stimulants, sedatives/tranquilizers, and sex, PDM was also analyzed according to stress levels, university year, etc. Results Lifetime prevalence of prescription sedative and tranquilizers misuse among students was 21% (CI 95% 18.6- 23.7), of stimulants - 5,4% (CI 95% 4.2- 7.1). Statistically significantly more male students misused prescription stimulants. Prevalence of PDM increased up to the 4th year of university. Primary reasons for PDM are to suppress anxiety and stress -62,4%, ‘to feel good/get high' -31 %, to improve academic performance -18%. 20.5% of the students that participated in PDM reported combining PDM with illicit drug use, 19.5% - with alcohol use and 7.6% used several prescription drugs non medically at once. Most students (61%) receive prescription medication from family members or friends and pay no attention to patient information leaflet. Conclusions These results further suggest the importance of assessing PDM risk factors for young adults. Students who often feel stress, anxiety are more likely to participate in PDM. Effective monitoring and prevention strategies should be developed. Key messages There is a need to increase public health literacy and to introduce innovative interventions to build mental resilience of young people. Greater availability of mental health services to students is likely to reduce PDM.

Factors associated with permissive attitudes of university students towards prescription medication misuse

ABSTRACT Background University students with more permissive attitudes toward prescription medication misuse are more likely to engage in such misuse. This study investigated the factors associated with attitudes toward prescription medication misuse, and whether these factors differ between misuse for academic vs. recreational purposes. Methods An online survey included standardized measures of anxiety, depression, insomnia symptoms, daytime sleepiness, sleep quality, and attitudes toward prescription medication misuse. Participants were 3,160 university students aged 18–35 years. Univariate and multivariate linear regressions examined factors associated with attitudes toward prescription medication misuse. Results Factors associated with more permissive attitudes were nonwhite ethnicity, international student status, alcohol, tobacco, and nicotine vapor use, depressive symptoms, and clinical level of anxiety symptoms. Female gender, part-time study, and mild anxiety symptoms were associated with less permissive attitudes toward prescription medication misuse. Older age was associated with more permissive attitudes toward medication misuse for recreational purposes. No factors were associated with attitudes toward misuse for academic purposes. Conclusions Groups that have more permissive attitudes toward prescription medication misuse could be targeted by prevention programs. More investigation is needed regarding attitudes toward academic vs. recreational misuse of prescription medication.

Prescription Drug Misuse among African Americans and Afro Caribbeans: Results from the National Survey of American Life

Background The misuse of prescription medications is an understudied topic among the non-Hispanic Black population in the U.S. Even less is known about the prevalence and correlates of misuse among African Americans and Afro-Caribbeans, despite documented differences in their substance use behaviors. Objectives We aimed to examine the prevalence and correlates of lifetime prescription drug misuse among African Americans and Afro Caribbeans using data from the National Survey of American Life. Methods A national household probability sample of non-institutionalized African Americans and Afro Caribbeans from the Collaborative Psychiatric Epidemiology Surveys was used. Pooled and ethnicity-stratified logistic regressions were estimated. Results Findings showed no significant differences between African Americans (6.36%) and Afro-Caribbeans (5.71%) in lifetime prescription drug misuse. Several correlates were found to be associated with misuse among only African American or Afro-Caribbean respondents. Conclusions While research has shown prescription drug misuse is an issue among Blacks overall, our results show that the role of ethnicity must not be overlooked, especially when tailoring prevention and intervention programs. Limitations of this study are discussed.

Opioid painkiller dependence in a sample of elderly medical inpatients.

Over the past few years, there has been a growing concern about prescription opioid misuse and dependence in the elderly. Our study aimed to investigate the prevalence of previous and current prescription opioid dependence among elderly medical inpatients recruited from a large German hospital. This cross-sectional study analyzed a cohort of inpatients aged 65 years and older who were assessed with a structured clinical interview. Levels of past and current dependence on opioids benzodiazepines, hypnotics, and non-opioid analgesics were assessed. Of 2108 elderly inpatients admitted to the hospital during a 6-month period, 400 fulfilled the inclusion criteria and agreed to participate to the survey. Among these 400 subjects, 43 (10.8%) presented with a dependence on opioid analgesics, including 41 with current dependence and 22 (51.2%) with a de novo condition. Addiction severity was considered mild in 65.1% of cases and severe in 11.6% of cases. Tilidine and oxycodone were the most typically reported molecules. Further research is warranted, to better understand the possible risk factors of prescription drug misuse, abuse, and addiction in this vulnerable population. Clinicians should be updated and informed regarding both prescription medication misuse potential and safe prescribing practices in the elderly.