Misuse Of Sedatives Research Articles

Changing patterns of hospitalization for sedative misuse among youth aged 10–24 years in Quebec, Canada

PurposeTo assess trends in hospitalization for sedative misuse among youth. MethodsUsing a serial cross-sectional design, we computed hospitalization rates for sedative-related suicide attempts, sedative use disorders, and other sedative poisonings within individuals aged 5–24 years in Quebec, Canada. We computed sedative-related hospitalization rates in 2006–2011, 2012–2017, and 2018–2023, and examined differences according to age, sex, polysubstance use, mental health comorbidity, and social vulnerability using rate ratios (RR) and 95 % confidence intervals (CI) comparing the last time period relative to the first. ResultsSedative-related hospitalization rates more than doubled during the study. Suicide attempts using sedatives increased from 50.5 per 100,000 youth in 2006–2011, to 82.2 in 2012–2017 and 114.4 in 2018–2023 (RR 2.26, 95 % CI 1.63–3.15), while sedative use disorders increased from 13.1 to 21.8 and 60.5 per 100,000 in these same time periods (RR 4.62, 95 % CI 2.54–8.40). Rates increased for 10–24 year-olds and in both sexes, particularly among youth with polysubstance use, anxiety and attention disorders, and social vulnerability. DiscussionSedative misuse requiring hospitalization appears to be a growing issue among youth.

Tranquilisers and sedatives misuse and associated factors among adolescents in Estonia: findings from cross-sectional ESPAD surveys, 2003–2019

ObjectivesThis study aimed to (1) to describe trends of tranquilliser and sedative (TS) misuse in Estonia during 2003–2019 and (2) to analyse the associations between TS misuse and explanatory factors...

Assessing the relationship between drug use initiation age and racial characteristics

Initiating drug use in adolescence is associated with greater risk of drug misuse and dependence in adulthood and co-occurring mental health disorders. Initiating drug use in adulthood has been linked to higher-risk drug use networks and primary use of “harder drugs”. The aim of our research is to examine racial/ethnic differences in age at drug use initiation and its relationship with adult outcomes. Based on data from the 2019 National Survey on Drug Use and Health (NSDUH), we used survey-weighted Poisson regression models with robust variance to identify associations between racial characteristics, age at drug use initiation, and three adult outcomes – past year polydrug use, substance use, and mental illness – adjusting for individual-level characteristics. Among 25,986 respondents who ever used drugs and reported their drug use initiation age, Asian-Americans reported the oldest drug use initiation age (19.5) on average, while Native Americans reported the youngest initiation age (16.6). While there were no significant differences in type of drug used during onset by race or ethnicity, generally, individuals start to use inhalants at the earliest age (17.4), while the misuse of sedatives is initiated at the oldest age (46.4). Initiation during late adolescence was associated with greater likelihood of a substance use disorder diagnosis, mental health diagnoses, and polydrug use in adulthood. Drug use prevention interventions should be tailored and accessible during adolescence to delay onset. Interventions that are culturally sensitive, screen for vulnerability to drug use, and offer age-appropriate services should be prioritized.

Binge Drinking and Cannabis Use among Transgender and Gender-Diverse Young Adults in Michigan.

Substance use rates are higher among transgender and gender-diverse people than cisgender people. Rates of substance use are also higher among young adults compared with other age groups. However, little research examines substance use among transgender and gender-diverse young adults. This study examines factors associated with binge drinking and cannabis use among transgender and gender-diverse young adults in Michigan. Participants (N = 78; ages 18-25) completed an online survey that included demographics and substance use and related characteristics. Race, stimulant misuse, and sedative misuse were associated with more frequent binge drinking. Older age and past-year pain reliever misuse were associated with less frequent cannabis use. Past-year stimulant use and using cannabis alone were associated with more frequent cannabis use. These findings suggest that additional marginalized identities may increase the risk for maladaptive substance use. Future research should examine substance use behaviors and correlates to inform interventions among this population.

Sex differences in the associations of non-medical use of prescription drugs with depressive and anxiety symptoms among undergraduates in China

BackgroundNon-medical use of prescription drugs (NMUPD) and their association with depression and anxiety are becoming global concerns. Biological sex may introduce differential exposure to NMUPD or depressive/anxiety symptoms. However, few studies have investigated the potential sex differences in the associations of NMUPD with depressive/anxiety symptoms. MethodsData were drawn from the 2019 School-based Chinese College Students Health Survey. A total of 30,039 undergraduates (mean age: 19.8 [SD: 1.3] years) from sixty universities/colleges in China completed standard questionnaires and were included in the study (response rate: 97.7 %). ResultsIn the final adjusted model, non-medical use of opioids (experimenters: β = 1.10, [95 % CI, 0.62 to 1.57]) or sedatives (frequent users: β = 2.98, [95 % CI, 0.70 to 5.26]) was associated with depressive symptoms, while non-medical use of opioids (frequent users: β = 1.37, [95 % CI, 0.32 to 2.42]) or sedatives (frequent users: β = 1.19, [95 % CI, 0.35 to 2.03]) was also associated with anxiety symptoms. Sex-stratified analyses indicated that lifetime opioids misuse was associated with depressive symptoms in both sexes but with anxiety symptoms only in males (β = 0.39, [95 % CI, 0.09 to 0.70]). The association of lifetime sedative misuse with depressive symptoms was greater in males, while the significant association with anxiety symptoms remained only in female (β = 0.52, [95 % CI, 0.14 to 0.91]). LimitationsCausal inference cannot be made due to the cross-sectional nature of the data. ConclusionsOur study suggests NMUPD is associated with depressive and anxiety symptoms among Chinese undergraduates, and the associations may differ by sex.

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.

Eating disorders and substance use: Examining associations among US college students.

To investigate associations between reported eating disorder (ED) diagnosis and substance use disorder (SUD) diagnosis, substance misuse, and illicit drug use among US college students. Data consisting of n= 414,299 students' responses to the National College Health Assessment survey conducted by the American College Health Association between fall 2015 and spring 2019 were utilized for this study. Unadjusted and adjusted odds ratios were used to determine the association of reported ED diagnosis with reported SUD diagnosis, misuse of cigarettes, e-cigarettes, alcohol, marijuana, cocaine/methamphetamine, sedatives, hallucinogens, opiates, inhalants, MDMA, and other club drugs, as well as illicit use of prescription pain killers, prescription sedatives, and prescription stimulants. A sensitivity analysis investigating associations between reported anorexia nervosa (AN), bulimia nervosa (BN), and each substance use outcome was also conducted. Among all in our analytic cohort, 7.15% reported receiving an ED diagnosis or being treated for an ED in the last 12 months. Students with ED indications were significantly more likely to report each of the substance use outcomes investigated in this study, including SUD diagnosis (aOR: 7.43; 95% CI: 6.98, 7.92; p< .0001), opiate misuse (aOR: 8.35; 95% CI: 7.38, 9.45; p< .0001), and misuse of other club drugs (aOR: 10.37; 95% CI: 9.10, 11.81; p< .0001) than peers without reported EDs. Both AN and BN were associated with an increased likelihood of SUD diagnosis. These findings demonstrate strong associations between EDs and the most extensive list of substance use outcomes explored in the context of college setting ED research to date.

Contextualizing prescription opioid misuse and heroin use within dimensional models of drug involvement

BackgroundPrescription opioid misuse (POM) is often implicated in heroin initiation, despite evidence that POM does not predict heroin initiation any better than other drug use. Additionally, prescription misuse and illicit use behaviors tend to respectively “cluster” together. This study aimed to test a series of theory-driven factor models to explore how POM and heroin use are situated within the broader constellation of drug use that typically occurs alongside opioid (mis)use. Methods36,309 individuals from NESARC-III (56.31% female; mean age=45.63 [SD=17.53]) reported their lifetime (mis)use of prescription opioids, prescription stimulants, prescription sedatives, heroin, cannabis, cocaine/crack, illicit stimulants (e.g., methamphetamine), club drugs, hallucinogens, and inhalants, and were administered a DSM-5 substance use disorder (SUD) assessment. Bifactor, correlated factors, and one-factor confirmatory factor models were fit using all drug use/SUD variables and subsequently compared. ResultsPOM was most strongly correlated with prescription sedative misuse; heroin use was most strongly correlated with cocaine/crack use. All factor models fit the data well. Highly correlated factors and patterns of factor loadings suggested that POM and heroin use were most parsimoniously captured within a general factor alongside all other forms of drug use. This was also the case for SUD. Additional analyses testing an alternate factor structure provided further support for unidimensionality. ConclusionsPOM and heroin use, as well as prescription- and heroin-based SUDs, were neither separable nor distinctly associated. Future research should account for other drug use more comprehensively rather than isolating POM as a primary risk factor in heroin use and use disorder.

Immigration policies as political determinants of alcohol and drug misuse among US-born Latinos.

The role of immigration policies as political determinants of health among US-born Latinos is significantly understudied. Immigration policies can produce immigration-related stressors that have 'spill over' effects on the health behaviors of US-born Latinos. However, less is known about how immigration-related stressors relate to substance misuse among US-born Latinos. 1,784 US-born Latinos were recruited via web-panels in September 2021 to complete an online questionnaire. Inclusion criteria included: (1) self-identifying as Latino; (2) born in the US; and (3) being 18 years of age or older. Participants were asked 14-items related to immigration-related stressors and past-year substance use behaviors. Dependent variables included past-year: heavy drinking, high intensity drinking, illicit drug use, prescription drug misuse, cannabis use, cocaine use, methamphetamine use, prescription sedative misuse, and prescription opioid misuse. Two separate multivariable logistic regression models were conducted for each outcome to investigate associations between (1) specific immigration-related stressors and substance misuse; and (2) experiencing greater (vs. fewer) number of immigration-related stressors and substance misuse. On average, US-born Latinos reported experiencing 3 immigration-related stressors. In multivariable analyses, being fearful or worried about being detained for immigration reasons was associated with increased odds of engaging in heavy drinking, high intensity drinking, and illicit drug use. Having ever feared or worried about being potentially deported for immigration reasons and having ever witnessed or experienced an immigration raid was associated with high intensity drinking. Parental detentions and deportations in childhood were independently associated with high intensity drinking, illicit drug use, and prescription drug misuse. Notably, greater number of immigration-related stressor experiences increased the odds of substance misuse. Punitive immigration and enforcement policies give rise to multiple stressors that may render US-born Latinos vulnerable to misusing substances as a way of coping. Policies and public health interventions aimed at preventing and treating substance misuse should consider how immigration policies impact the behaviors of US-born Latinos.

Misuse of prescription drugs and other psychotropic substances among university students: a pilot study.

Prescription drug abuse has emerged as the fastest growing problem globally. While people of all ages suffer from the harmful effects, the impact on the health of young people and their quality of life constitutes a significant public health problem. To estimate the prevalence of the use of prescription drugs and other substances among university students. An online survey method was used. The tools were distributed in 2019 to 794 university students at Aden University in Yemen 48.2% (n = 383) and King Khalid University in Saudi Arabia 51.8% (n = 411). Students answered the Drug Abuse Screening Test (DAST-10), and a questionnaire on drug and substance abuse. The overall prevalence of low, moderate, substantial and severe on the DAST-10 scale was 27.2%, 10.5%, 2.1% and 0.8%, respectively. The prevalence of sedative misuse among university students was high (12.5%) and the differences between Yemeni and Saudi Arabian students in prescription drug and sedative misuse were significant. Female students were significantly lower than males on the DAST-10 scale. About 3% of the Yemenis were abusing diazepam, while over 31% of Saudi Arabians were abusing inhalants. Our findings highlight the differences between university students in Yemen and Saudi Arabia misusing prescription stimulants and sedatives and the inhalation of volatile substances.

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.

Misuse of Prescription and Illicit Drugs in Middle Adulthood in the Context of the Opioid Epidemic

Background: The United States’ opioid epidemic continues to escalate overdose deaths. Understanding its extent is complicated by concurrent misuse of other prescription or illicit drugs, increasing risk for overdose. Current surveillance using electronic medical records and police data has limitations and frequently fails to distinguish middle-aged adults from other age groups in reporting. Objectives: The purpose of this analysis is to (1) describe characteristics of middle-aged US adults who report misusing prescription and illicit drugs and (2) evaluate if misusing prescription opioids increases risk of misusing other drugs. Methods: We analyzed data from 12,300 adults ages 32–42 from Wave V of the Add Health study collected from 2016 to 2018. Self-reported past 30-day misuse of prescription sedatives, tranquilizers, stimulants, and opioids as well as cocaine, crystal methamphetamine, heroin, and other illicit drugs were analyzed for associations with demographic characteristics in weighted bivariate analysis and multivariable logistic regression. Results: Those misusing prescription opioids were more likely to misuse prescription sedatives, tranquilizers, and stimulants compared to those not misusing prescription opioids. Those misusing prescription opioids were also more likely to misuse heroin, crystal meth, cocaine, and other illicit drugs. Higher levels of education and personal income were protective for prescription opioid misuse, any prescription drug misuse, and any illicit drug misuse. Race/ethnicity was not significantly associated with prescription opioid misuse. Conclusions/Importance: Our analysis shows those misusing prescription opioids are at high risk of misusing other prescription and illicit drugs. Practitioners and researchers should consider concurrent drug misuse when treating and studying opioid misuse disorders.

Misuse of Prescription Pain Relievers, Stimulants, Tranquilizers, and Sedatives Among U.S. Older Adults Aged ≥50 Years

Misuse of prescription medications has led to higher mortality and morbidity in the U.S. This study investigates medical and nonmedical use of prescription medications (prescription pain relievers, stimulants, prescription tranquilizers, and sedatives) among adults aged ≥50 years. Data were from the 2015-2017 National Survey of Drug Use and Health. For each prescription medication, medical and nonmedical use were mutually exclusive (prescription pain relievers, stimulants, tranquilizers, and sedatives). Nonmedical use (misuse) was defined as the use of any prescription medications in greater amounts, frequency, or duration than prescribed or the use of medications without a prescription of the individual's own. Descriptive analysis was performed to assess prescription medication use and misuse among adults aged ≥50 years (pooled N=26,322). Correlates of misuse were assessed within multivariable logistic regression analyses at p<0.05. All analyses were conducted in 2019. In the past 12 months, 46.7% (51.7 million) of adults reported using any prescription medication, of which 7.7% (4.0 million) reported misuse. The proportion of past 12-month users reporting misuse was 5.4% for sedatives, 6.4% for prescription pain relievers, 6.5% for prescription tranquilizers, and 8.1% for stimulants. Overall, 16.2% (17.9 million) reported using 2 or more prescription medications within the past 12 months. Multiple prescription medication use was associated with female sex; White race; younger age; and use of nonprescription substances, including alcohol, tobacco, marijuana, and heroin. It is important to monitor medication misuse behaviors among older adults who may be living with several chronic conditions requiring pain management. The strong associations with serious psychological distress underscore the need for increased access to mental health services among this key population.

Higher and Higher? Drug and Alcohol Use and Misuse among HIV-Vulnerable Men, Trans Men, and Trans Women Who Have Sex with Men in the United States

Background: Substance use (SU) and misuse are disproportionately more common among sexual and gender minority (SGM) individuals compared to their heterosexual peers. Yet, little is known about regional and demographic differences in use and misuse among SGM. In this study, we investigated regional and demographic differences in SU and misuse in a U.S. national, internet-based cohort (n = 6,280) of men and trans persons who have sex with men. Methods: Data collected included the WHO ASSIST (substance) and AUDIT (alcohol) SU scales to estimate recent (≤ 3 months) non-problematic use (≤ 3 ASSIST, ≤ 10 AUDIT) and misuse (≥4 ASSIST, ≥11 AUDIT). We used bivariate and multivariable logistic models to examine demographic and regional factors associated with SU and misuse. Results: Participants reported using alcohol (85.6%), cannabis (53.9%), and inhalants (39.1%) in the past three months. More than one-third self-reported misuse of cannabis, Gamma-Hydroxybutyrate (GHB), inhalants, methamphetamines, and prescription sedatives. We observed regional differences in substance use for cannabis (Southeast aOR = 0.76, 95% CI: 0.63–0.93; West aOR = 1.27, 95% CI: 1.02–1.59, ref. Northeast) and prescription Stimulants (Midwest aOR = 1.39, 95% CI: 1.00–1.93), as well as for cannabis misuse (Southeast aOR = 0.83, 95% CI: 0.69–0.99). We also observed significant associations between socioeconomic factors with use and misuse. Conclusions: Findings suggest geographic differences in misuse of certain substances among men and trans persons who have sex with men in the US, and that socio-economic factors, also play a key role in indicating risk.

Early life exposure to tetrachloroethylene (PCE) and misuse of prescription drugs: a retrospective cohort study in Cape Cod, MA

Background/Aims: Between 1968 and 1983, public drinking water supplies of Cape Cod, Massachusetts were contaminated with tetrachloroethylene (PCE), an established neurotoxicant. We previously found an affinity for risk-taking behaviors, including the use of illicit drugs, following early-life exposure to PCE. Using newly collected data, we investigated the risk of misusing prescription drugs following early life PCE exposure. Methods: Participants were identified from a retrospective cohort study ("Cape Cod Health Study”) via cross-matching birth certificates and water system data. The original self-administered questionnaire gathered data on demographics, work and medical history, and alcohol and illicit drug use from 615 individuals (361 with early-life exposure and 254 unexposed). The follow-up survey added questions on misuse of prescription pain relievers, tranquillizers, stimulants and sedatives. A validated leaching and transport model was used to estimate exposure to PCE exposure in drinking water. Results: One hundred and thirty-four (19.3%) participants misused at least one type of prescription drug. Pain relievers were the most commonly misused prescription drug (14.3%). Compared to unexposed subjects, individuals with early-life exposure to PCE were 93% more likely to misuse prescription drugs (Adjusted relative risk (RR)1.93, 95% CI: 1.31, 2.83), after adjusting for maternal education, father occupation and participant age. Similar increases in risk were seen for pain relievers, tranquillizers and stimulants (Adjusted RRs:1.82-2.17) and for misusing only 1 or 2 or more prescription drugs [Adjusted RRs 1.97 and 2.12, respectively]. Participants exposed to PCE levels &gt;= median had a slightly higher risk of misusing prescription drugs than those exposed to levels &lt; median [Adjusted RRs: 2.06 (95% CI: 1.34, 3.17) and 1.83 (95% CI: 1.20, 2.79), respectively]. Conclusions: Results suggest early life exposure to PCE increases the risk of misusing several types of prescription drugs.

Mental health, pain, and risk of drug misuse: A nationwide cohort study

Evidence suggests that rising drug misuse, particularly of prescription painkillers, is more closely linked with period increases in reported pain among Americans of the same age range than with deterioration in mental health, but it is unclear whether those cross-sectional associations reflect causal effects of pain and mental health on drug misuse. Using data from the 1995-96, 2004-05, and 2013-14 waves of a nationwide cohort study, we evaluate the effects of pain and mental health on subsequent misuse of prescription painkillers and sedatives. Logistic regression is applied to model drug misuse (separately for painkillers and sedatives) as a function of predictors measured at the previous wave; respondents who reported misuse of that drug type at the prior wave are excluded from the analysis. Mental health is an important predictor of both painkiller and sedative misuse, whereas pain plays a much bigger role in painkiller misuse. Frequency of joint aches and stiffness has the strongest effect on subsequent painkiller misuse, although mental health yields substantial incremental predictive ability above and beyond pain. Negative affect, positive affect, and psychological well-being have notable effects on sedative misuse, while pain (particularly backache) makes only a small incremental contribution to sedative misuse. We suspect that increases over time in pain levels may have played a bigger role than mental health in explaining the rise in prescription painkiller misuse and may have contributed to growing misuse of sedatives. In contrast, deteriorating mental health was probably more important in explaining the rise of sedative misuse.

The roles of emotion regulation difficulties and impulsivity in the associations between borderline personality disorder symptoms and frequency of nonprescription sedative use and prescription sedative/opioid misuse

Despite evidence of a strong relationship between borderline personality disorder (BPD) and substance use problems in general, little research has examined the associations of BPD symptoms with the misuse of sedatives or opioids, and no studies have explored possible factors that may underlie these associations. Thus, this study examined the relationships of BPD symptoms (i.e., the number of BPD criteria with threshold ratings on a diagnostic interview) to nonprescription sedative use, nonprescription opioid use, and prescription sedative/opioid misuse among 194 patients with alcohol and/or cocaine dependence in a residential substance use disorder treatment facility, as well as the roles of two theoretically-relevant factors in these relationships: emotion regulation (ER) difficulties and impulsivity facets. We found significant positive associations between BPD symptoms and nonprescription sedative use, nonprescription opioid use, and prescription sedative/opioid misuse. We also found significant positive indirect relationships of BPD symptoms to nonprescription sedative use through ER difficulties, ab = 0.04, 95% CI [0.003, 0.09], and to prescription sedative/opioid misuse through two facets of impulsivity: lack of perseverance, ab = 0.05, 95% CI [0.01, 0.11], and negative urgency, ab = 0.03, 95% CI [0.002, 0.07]. Findings highlight the differential relevance of ER difficulties and impulsivity dimensions to the relationships of BPD symptoms to nonprescription sedative use and prescription sedative/opioid misuse, respectively, among patients with alcohol and/or cocaine dependence.

Problematic Internet Use, Non-Medical Use of Prescription Drugs, and Depressive Symptoms among Adolescents: A Large-Scale Study in China.

This large-scale study aimed to test, among Chinese adolescents, the association between problematic Internet use (PIU), non-medical use of prescription drugs (NMUPD), and depressive symptoms, as well as the mediating effects of NMUPD on the associations above. This study used the data from the 2017 National School-based Chinese Adolescents Health Survey, and 24,345 students’ questionnaires qualified for the analyses. Generalized linear mixed models and path models were performed. In the models without mediation, PIU was associated with depressive symptoms (unstandardized β estimate = 0.26, 95% CI = 0.25–0.27); frequent use of opioid or sedative was also related to depressive symptoms (unstandardized β estimate for opioid = 2.77, 95% CI = 1.90–3.63; unstandardized β estimate for sedative = 4.45, 95% CI = 3.02–5.88). Additionally, the results of the path models indicated that opioid misuse partially mediated the association between PIU and depressive symptoms. PIU and opioid/sedative misuse were related to the increased risk of depressive symptoms, respectively. The association above might be complicated, and PIU may elevate the risk of opioid or sedative misuse and depressive symptoms, which in turn could worsen the situation of PIU and vice versa. Multidisciplinary health intervention programs to prevent adolescents involving in PIU, as well as NMPUD, are recommended to be provided.

Trends in college students’ alcohol, nicotine, prescription opioid and other drug use after recreational marijuana legalization: 2008–2018

BackgroundYoung adult college students may be particularly sensitive to recreational marijuana legalization (RML). Although evidence indicates the prevalence of marijuana use among college students increased after states instituted RML, there have been few national studies investigating changes in college students’ other substance use post-RML. MethodThe cross-sectional National College Health Assessment-II survey was administered twice yearly from 2008 to 2018 at four-year colleges and universities. Participants were 18–26 year old undergraduates attending college in states that did (n = 243,160) or did not (n = 624,342) implement RML by 2018. Outcome variables were self-reported nicotine use, binge drinking, illicit drug use, and misuse of prescription stimulants, sedatives, and opioids. Other variables included individual and contextual covariates, and institution-reported institutional and community covariates. Publicly available information was used to code state RML status at each survey administration. ResultsAccounting for state differences and time trends, RML was associated with decreased binge drinking prevalence among college students age 21 and older [OR (95% CI) = 0.91 (0.87 − 0.95), p < .0001] and increased sedative misuse among minors [OR (95% CI) = 1.20 (1.09 − 1.32), p = .0003]. RML did not disrupt secular trends in other substance use. ConclusionsIn the context of related research showing national increases in college students’ marijuana use prevalence and relative increases following state RML, we observed decreases in binge drinking and increases in sedative use that both depended on age. Findings support some specificity in RML-related changes in substance use trends and the importance of individual factors.

Prevalence and correlates of nonmedical use of prescription drugs (NMUPD) among Young adults experiencing homelessness in seven cities across the United States

Background: Nonmedical use of prescription drugs (NMUPD) is an urgent public health concern facing the United States. Young adults experiencing homelessness (YEH) are at increased risk of NMUPD; however, community estimates of NMUPD among YEH are sparse. This current study sought to understand patterns and correlates of NMUPD in a geographically heterogeneous sample of YEH recruited from seven cities across the United States.Methods: From June 2016 to July 2017, 1,426 YEH (aged 18–26) were recruited from seven cities (Houston, Los Angeles, Denver, Phoenix, New York City, St. Louis, San Jose). Participants provided information on substance use, mental health, trauma, and sexual-risk behaviors. Multivariable logistic regression was utilized to assess demographic, psychological, and behavioral correlates of self-reported past-month NMUPD and NMUPD types (i.e., prescription stimulant, sedative, and opioids).Results: Approximately 20% of participants reported past-month NMUPD. Almost 9% reported misusing prescription opioids, 8.7% misused prescription sedatives, and 6% misused prescription stimulants. Multivariable logistic regressions revealed unmet mental health needs were associated with sedative and stimulant misuse but not opioid misuse. Having suicidal thoughts was associated with opioid misuse but not sedative or stimulant misuse. Although no geographical differences emerged for stimulant and sedative misuse, youth from Denver, Phoenix, and San Jose were more likely to engage in opioid misuse relative to youth in Los Angeles.Conclusions: These findings indicate that interventions designed to address NMUPD need to be multifaceted, designed to address other risk behaviors correlated with NMUPD, and target unmet mental health needs.