Nonmedical Use Of Prescription Drugs Research Articles

Predictors, motives, sources and patterns of nonmedical use of prescription drugs among youths in Buea, Southwest region of Cameroon: A mixed method analysis

BackgroundThe non-medical use of prescription drugs (NMUPD) is an emerging phenomenon of serious public health concern among young people globally. This study seeks to determine the predictors, motives, sources, patterns of use of NMUPD among youths in the Buea Health District of the South west region. Materials and MethodsA mixed-method community-based, cross-sectional study conducted from May to June 2018, enrolled participants aged 15 - 29 years from schools and community. A pretested semi-structured questionnaire was used to capture data and focus group discussions and key informant interviews were conducted. Quantitative and qualitative analyses were performed with SPSS version 24 and ATLAS.ti version 7 respectively. Logic regression analysis were carried at 5 % significance level. ResultsThe study enrolled 464 participants (median age of 21 years, IQR: 18 – 23.8 years) into the quantitative study, 63 % were females. Forty-nine participants were enrolled for the qualitative study. A total of 90 (19.6 %; CI: 15.9 – 23.3 %) participants accepted they have used prescriptions medications in the last 12 months for non-medical purposes. Opioids (74.4 %) particularly tramadol (60.1 %) were the most common drugs used. Male gender (p = 0.001), the age group 20–24-year, smoking (p = 0.043) and use of illicit substances (p < 0.001) were independent predictors of NMUPD. Prominent motivations were:- curiosity (31.1 %) and enhancement of work performance (30 %). Unregistered pharmacies and private health facilities were the main sources of these drugs which are acquired mainly without prescription. ConclusionMale gender, young adults, smoking and use of illicit substances were independent predictors of NMUPD. Motives were hinged to enhancement of performance in various domains of social life. Opioids, particularly tramadol was the predominant drug used, acquired without prescription from unregistered pharmacies. Findings of this study provide baseline evidence that could guide policies on drug prevention, treatment and harm reduction interventions.

Driving after substance use in Rhode Island adolescents: A cross-sectional analysis of surveillance data

Objective Existing literature on driving under the influence during adolescence is sparse, especially for driving after the use of non-medical prescription drugs (DAP). This study examines the prevalence of driving after use of alcohol (DAA), cannabis (DAC), and DAP, and examines the role of several potential risk and protective factors. Methods This was a secondary analysis of the 2022 Rhode Island Study Survey, a cross-sectional survey of middle and high school students. Separate multivariable regressions were conducted for each outcome among lifetime users for each substance, controlling for current substance use, individual-, perceived parental-, and perceived friend-substance use risk perception, age, sexual/gender minority (SGM) status, race, ethnicity, school level, and town poverty level. Results Among lifetime users of alcohol (n = 3849), cannabis (n = 2289), and non-medical prescription drugs (n = 611), the prevalence of DAA, DAC, and DAP was 4.9, 14.3, and 16.9%, respectively. Current substance use, high individual risk perception, being nonwhite, and being Hispanic were risk factors for DAA while perceiving parent’s risk perception as negative and being heterosexual cisgender-female were protective. Current substance use, negative individual risk perception, and being nonwhite were risk factors for DAC while perceiving parent’s risk perception as negative and being in high school were protective. Current substance use and older age were risk factors for DAP while perceiving parent’s risk perception as negative and perceiving friend’s risk perception as negative were protective. Conclusions Driving under the influence is a concern among adolescent substance users. Current substance use and perceived parental risk perception as negative are common risks and protective factors, respectively. Findings suggest substance-specific, heterogeneous interventions are needed. For example, interventions focusing on peer perceptions are most relevant for DAP, while shifting personal perceptions of harm are most relevant for DAC.

The Relationship of Risk-Related Behaviors and Substance Use Among U.S. Army National Guard/Army Reserve Soldiers and Deployment Differences

U.S. Army National Guard and Army Reserve (ANG/USAR) soldiers are at risk for substance use, and research in other populations suggests risk-related behaviors and traits affect the propensity for use. Less is known about how deployment might amplify these effects. Our research explored the relations between risk-related behaviors and substance use among ANG/USAR soldiers and investigated differences by deployment (previously vs. never deployed). We drew a subset of data from Operation: SAFETY, an ongoing study of ANG/USAR soldiers and their partners (married/living together as if married). Cross-sectional regression models examined domains of risk (i.e., risk perception, risk-taking/impulsivity, sensation-seeking) and substance use (any current drug use, current non-medical use of prescription drugs, current illicit drug use, alcohol problems, and frequent heavy drinking [FHD]). Final models controlled for age, sex, anger, and PTSD. Interaction terms between risk behaviors and deployment status on substance use were also noted. Results revealed that greater risk perception was significantly associated with a lower likelihood of and protective against FHD. Greater risk-taking/impulsivity was associated with a higher likelihood of any current drug use and alcohol problems. Additionally, interaction models suggest that non-deployed soldiers at every level of risk-taking/impulsivity had a consistently high likelihood of illicit drug use overall. Sensation-seeking was not associated with any outcome. Findings demonstrate that greater risk-taking/impulsivity was associated with substance use, and never deployed/non-deployed ANG/USAR soldiers might be more vulnerable. Our work can help inform substance use interventions in the military by highlighting the role and impact of risk-related behaviors and non-deployment.

Longitudinal effects of military separation and mental health symptomatology on substance use among a cohort of reservists.

The relationship between mental health and substance use among military populations is well-established, and evidence suggests these risks may be greater for those who have left the military. However, it is less clear what independent effects leaving the military may have on substance use behaviors. This study examined the longitudinal relationship between leaving the military and substance use outcomes (hazardous drinking, frequent heavy drinking, non-medical use of prescription drugs, illicit drug use) in a cohort of Reserve and National Guard (R/NG) soldiers. Further, we examined whether mental health symptoms moderate the relationship between leaving the military and substance use. Analyses used data (N=485 soldiers) from the first four annual waves of Operation: SAFETY, an ongoing prospective cohort study of US Army R/NG soldiers and their spouses. We used generalized estimating equations (GEE) to examine the relationships between military status (former vs. current soldier) and substance use outcomes over four years. Lastly, we examined interactions between military status and mental health indicators (anxiety, anger, depression, and PTSD) on substance use over time. After controlling for sex, age, race, years of military service, sleep problems, bodily pain, and substance use norms, being a former soldier, compared to a current soldier, was associated with greater odds of current illicit drug use (AOR: 2.86; 95% CI: 1.47, 5.57; p<.01). Mental health symptomatology did not moderate the relationship between leaving the military and current drug use. Leaving the military in and of itself may result in increased drug use for some individuals, regardless of mental health symptomatology.

Illicit Trade of Prescription Medications Through X (Formerly Twitter) in Japan: Cross-Sectional Study.

Nonmedical use of prescription drugs can cause overdose; this represents a serious public health crisis globally. In this digital era, social networking services serve as viable platforms for illegal acquisition of excessive amounts of medications, including prescription medications. In Japan, such illegal drug transactions have been conducted through popular flea market applications, social media, and auction websites, with most of the trades being over-the-counter (OTC) medications. Recently, an emerging unique black market, where individuals trade prescription medications-predominantly nervous system drugs-using a specific keyword ("Okusuri Mogu Mogu"), has emerged on X (formerly Twitter). Hence, these dynamic methods of illicit trading should routinely be monitored to encourage the appropriate use of medications. This study aimed to specify the characteristics of medications traded on X using the search term "Okusuri Mogu Mogu" and analyze individual behaviors associated with X posts, including the types of medications traded and hashtag usage. We conducted a cross-sectional study with publicly available posts on X between September 18 and October 1, 2022. Posts that included the term "Okusuri Mogu Mogu" during this period were scrutinized. Posts were categorized on the basis of their contents: buying, selling, self-administration, heads-up, and others. Among posts categorized as buying, selling, and self-administration, medication names were systematically enumerated and categorized using the Anatomical Therapeutic Chemical (ATC) classification. Additionally, hashtags in all the analyzed posts were counted and classified into 6 categories: medication name, mental disorder, self-harm, buying and selling, community formation, and others. Out of 961 identified posts, 549 were included for analysis. Of these posts, 119 (21.7%) referenced self-administration, and 237 (43.2%; buying: n=67, 12.2%; selling: n=170, 31.0%) referenced transactions. Among these 237 posts, 1041 medication names were mentioned, exhibiting a >5-fold increase from the study in March 2021. Categorization based on the ATC classification predominantly revealed nervous system drugs, representing 82.1% (n=855) of the mentioned medications, consistent with the previous survey. Of note, the diversity of medications has expanded to include medications that have not been approved by the Japanese government. Interestingly, OTC medications were frequently mentioned in self-administration posts (odds ratio 23.6, 95% CI 6.93-80.15). Analysis of hashtags (n=866) revealed efforts to foster community connections among users. This study highlighted the escalating complexity of trading of illegal prescription medication facilitated by X posts. Regulatory measures to enhance public awareness should be considered to prevent illegal transactions, which may ultimately lead to misuse or abuse such as overdose. Along with such pharmacovigilance measures, social approaches that could direct individuals to appropriate medical or psychiatric resources would also be beneficial as our hashtag analysis shed light on the formation of a cohesive or closed community among users.

Moral injury and substance use among United States healthcare workers.

Moral injury (i.e., perpetrating, witnessing, failing to prevent, or being a victim of acts that transgress one's moral beliefs, values, or ethics) has largely been studied in military-connected populations and is associated with a range of adverse psychological sequelae. Emerging literature suggests that healthcare workers also experience moral injury, particularly in the context of the ongoing COVID-19 pandemic. However, it is not known if moral injury contributes to substance use among healthcare workers or whether these effects might differ by gender, race/ethnicity, or occupational level. In March 2022, we collected self-reported pilot data from a diverse sample of US healthcare workers (N=200) We examined the cross-sectional relationships between moral injury and several measures of substance use (i.e., current non-medical use of prescription drugs [NMUPD], current cannabis use, current use of other illicit drugs, and hazardous drinking) using separate logistic regression models. Next, we used separate interaction models to examine if any of these relations differed by gender, race/ethnicity, or occupational level. In main effects models, healthcare workers reporting greater moral injury had greater odds of current NMUPD (adjusted odds ratio (aOR)=1.07; p<0.001), current use of other illicit drugs (aOR=1.09; p<0.01), and hazardous drinking (aOR=1.07; p<0.01). These relations did not differ by race/ethnicity or occupational level (ps>0.05); however, men were more likely to report current NMUPD and hazardous drinking (ps<0.05) in the presence of high moral injury than women healthcare workers. Our findings suggest that healthcare workers experience substantial distress related to morally injurious events, which may affect their likelihood of NMUPD, cannabis use, use of other illicit drugs, and hazardous drinking, and that men in healthcare may be particularly at risk. Healthcare organizations should address systemic issues driving moral injury (e.g., resource shortages, lack of psychosocial support) to prevent substance-related harms among healthcare workers.

Prevalence and associated factors of non-medical use of prescription drugs among adolescents in secondary schools in Buea, Cameroon: a cross-sectional study

BackgroundThe non-medical use of prescription drugs is a growing public health problem worldwide. Recent trends in Cameroon show that the use of psychoactive substances, among which are prescription drugs by adolescents is becoming a public health issue and is linked to juvenile delinquency and violence in schools. However, there is a paucity of data on the burden of this phenomenon among adolescent secondary school students in the country. The aim of this study was to determine the prevalence and factors associated with the use of non-prescription drugs in secondary schools in Buea, South West region of Cameroon.MethodsWe conducted a cross-sectional study from 1st February 2021 to 30th April 2021. Secondary school students were recruited using a multistage stratified cluster sampling. A modified and standardized version of the World Health Organization student drug-use survey model questionnaire was used. Ethical approval was obtained from the Institutional Review Board of the Faculty of Health Sciences, University of Buea (No. 2021/1273–02/UB/SG/IRB/FHS). The Statistical Package for Social Sciences, IBM SPSS Statistics for Windows, Version 25.0. was used for data analysis. Descriptive statistics were used to describe the sociodemographic characteristics of participants. Univariate and multivariate logistic regression models were used to explore associated factors of non-medical use of prescription drugs.ResultsA total of 570 participants were enrolled for the study, and 510 participants responded giving a response rate of 89.5%. The prevalence of non-medical use of prescription drugs was 15.3%, tramadol being the most used. Motivators for non-medical use of prescription drugs were “to work longer”, “to be courageous”, and “curiosity”. Logistic regression results showed that alcohol consumption [OR 3.68; 95% CI: 2.24–6.06; p < 0.001], smoking [OR 6.00; 95% CI: 3.07–11.75; p < 0.001] and use of illicit drugs [OR 10.85; 95% CI: 5.48–21.48; p < 0.001] were independent factors associated with non-medical use of prescription drugs.ConclusionNon-medical use of prescription drugs was prevalent among adolescent secondary school students in Buea, Cameroon. Tramadol is the main drug of prescription involved. Our results can guide policymakers on strategies to screen, prevent and control non-medical use of prescription drugs among secondary school students in Cameroon.

Suicide ideation and behavior and ATOD use among bisexual high school students

ABSTRACT Background Research has indicated that sexual minorities have higher prevalence rates for ATOD use and suicide ideation and behavior compared to heterosexual youth. Yet, most studies to date have combined gay, lesbian, and bisexuals into one category. This study sought to assess the uniqueness of bisexuality to assess the risk of ATOD use and suicide ideation and behavior among bisexual high school students. Methods Data for this study were derived from the 2019 Centers for Disease Control’s Youth Risk Behavior Survey (YRBS). Chi-square analysis was conducted to determine the prevalence of ATOD use and suicide ideation and behavior. Logistic regression was then used to estimate the association between ATOD use and suicide ideation and behavior among bisexual adolescents. Results This study found that ever use an electronic vape product, non-medical use of prescription drugs, and current alcohol and marijuana use were significant predictors for suicide ideation and behavior. Conclusions Based on our results, we believe that it is important to address the relationship of substance use as a risk factor for suicide and ideation and behavior of bisexual adolescents, as bisexual adolescents may need more emotional support as they come to understand their sexual identity.

Implementation of substance use screening in rural federally-qualified health center clinics identified high rates of unhealthy alcohol and cannabis use among adult primary care patients

BackgroundScreening for substance use in rural primary care clinics faces unique challenges due to limited resources, high patient volumes, and multiple demands on providers. To explore the potential for electronic health record (EHR)-integrated screening in this context, we conducted an implementation feasibility study with a rural federally-qualified health center (FQHC) in Maine. This was an ancillary study to a NIDA Clinical Trials Network study of screening in urban primary care clinics (CTN-0062).MethodsResearchers worked with stakeholders from three FQHC clinics to define and implement their optimal screening approach. Clinics used the Tobacco, Alcohol, Prescription Medication, and Other Substance (TAPS) Tool, completed on tablet computers in the waiting room, and results were immediately recorded in the EHR. Adult patients presenting for annual preventive care visits, but not those with other visit types, were eligible for screening. Data were analyzed for the first 12 months following implementation at each clinic to assess screening rates and prevalence of reported unhealthy substance use, and documentation of counseling using an EHR-integrated clinical decision support tool, for patients screening positive for moderate-high risk alcohol or drug use.ResultsScreening was completed by 3749 patients, representing 93.4% of those with screening-eligible annual preventive care visits, and 18.5% of adult patients presenting for any type of primary care visit. Screening was self-administered in 92.9% of cases. The prevalence of moderate-high risk substance use detected on screening was 14.6% for tobacco, 30.4% for alcohol, 10.8% for cannabis, 0.3% for illicit drugs, and 0.6% for non-medical use of prescription drugs. Brief substance use counseling was documented for 17.4% of patients with any moderate-high risk alcohol or drug use.ConclusionsSelf-administered EHR-integrated screening was feasible to implement, and detected substantial alcohol, cannabis, and tobacco use in rural FQHC clinics. Counseling was documented for a minority of patients with moderate-high risk use, possibly indicating a need for better support of primary care providers in addressing substance use. There is potential to broaden the reach of screening by offering it at routine medical visits rather than restricting to annual preventive care visits, within these and other rural primary care clinics.

Substance use, psychiatric symptoms, personal mastery, and social support among COVID-19 long haulers: A compensatory model.

Substance use has become a critical health concern during the COVID-19 pandemic, and emerging attention has been paid to people with the persistent symptoms of COVID-19 (COVID-19 long haulers) due to their high vulnerability. However, scant research has investigated their substance use and relevant psychosocial factors. The current study was to (1) examine substance use behaviors (i.e., legal drug use, illicit drug use, and non-medical use of prescription drugs); and (2) assessed their associations with psychiatric symptoms (i.e., depression, anxiety, and post-traumatic stress disorder) and psychosocial factors (i.e., personal mastery and social support) among COVID-19 long haulers. In January-March 2022, 460 COVID-19 long haulers (50% female), with an average age of 32, completed online surveys regarding their demographics, substance use, psychiatric symptoms, and psychosocial factors. In the past three months, the most commonly used or non-medically used substances were tobacco (82%) for legal drugs, cocaine (53%) for illicit drugs, and prescription opioids (67%) for prescription drugs. Structural equation modeling suggested that psychiatric symptoms were positively associated with substance use behaviors (βs = 0.38 to .68, ps < 0.001), while psychosocial factors were negatively associated with substance use behaviors (βs = -0.61 to -0.43, ps < 0.001). Substance use is common in COVID-19 long haulers and psychiatric symptoms are the risk factors. Personal mastery and social support appear to offer protection offsetting the psychiatric influences. Substance use prevention and mental health services for COVID-19 long haulers should attend to personal mastery and social support.

Systematic assessment of non-medical use of prescription drugs using doctor-shopping indicators: A nation-wide, repeated cross-sectional study.

The aim of this study was to present the first nation-wide, systematic, repeated assessment of doctor-shopping (i.e. visiting multiple physicians to be prescribed the same drug) during 10years for more than 200 psychoactive prescription drugs in the 67 million inhabitants in France. This was a nation-wide, repeated cross-sectional study. Data are from the French National Health Data System in 2010, 2015 and 2019 for 214 psychoactive prescription drugs (i.e. anaesthetics, analgesics, antiepileptics, anti-Parkinson drugs, psycholeptics, psychoanaleptics, other nervous system drugs and antihistamines for systemic use). The detection and quantification of doctor-shopping relied upon an algorithm that detects overlapping prescriptions from repeated visits to different physicians. We used two doctor-shopping indicators aggregated at population level for each drug dispensed to more than 5000 patients: (i) the quantity doctor-shopped, expressed in defined daily doses (DDD), which measures the total quantity doctor-shopped by the study population for a given drug; and (ii) the proportion doctor-shopped, expressed as a percentage, which standardizes the quantity doctor-shopped according to the use level of the drug. The analyses included approximately 200 million dispensings to approximately 30 million patients each year. Opioids (e.g. buprenorphine, methadone, morphine, oxycodone and fentanyl), benzodiazepines and non-benzodiazepine hypnotics (Z-drugs) (e.g. diazepam, oxazepam, zolpidem and clonazepam) had the highest proportions doctor-shopped during the study period. In most cases, the proportion and the quantity doctor-shopped increased for opioids and decreased for benzodiazepines and Z-drugs. Pregabalin had the sharpest increase in the proportion doctor-shopped (from 0.28 to 1.40%), in parallel with a sharp increase in the quantity doctor-shopped (+843%, from 0.7 to 6.6DDD/100 000 inhabitants/day). Oxycodone had the sharpest increase in the quantity doctor-shopped (+1000%, from 0.1 to 1.1DDD/100 000 inhabitants/day), in parallel with a sharp increase in the proportion doctor-shopped (from 0.71 to 1.41%). Detailed results for all drugs during the study period can be explored interactively at: https://soeiro.gitlab.io/megadose/. In France, doctor-shopping occurs for many drugs from many pharmacological classes, and mainly involves opioid maintenance drugs, some opioids analgesics, some benzodiazepines and Z-drugs and pregabalin.

Associations Between Kratom-Related State Policy Environments and Kratom Use in a Nationally Representative Population in the United States

ABSTRACT Limited research has resulted in conflicting views on the risks versus benefits associated with kratom use. Despite no federal policy in the United States, individual states have implemented diverging policies through kratom bans, and legalization and regulation through Kratom Consumer Protection Acts (KCPAs). The Survey of Non-Medical Use of Prescription Drugs (NMURx) Program employs nationally-representative, repeated cross-sectional surveys on drug use. In 2021, weighted prevalence of past−12 month kratom use was compared across three state legal frameworks: no overarching state policy, KCPAs, and state bans. There was lower estimated prevalence of kratom use in banned states (prevalence: 0.75% (0.44, 1.06) relative to states with a KCPA (1.20% (0.89, 1.51)), and relative to states with no policies (1.04% (0.94, 1.13), though odds of use were not significantly associated with policy type. Kratom use was significantly associated with medicated treatment for opioid use disorder. While there were observed differences in the prevalence of past−12 month kratom use by state policy type, low uptake mitigated meaningful distinctions by limiting statistical precision, and potentially confounding effects, such as accessibility online. Future kratom-related policy decisions should be informed through evidence-based research.

Differential effects of healthcare worker burnout on psychotropic medication use and misuse by occupational level.

Burnout has been well examined among physicians and other high-wage, high-autonomy healthcare positions. However, lower-wage healthcare workers with less workplace autonomy (e.g., medical assistants, nurses' aides) represent a substantial proportion of the workforce, but remain understudied. We aimed to examine the effects of burnout on psychotropic medication use and misuse and whether these effects differed by occupational level. In March 2022, we collected data from a diverse sample of US healthcare workers (N = 200) and examined the cross-sectional relationship between burnout and changes in prescribed psychotropic medication (i.e., starting, stopping, and/or having a change in the dose/frequency) during the COVID-19 pandemic. We also separately examined the relationship between burnout and psychotropic medication misuse (i.e., without a prescription, in greater amounts, more often, longer than prescribed, and/or for a reason other than prescribed). We stratified models by occupational level (prescribers/healthcare administrators vs. other healthcare workers). Greater burnout was associated with higher odds of changes in prescribed psychotropic medication among prescribers/healthcare administrators (aOR = 1.23, 95% CI 1.01, 1.48), but not among other healthcare workers (aOR = 1.04, 95% CI 0.98, 1.10). Greater burnout was not associated with psychotropic medication misuse among prescribers/healthcare administrators (aOR = 0.96, 95% CI 0.82, 1.12) but was associated with increased odds of psychotropic medication misuse among other healthcare workers (aOR = 1.07, 95% CI 1.01, 1.14). Potential disparities in help-seeking and healthcare access might manifest in non-medical use of prescription drugs among some healthcare workers, which has implications for worker safety and well-being.

Association of State Drug Laws with Nonmedical Use of Prescription Medications in Adolescents.

The aim of the study is to examine the associations between mandatory access prescription drug monitoring programs (PDMPs), pain management clinic (PMC) laws, and doctor shopping (DS) laws with adolescent nonmedical use of prescription medications (NUPM). We linked 2011-2015 Youth Risk Behavior Survey data on 364,103 adolescents across 40 states with PDMP, PMC laws, and DS laws. We conducted a 2-way fixed effects logistic regression model to examine the associations between state drug laws and adolescent self-reported NUPM. We found some evidence that implementation of a mandatory access PDMP was associated with a decrease in nonmedical use of prescription drugs at the P = 0.079 level (average marginal effect: -0.017, 95% confidence interval = -0.036 to 0.002), while there were no associations with the implementation of PMC and DS laws. Our findings suggest that current state drug laws to combat NUPM are inadequate for adolescents.

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.

Current Prevalence of Substance Use Disorders and Its Dynamics in the Republic of Crimea: A Retrospective Study

Introduction: The study of the prevalence of narcological disorders is an integral part of the monitoring of the drug situation allowing identification of the main trends in the situation with the use of narcotic drugs. Objective: To analyze the level and structure of non-medical use of prescription drugs among the population of the Republic of Crimea and to assess their dynamics in 2020–2021. Materials and methods: The subject of the study was quantitative indicators characterizing the spread of drug use disorders in the Republic of Crimea. The information base of the study included data and materials of the Federal State Statistics Service and the Ministry of Health of the Republic of Crimea. We processed data of the statistical reporting documentation for 2020–2021, Forms No. 37, Information on patients with alcoholism, drug addiction, substance abuse, and No. 11, Incidence of substance use disorders. Incidence and prevalence rates were estimated per 100 thousand population. The data were analyzed in Microsoft Excel. Results: We established an increase in the incidence of substance use disorders in the Republic of Crimea in 2020–2021 from 38.3 to 42.9 per 100 thousand population (by 12.01 % in the year 2021 compared to 2020) and an increase in the overall incidence of drug addiction and abuse from 566.5 to 578.3 per 100 thousand population (2.08 %). We noted a slight decrease in opium addiction, transition to new synthetic drugs, and an increase in the proportion of a combined use of narcotic drugs. Males aged 20 to 59 years predominate among drug users. Conclusions: Our findings show a consistently high prevalence of non-medical use of prescription drugs among the population in the Republic of Crimea, an increase in the incidence and prevalence of drug addiction and in the number of doctor’s visits among drug abusers, and a growth of drug overdose deaths.

Workplace alcohol and other drug policy and support services in the United States, 2015-2019.

Despite their growing popularity, the extent and nature of workplace alcohol and other drug (AOD) policy and support services in the United States remain unclear. The present study examined the availability of AOD policies and support services in workplaces. Also, the associations between a combination of these workplace measures and the current AOD consumption (focusing on binge drinking, use of marijuana and other illicit drugs, and nonmedical use of prescription drugs) were assessed. Pooled Data from the 2015-2019 National Survey on Drug Use and Health (NSDUH) were utilized to examine a nationally representative sample of 131,751 employed adults. First, the rates of those who reported having a written AOD policy at their workplaces among the total sample and subpopulations across socioeconomic status, and those who reported an employee assistance program or other counseling services for substance use problems were estimated. Then the associations between a combination of the two workplace measures and individuals' current AOD consumption were tested using multinomial logistic regression analyses. Although 77.2% of employed individuals reported having a written AOD policy at their workplaces, only 50% of the sample had access to support services for substance use problems. The limited access to support services was most notable among traditionally disadvantaged groups (e.g., females, Hispanics, and individuals with limited English proficiency). The models suggest that having both a workplace AOD policy and support services was associated with significantly lower rates of marijuana and other illicit drug use compared to having neither of the two measures or only support services. Regardless of workplace AOD policies, the limited availability of support services, especially for disadvantaged workers, raises concerns. While further investigation is needed to understand the effectiveness of the comprehensive prevention approaches at workplaces, it is also important to advocate for the potential benefits of having employee assistance or other services available along with AOD policies.

When Substance Use Is Underreported: Comparing Self-Reports and Hair Toxicology in an Urban Cohort of Young Adults

Large-scale epidemiological research often uses self-reports to determine the prevalence of illicit substance use. Self-reports may suffer from inaccurate reporting but can be verified with objective measures. This study examined the following: the prevalence of illicit and non-medical substance use with self-reports and hair toxicology, the convergence of self-reported and objectively quantified substance use, and the correlates of under- and overreporting. The data came from a large urban cohort study of young adults (n= 1,002, mean age= 20.6 years, 50% female). The participants provided 3 cm of hair (covering the previous 3 months) and reported their illicit and non-medical substance use and their sociodemographic, psychological, and behavioral characteristics. Hair toxicology analyses targeted cannabinoids, ketamine, opiates/opioids, stimulants including 3,4-methylenedioxymethamphetamine, and relevant metabolites. Self-reports underestimated the prevalence of most substances by 30% to 60% compared to hair tests. The average detection ratio (hair test/self-report) was 1.50. Hair tests were typically more sensitive than self-reports. Underreporting was associated with a low level of that substance in hair. Self-reported delinquency and psychopathology were correlated with an increased likelihood of concordant positive self-reports and hair tests compared to underreporting. Overreporting was associated with infrequent self-reported use. Our study suggests that self-reports underestimate young adults' exposure to illicit substances and non-medical use of prescription drugs. Consequently, estimates of associations between substance use and risk factors or outcomes are likely biased. Combining self-reports with hair tests may be most beneficial in study samples with occasional substance use. Researchers can use specific factors (eg, detection ratios) to adjust prevalence estimates and correlations based on self-reports.

Use of substances to cope during the COVID-19 pandemic among transgender and gender diverse adults

ABSTRACT Background: Studies have found changes in substance use during the COVID-19 pandemic in specific populations. Transgender and gender diverse (TGD) individuals have experienced greater distress compared to cisgender individuals during the pandemic; however, there is little research on substance use among TGD individuals during this sensitive time period. Objectives: The objective of this study is to examine distress from COVID-19 and coping via substance use including alcohol, cannabis, tobacco, and non-medical use of prescription drugs (NMUPD) among TGD adults. Method: An online survey assessing substance use, general psychiatric symptoms, and COVID-19 anxiety was completed by 342 TGD individuals (16.4% transfeminine, 19.6% transmasculine, 64.0% Gender Diverse) in June/July 2020. Chi-square and structural equation modeling (SEM) analyses examined the connections between distress, coping, and substance use. Results: Seventy-one percent of participants reported no changes in substance use since the start of the pandemic and 22% reported an increase in substance use. Increased substance use was associated with alcohol (p < .001), cannabis (p < .001), and combustible tobacco (p < .001) use in the prior three months. SEM showed significant direct effects between distress and substance use coping, substance use coping and recent drug use, and an indirect effect of distress on recent drug use through substance use coping (β = .31, p = .001). Conclusion: Results highlight the risk of substance use to cope with COVID-19-related stress in a large sample of a minoritized population with mental health disparities. Transmasculine and gender diverse participants were especially likely to report using substances to cope.

Nemedicinska upotreba lekova koji se izdaju na recept u Srbiji - rezultati nacionalnog istraživanja o stilovima života - zloupotreba supstanci i kockanje

Background: Non-medical prescription drug use (NMPDU) of anti-anxiety medications is a growing public health concern. The aim of this study was to examine the prevalence of the use of anti-anxiety medications, as well as the factors associated with the NMPDU of these medications among adults in Serbia. Materials and methods: The study is a secondary analysis of the data from the National Survey on Lifestyles in Serbia - Substance Abuse and Gambling, conducted in 2014 and 2018, with 7,385 participants. Results: The prevalence of prescription only use of anti-anxiety medications was 13.5% (995/7,385), while the prevalence of the non-medical prescription drug use was 5.04% (372/7,385). Multinomial logistic regression analysis showed an association between non-medical prescription use of anti-anxiety medications and the female sex (OR: 3.23), the age between 35 and 44 years (OR: 1.91), the age between 45 and 54 years (OR: 2.40), or the age between 55 and 64 years (OR: 2.97), reporting a low (OR: 2.40) or average (OR:1.67) satisfaction with health status, being a smoker (OR: 1.62), having moderate (OR: 2.35) or high (OR: 4.56) psychological distress, and having a low/moderate risk for pathological gambling (OR: 1.86). Conclusion: There is a clear need for the inclusion of health care professionals and media in the education of patients on the risks of self-medication, medication exchange, or illegal purchase of these medications.