Nonmedical Use Of Prescription Drugs Research Articles

Alcohol and illicit and non-medical prescription drug use before and during pregnancy in Stockholm, Sweden: A cross-sectional study

ObjectivesTo provide current estimates of alcohol and drug use among pregnant women attending antenatal care lectures in preparation for childbirth in Stockholm, Sweden. Study designA cross-sectional study. Data was collected anonymously among women attending lectures in preparation for childbirth. Main outcome measuresThe prevalence of alcohol and illicit and non-medical prescription drug use among pregnant women attending antenatal care lectures in preparation for childbirth. ResultsNine hundred and thirty-six pregnant women attending lectures in preparation for childbirth participated. Among those answering all questions about alcohol use during pregnancy, 4.2 percent reported use (95% confidence interval (CI), 3.0–5.7%) and among those answering all questions about illicit or non-medical prescription drug use during pregnancy, 0.5 percent reported such use (95% CI, 0.1–1.3%). The prevalences of binge drinking during pregnancy and alcohol and drug use before pregnancy are presented. Comparisons of anonymously and non-anonymously collected data are included. ConclusionsApproximately one in 25 women reported using alcohol and approximately one in 200 reported using illicit or non-medical prescription drugs while pregnant. Alcohol use during pregnancy may have decreased in Stockholm, Sweden.

Concussion, sensation-seeking and substance use among US adolescents

Background No large-scale epidemiological survey of adolescents in the US has assessed the association between lifetime history of concussion, propensity toward sensation-seeking, and recent substance use. Methods: This study assesses the association between lifetime history of diagnosed concussions, sensation-seeking, and recent substance use (i.e., cigarette use, binge drinking, marijuana use, illicit drug use, and nonmedical prescription drug use) using the 2016 and 2017 Monitoring the Future study of 25,408 8th, 10th, and 12th graders. Results: Lifetime diagnosis of concussion was associated with greater odds of past 30-day/2-week substance use. Adolescents who indicated multiple diagnosed concussions (versus none) had two times greater odds of all types of recent substance use, after adjusting for potential confounding factors. Adolescents indicating multiple diagnosed concussions also had higher adjusted odds of cigarette use, binge drinking, and marijuana use) when compared to adolescents who only indicated one diagnosed concussion. Accounting for adolescents’ propensity toward sensation-seeking did not significantly change the association between substance use and multiple diagnosed concussions. Conclusions: This study provides needed epidemiological data regarding concussion and substance use among US adolescents. Exposure to a single diagnosed concussion is associated with a modest increase in the risk of substance use and this association increases with the accumulation of multiple diagnosed concussions. These associations hold when controlling for sensation-seeking. Substance use prevention efforts should be directed toward adolescents who have a history of multiple concussions.

The Impact of Traumatic Stress, Social Support, and Substance Problems on Graduation Among Female Offenders in a Prescription Drug Court Program.

Trauma exposure and comorbid substance use are highly prevalent among female drug court participants. Despite the pervasiveness of the issue, few studies have investigated the impact of posttraumatic stress symptoms (PTSS) and nonmedical prescription drug use among this specific population. The present study examined the impact of posttraumatic stress, social support, and nonmedical prescription drug use on graduation outcomes among female participants in a specialized drug court program (N = 210). Participants either received motivational enhancement therapy/cognitive behavioral therapy (MET-CBT; N = 210) or both MET-CBT and Seeking Safety through intensive outpatient treatment (n = 109). The findings indicated that graduation was negatively correlated with posttraumatic stress, r = -.19, p = .007, d = 0.40; past 90-day nonmedical prescription painkiller, opiate, and analgesic use, r = -.19, p = .001, d = 0.44; tangible social support, r = -.24, p = < .001, d = 0.51; and past-month substance use problems, r = -.25, p < .001, d = .50. In addition, past-month substance use problems, OR = 0.84, 95% CI [0.72, 0.97]; PTSS, OR = 0.90, 95 % CI [0.82, 0.99]; and tangible social support, OR = 0.94, 95% CI [0.89, 0.98], were significant negative predictors of graduation. These results speak to the importance of facilitating the development of specialized evidence-based drug court interventions that target and improve comorbid substance use and trauma outcomes among female drug court participants to reduce recidivism and set a precedent for future research to replicate and expand upon these findings.

Quantifying Healthy Days Lost to the Non-Medical Use of Prescription Drugs (NMUPD) among a Sample of College Students

NMUPD remains a public health concern in the United States, especially among college students, and is associated with numerous poor health and economic consequences. This study aimed to quantify healthy days lost to the NMU of antidepressants, painkillers, sedatives, and stimulants using the Centers for Disease Control and Prevention’s “Healthy Days” index. A web-based survey was sent to a random, stratified sample of full-time students ages 18–24 at a large Mid-Atlantic university (N = 494). Healthy Days were calculated among demographics and for users and non-users of each prescription drug class by adding the number of poor physical and mental health days in the 30 days and subtracting the total from 30. Females reported significantly (P < .0001) fewer healthy days (N = 208) compared with males (N = 265). Significant healthy days differences were also detected between individuals who reported the NMU of antidepressants (P < .001) compared to those who did not for both males and females and for NMU of any drug (P < .01) for females only, but not for painkillers, sedatives, or stimulants. Based on our results we estimate, on average, females report 57 fewer healthy days per year than males. Furthermore, we estimate females lose an additional 34 days each year owing to the NMU of any drug and an additional 62 days for the NMU antidepressants. For males engaged in the NMU of antidepressants, we estimate the loss of 82 days each year. Results indicate significant impairment for the NMU of antidepressants and for the NMU of any drug, representing a critical barrier toward reaching Healthy People 2030 goals.

Sex differences in the associations of nonmedical use of prescription drugs with self-injurious thoughts and behaviors among adolescents: A large-scale study in China

Background To investigate the sex differences in the associations of nonmedical use of opioids and sedatives with non-suicidal self-injury (NSSI), suicidal thoughts, and suicide attempts.Methods This study presents secondary analyses of the 2015 National School-based Chinese Adolescents Health Survey. A total of 152, 527 students (aged 10-20 years) completing standard questionnaires were included in analyses. Appropriate sampling weights were utilized.Results After adjusting for the demographic profile, academic pressure, and depressive symptoms, nonmedical use of opioids (adjusted odds ratio [aOR]=1.82, 95% confidence interval [CI]=1.69~1.96) and sedatives (aOR=2.03, 95% CI=1.90~2.18) remain positively associated with NSSI, and adolescents who reported opioids or sedatives misuse were at a higher risk for suicidal thoughts and suicide attempts. A significant sex difference was found in the effects of nonmedical use of sedatives on NSSI, with the effects in girls stronger than that in boys (Ratio of two odds ratio [ROR]=1.18, P=0.011). Girls reporting nonmedical use of opioids and sedatives also had an increased risk of suicidal thoughts than boys (opioids misuse: ROR=1.25, P=0.002; sedatives misuse: ROR=1.21, P=0.006).Limitations Causal inference could not be tested due to the cross-sectional design.Conclusion Although nonmedical use of opioids or sedatives was associated with the increased risks of NSSI, suicidal thoughts, and suicide attempts among both boys and girls, there exist significant sex differences in these associations, and girls exhibited a higher risk of NSSI and suicidal thoughts than boys. Intervention strategies are needed to help vulnerable adolescents (e.g., those involved in NMUPD), with a focus on girls.

Evaluating the Relationships Between Demographic, Level of Drug Use and Self Esteem Among Female Students in Kaduna, Nigeria

Starting the early 1990s, the prevalence of nonmedical prescription drug use in Nigeria has been increased, especially among college students. Potential adverse effects such as poor academic performance and low self-esteem are known. The research is aimed but it is not understood whether demographics (age, socioeconomic level, educational level, and history of mental illness), level of drug use and self-esteem are related to drug use for female college students. The purpose of this quantitative correlational study of a cross-sectional nature was to determine if there were predictive relationships between level of drug use (as measured by the Drug Abuse Screening Test [DAST], and self-esteem (as measured by the Modified Rosenberg Self-Esteem Scale [MRSES] in female students in Kaduna in Nigeria. The theoretical framework was provided by the psychology of self-esteem theory, social learning theory, and identity theory. Primary data from a purposeful convenience and snowball sample of 300 female undergraduates (age 18-25) enrolled in three colleges was used to analyze data. The results of the multiple linear regression indicated that history of mental illness (p = .012) and DAST score (p = .000) were related to the MRSES score at statistically significant levels. Because the independent variables (level of drug use) were not related to the dependent variable (self-esteem) at a statistically significant level, the null hypothesis was not rejected. The results from this study could provide justification for college administrators to plan appropriate social, health, educational programs, and policies that could assist college students at risk of nonmedical prescription drug use and guide students in making right health choices and decisions. The research recommends that these investigations could inform the development of educational materials and methods/strategies toward stemming, minimizing and possibly preventing the risk of Non-Medical Prescription Drugs (NMPDU) among college students over the lifetime of their college careers and after.

Knowledge and attitude of substance abuse among the youths in Tikrit Iraq.

The data of substance abuse are limited in Iraq. Psychiatrists perceived non-medical use of prescription drugs, including benzhexol (muscle relaxant), benzodiazepines (anti-anxiety medication), and codeine (opiate painkiller), as the most common form of illicit substance use. This study was designed to assess the substance - abuse - related knowledge and attitude among the youth in Tikrit. Results showed that 78% didn't know any substance abusers while 22 knew at least one substance abuser. Also, a sizeable number of females and males(57.4%) were not able to define substance abuse correctly. Avoiding friends who are substance abusers can help in the prevention of substance abuse" was the most agreed upon factor for the prevention of substance abuse among males (82.5%) and females (85.7%). A percentage of females (84.6%) and males (70.2%) wary of those who used illegal substances. Also, females (76.9%) and males(68.2%) tended to avoid drug addicts. Both genders did not have enough knowledge about globally and locally used illicit substances. Negative attitudes toward substance abusers and substance abuse were clearly apparent in their responses. The youth agreed with spending as much money as possible on the treatment of substance abusers. The population showed good knowledge about the ways and factors that may help in the prevention of substance abuse.

Past 30–Day Marijuana Vaping: Prevalence and Predictors of Use in a Nationally Representative Study of U.S. Youth

Vaping has become an increasingly common mode of administration for marijuana among youth, but there are limited data on its prevalence. There is a need to better understand youth prevalence of past 30-day marijuana vaping and its predictors. Data were from a nationally representative sample of students from the Monitoring the Future survey in 2018 (N=9,131). This study examined past 30-day prevalence of marijuana vaping, and for a subset with complete data (n=5,755), the predictors of marijuana vaping among respondents asked about that behavior. Bivariate chi-square tests and multivariable logistic regression estimated the extent to which various factors were associated with marijuana vaping. These factors included the current use of various substances, school-related risk behaviors, attitude and risk behaviors related to substance use, and selected sociodemographic variables. Past 30-day prevalence of marijuana vaping was higher among 10th graders, male youth, and those in the Other race/ethnicity category. Students who engaged in current past 30-day alcohol use, cigarette use, binge drinking, and nonmedical use of prescription drugs had significantly greater odds of past 30-day marijuana vaping. Past 30-day use was more common among students with a lower perceived risk of marijuana use, those who claimed that it was easy to obtain a vaporizer or marijuana, students with a lower grade point average, and those with recent truancy. Past 30-day marijuana vaping is prevalent among U.S. students, and there are robust associations between use and school- and substance-related risk behaviors. These results suggest that the emergence of vaping products might redefine populations at risk, which should be taken into account by marijuana regulatory policies or prevention programs.

Developing and Implementing a Substance Abuse Prevention and Awareness Campaign at a State-Supported Regional University

The purpose of this descriptive study was to analyze the percent of targets achieved for five Student Objectives of Healthy Campus 2020. The objectives were chosen to assess the University's implementation of a substance abuse prevention and awareness campaign. Overall, 1,019 students completed the ACHANCHA II Survey. We identified non-medical use of prescription drugs (NMUPD) as a main area of concern. This state-supported regional university is committed to creating and sustaining an educational environment free from all forms of substance abuse.

Assessment and Evaluation of Student Health Behaviors at a State-Supported Regional University

The purpose of this study was to analyze the percent of targets achieved for 31 student objectives from eight of the topic areas of Healthy Campus 2020. The objectives chosen for critical review were based on Healthy Campus 2020 topics that were relevant to course objectives for a required general education undergraduate course on wellness. The assessment of these behaviors will be used to develop future interventions and curriculum additions aimed at increasing the health behaviors among undergraduate students and reducing the risky behaviors that might hinder their educational success. Overall, 1019 students at our university filled out the ACHA-NCHA II Survey. Our SSRU identified 12 areas of health concerns where improvements are necessary to more closely align with Healthy Campus 2020 – depression, anxiety, healthy weight, obesity, fruit/vegetable consumption, aerobic physical activity, muscle strengthening, condom and contraception use, HIV testing, nonmedical use of prescription drugs, and hookah use. The results show the institution needs to expand the emphasis on protective factors and reduce risk factors. Relaying reliable, evidence-based health information to our students is imperative in order to allow individuals to make informed choices.

Patterns of Substance Use and Associations with Mental, Physical, and Social Functioning: A Latent Class Analysis of a National Sample of U.S. Adults Ages 30–80

Objective: Trends show increased substance use among adults, yet little research on general population samples has examined differential patterns of licit and illicit substance use that can inform prevention and treatment efforts. This study identifies distinct patterns (classes) of substance use among 30- to 80-year olds, identifies demographic subgroups with the highest probability of class memberships, and compares classes on key indicators of functioning. Method: Participants (n = 1,877) were from the RAND American Life Panel. Online survey measures included current alcohol, tobacco, cannabis, and nonmedical prescription drug use, as well as mental, physical, and social functioning. Results: Latent class analysis identified four classes: “Lighter Drinking” (46.6%), “Abstaining” (33.7%), “Heavy Drinking with Cigarette/Cannabis Use” (17.1%), and “Cigarette Smoking with Prescription Drug/Cannabis Use” (2.6%). Of these classes, “Cigarette Smoking with Prescription Drug/Cannabis Use” reported the worst mental and physical functioning, and greater loneliness than the “Lighter Drinking” class. “Heavy Drinking with Cigarette/Cannabis Use” reported worse mental and physical functioning than the “Lighter Drinking” class and less social support than the “Lighter Drinking” and “Abstaining” classes. The “Abstaining” class reported consistently worse functioning than the “Lighter Drinking” class. Both polysubstance use classes were associated with younger age, less education, and lower income, and heavy drinking polysubstance use was associated with being male and unmarried. Conclusions: Although lighter drinking was the most common pattern, 20% of adults were classified into two polysubstance use classes associated with poorer functioning. Targeted efforts may be needed to reach certain subgroups of adults who are particularly susceptible to polysubstance use.

Prenatal and early childhood exposure to tetrachloroethylene (PCE) and non-medical use of prescription drugs: A retrospective cohort study in Cape Cod, MA

BackgroundBetween 1968 and 1983, public drinking water supplies of Cape Cod, Massachusetts were contaminated with the chlorinated solvent tetrachloroethylene (PCE). We previously found an affinity for risk-taking behaviors, including the use of illicit drugs, following prenatal and early childhood exposure to PCE. Using newly collected data, we investigated the risk of non-medical use of prescription drugs (NMUPD) following prenatal and early childhood PCE exposure. MethodsParticipants 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 618 individuals (363 exposed and 255 unexposed). The follow-up survey added questions on non-medical use of prescription pain relievers, tranquilizers, stimulants and sedatives. A validated leaching and transport model was used to estimate exposure to PCE exposure in drinking water. ResultsThere was a wide distribution of cumulative prenatal and early childhood PCE exposure levels (range: 0.04 g–3722.2 g). PCE exposed subjects had a 1.92-fold increase in risk of any non-medical use of prescription drugs [Adjusted RR: 1.92, (95% CI: 1.31, 2.83)]. Furthermore, the association followed a dose-response relationship where the risk of NMUPD was higher for those exposed to PCE levels greater than or equal the median level versus those exposed to levels less than the median [Adjusted RR: 2.05 (95% CI: 1.34, 3.15) vs. 1.83 (95% CI: 1.20, 2.79) (p-value for trend < 0.01)]. Additionally, we found moderate increases in risk by level of non-medical use (any non-medical use, non-medical use of 1 or more categories of prescription drugs, or 2+ categories) as well as by category of drug for pain relivers, stimulants and tranquilizers. ConclusionWe found that prenatal and early childhood exposure to PCE was associated with a moderate increase in the risk of NMUPD. Exposed subjects had dose-related increased risks of NMUPD of pain relievers, tranquilizers, and stimulants. This study has a number of limitations and is the first to report this association. Additional longitudinal studies of populations exposed to PCE during early life should be conducted to examine its long-term neurotoxic effects.

Modifiable Risk Factors Associated With Disposal of Unused Prescription Drugs by Parents of Adolescents.

The safe disposal of unused medications is one primary prevention strategy to reduce nonmedical prescription drug use among adolescents. We sought to identify modifiable risk factors associated with disposal of unused prescription drugs by parents of adolescents residing in ten south central Kentucky counties with disposal programs. In the fall of 2017, 4148 parents of adolescents participated in an anonymous, paper-based survey. We conducted generalized logit mixed models adjusted for within-school clustering to assess the relationship between disposal behaviors and modifiable risk factors while controlling for respondents' sociodemographic characteristics. The analytic sample consisted of parents in households in which someone had been prescribed an opioid medication within the past 12months (N = 627). Our findings indicated that almost 42% of parents reported disposing of unused prescription medication within the past 12months, and the majority disposed of medications at home rather than using a disposal program. Parents who perceived that any, compared to none, of their child's close friends engaged in nonmedical prescription opioid use had higher odds of reporting use of a disposal program. Parents who were aware of disposal programs, compared to those who were not aware, had greater odds of using them, rather than not disposing at all or disposing unused prescription medications at home. Compared to parents who perceived prescription drugs to be hard for adolescents to obtain for nonmedical use, parents who believed that prescription drugs were easily accessible to adolescents for nonmedical use had lower odds of using disposal programs than disposing of medications at home. Collectively, our findings suggest that enhancing awareness of disposal programs, while addressing parents' perceptions of their children's peers' use of nonmedical prescription opioids, should be considered to facilitate the disposal of unused medications and optimize current public health prevention efforts related to adolescent nonmedical useof these drugs.

Enhancement motivations for using prescription drugs among young adults in Nigeria

BackgroundThe desire for enhancement is a common motive for non-medical use of prescription drugs in Western countries. Little is known about the factors that motivate use in non-Western contexts. MethodsThe study explores access to prescription drugs and the motivations for using them among educated young adults in a city located in Anambra State, South-Eastern Nigeria. Semi-structured interviews were conducted with 23 participants aged 23–29 years. Data were thematically analysed using NVivo 12 Software. ResultsThe data indicate that prescription drugs are widely available and easy to access without a prescription in the unregistered ‘pharmacies’ and medicine shops that form part of Nigeria's informal healthcare system. Social networks are also a source of drugs. Participants shared detailed perspectives on their use of prescription drugs, revealing that codeine, Rohypnol, and high doses of tramadol are used to enhance performance in several social life domains. These drugs were described as enhancing performance and productivity in the workplace, and were taken by participants working as labourers and sales representatives. Male participants also shared accounts of using high doses of tramadol to improve stamina and skill in sports. Some participants took Rohypnol to enhance their creative and academic performance. Participants stated that drug use enabled them to meet the pressures associated with work, academia, and parental expectations. ConclusionThe findings suggest that prescription drugs are being strategically and instrumentally deployed by users to enhance different domains of social life. This is driven by users’ experiences of the drugs’ bodily effects, and it is supported by a context in which self-medication and informal healthcare are common. Participants’ reasons for seeking drug-induced enhancement reflect sociocultural factors within Nigeria and some West African countries, such as employment scarcity and the championing of sporting prowess. The findings can be used to inform the design of tailored approaches to reduce the harms presented by the non-medical use of pharmaceuticals among young adults.

Tramadol non-medical use in Four European countries: A comparative analysis

BackgroundUnderstanding prescription medication misuse is challenging due to lack of consistent measures of misuse behaviors and prevalence between countries. Tramadol is an atypical opioid with a dual mechanism, and has low drug liking compared to conventional opioids. We evaluate tramadol misuse compared to conventional opioids utilizing a harmonized validated national survey across four countries: Germany, Italy, Spain, and the United Kingdom (UK). MethodsData from the Survey of Non-Medical Use of Prescription Drugs (NMURx) Program online cross-sectional general population national surveys are analyzed from 2018 from four countries, with 45,000 total responses. Misuse and abuse of tramadol, codeine, morphine, and oxycodone are compared, and national prevalence estimates calculated via calibration weighting. Rates are calculated per population and per drug availability. Supplemental data are included from patients entering treatment centres and poison centre exposures. ResultsIn 2018, distribution, misuse, and abuse of four prescription opioids show similar patterns across four countries. In all countries, codeine is misused by the largest number of adults (estimated 861,181 in Italy to 4,676,680 in Spain in past 12 months). When adjusted for availability, tramadol is misused uncommonly with lowest or second lowest rates in all countries. Most abuse occurs by the oral route for all opioids, including tramadol with only 7.27 (Germany) to 54.92 (UK) cases per 100,000 units sold. ConclusionsIn four countries, tramadol misuse and abuse are infrequent both in absolute number of cases and in comparison to conventional opioids. Even with availability of intravenous tramadol formulations, misuse by injection is rare.

The Longitudinal Association between Sleep Duration and Suicidal Behavior among Chinese Adolescents: The Role of Nonmedical Use of Prescription Drug

ABSTRACT Objective/Background Abnormal sleep and nonmedical use of prescription drugs are known to be factors associated with suicidal behavior, but the nature of the association between weekday sleep duration and suicidal behavior has not been elucidated. Nonmedical use of prescription drugs may play a mediator role in the association mentioned above. Participants There were a total of 3,273 high school students interviewed at baseline with a response rate of 96.8% and followed up at one year (retention rate, 96.1%). The mean (SD) age of the students was 13.7 (1.0) years. Methods Data were drawn from the longitudinal data of the School-based Chinese Adolescents Health Survey. A total of 12 high schools were selected in Guangzhou. Suicidal behavior, weekday sleep duration, and nonmedical use of prescription drugs were measured. Results Sleeping < 7 hours/day at time 0 was positively associated with suicidal ideation (Adjusted odds ratio [AOR] = 1.51, 95% CI = 1.21–1.89) and suicide attempts (AOR = 2.35, 95% CI = 1.02–5.38) at time 1. The mediation analyses showed that baseline opioids misuse or sedatives misuse partially mediated the associations of baseline short weekday sleep duration with suicidal ideation and suicide attempts at one-year follow-up. Conclusions Baseline short weekday sleep duration was positively associated with subsequent suicidal ideation and suicide attempts, and nonmedical use of opioids or sedatives partially mediated the associations mentioned above. Suicidal behavior can be prevented, short weekday sleep duration and nonmedical use of prescription drugs may be risk factors for suicidal behavior, and the respective roles of these factors are needed to be better understood.

Prospective associations of e-cigarette use with cigarette, alcohol, marijuana, and nonmedical prescription drug use among US adolescents

BackgroundAs e-cigarette use continues to increase in the U.S., research is needed to understand its prospective risk for cigarette smoking and other substance use in young adulthood, including alcohol, marijuana, and nonmedical prescription drugs (NMPDs). MethodsThis study used data from the Monitoring the Future (MTF) study a nationally representative annual survey of 12th graders (modal age 18) in the US. The analytic sample included 2014–2016 MTF cohorts that were selected and completed follow up one year later (modal age 19; n = 717). Using logistic regression, we examined cross-sectional and prospective associations of past 30-day e-cigarette use with past 30-day cigarette, alcohol, marijuana, and NMPD use. We examined prospective associations among the full sample and associations with incidence of each of these substances among those who reported no history of use in 12th grade. ResultsIn cross-sectional analysis, those who reported past 30-day e-cigarette use at age 18 were more likely to report past 30-day cigarette use, alcohol use, marijuana use, and NMPD use at age 19. In multivariable longitudinal analysis, past 30-day e-cigarette users at age 18 were more likely to report past 30-day cigarette, marijuana, and NMPD use at age 19, including e-cigarette users who had no history of using these substances at age 18. ConclusionsThis study suggests that e-cigarette use may be an indicator of future substance use risk in young adulthood. Adolescent e-cigarette users may benefit from secondary prevention efforts to mitigate this risk.

Non-medical use of benzodiazepines and GABA analogues in Europe.

We investigated the prevalence of non-medical use (NMU) of benzodiazepines and GABA analogues in Europe. Data were collected using the online Non-Medical Use of Prescription Drugs (NMURx) survey from France, Germany, Italy, Spain and the UK. The study included 55 223 eligible surveys which, after post-stratification weights were applied, represented approximately 260 million European adults. Lifetime NMU of benzodiazepines was highest in Spain (6.5%, 95% CI: 6.0-7.0) and lowest in Germany (1.7%, 1.5-2.0). Lifetime NMU of GABA analogues was highest in Germany (5.4%, 5.0-5.7) and lowest in France (2.2%, 1.9-2.5) and the UK (2.2%, 1.9-2.6) While no notable difference was observed for France or the UK, there was a higher prevalence of last 12-month NMU of benzodiazepines compared to GABA analogues in Italy (2.4 times higher) and Spain (3.0 times higher) and a higher prevalence of NMU of GABA analogues compared to benzodiazepines in Germany (2.6 times higher). This study shows that there is variation in NMU of benzodiazepines and GABA analogues among countries. Of particular interest is the high incidence of GABA analogue NMU in Germany and benzodiazepine NMU in Spain. Further research to identify factors and motivations responsible for the higher prevalence observed are essential to inform public health policies in those countries.

Sports betting in Serbia- National survey on lifestyles in Serbia: substance abuse and gambling

Abstract Background Sports betting has been one of the gambling games which are strongly associated with problem gambling. The aim of our study was to examine the association of social (socio-demographic and socio-economic) and lifestyle characteristics of sports bettors in Serbia. Methods The cross-sectional study was the secondary analysis of the data from the National Survey on lifestyles in Serbia: substance abuse and gambling, conducted during 2014. The questionnaire consisted of 158 items. The first part was on socio-demographic characteristics. The second was on lifestyle characteristics with Beverage Specific Quantity Frequency - BSQF Instrument developed during Standardized measurement of Alcohol-related troubles-SMART project, Kessler psychological distress scale, Problem Gambling Severity Index (PGSI), use of illicit drugs, and prescription/ non-medical prescription drug use. The sports betting was assessed with yes/ no question: 'Have you played sports betting in the past 30 days?' Results The 10% of participants reported sports betting in the past 30 days. The sports betting was associated with being male (OR:11.22, 95% CI: 7.62-16.53), aged 18-44 (OR: 2.33, 95% CI: 1.78-3.07), living in urban areas (OR: 1.79, 95%CI: 1.41-2.28), being single (OR: 1.35, 95 % CI: 1.06-1.72), having secondary education (OR: 1.47, 95% CI: 1.09-1.98), being unemployed (OR: 2.71, 95% CI:1.35-5.45), employed (OR: 3.00, 95 % CI: 1.53-5.90), or student (OR: 3.86, 95% CI: 1.83-8.17), binge-drinking (OR: 1.94, 95% CI: 1.39-2.71), non-medical prescription drug use (OR: 1.78, 95% CI: 1.22-2.59) and low/ moderate (OR: 12.82, 95% CI: 8.50-19.33), and problem gambling (OR: 43.38, 95% CI: 11.75-160.11). Conclusions The association of sports betting with risk behaviors among young males should be a concern for public health authorities. Key messages The prevalence of the past 30 days betting in Serbia is 10%. Sports betting is associated with risk behaviors.

Predictors of Opioid Misuse During Emerging Adulthood: An Examination of Adolescent Individual, Family and Peer Factors

IntroductionOpioid misuse has reached epidemic proportions among emerging adults in the U.S. To inform prevention efforts, this study examined adolescent factors related to alcohol and marijuana (AM) use that are associated with a higher or lower risk for opioid misuse during emerging adulthood. MethodsWe used 11 waves of survey data from a diverse California cohort (N = 6,509). Predictor variables from waves 1-7 (ages 11-17) included individual (resistance self-efficacy, positive expectancies) family (older sibling and important adult use), and peer (perceived norms, time spent with peers who use, peer approval) factors. Opioid misuse at wave 8 (mean age = 18.3) and wave 11 (mean age = 21.6) included heroin and nonmedical prescription drug use. ResultsInitial latent growth models (LGMs) indicated that nearly all intercepts and slopes for individual, family, and peer AM factors predicted opioid misuse at waves 8 and 11. These associations were reduced to non-significance after adjusting for prior other substance use with the exception of three intercepts: positive expectancies, peer approval, and older sibling use predicted a higher probability of opioid misuse at wave 8. ConclusionsStronger AM positive expectancies, perceived peer approval of AM use, and older sibling AM use during adolescence are associated with a higher likelihood of opioid misuse during the transition to emerging adulthood. However, most adolescent factors were no longer associated with subsequent opioid misuse after adjusting for history of other substance use, highlighting the importance of considering the larger context of substance use in studies of opioid misuse among young people.