Nonmedical Prescription Drug Research Articles

Nonmedical Use of Controlled Medications by Adolescents and Young Adults: Clinical Report

Nonmedical prescription drug use (NMPDU), the use of controlled prescription medications for purposes other than initially intended by the prescriber, is common among adolescents and young adults (AYAs). Prescription stimulants, sedatives, and opioid medications are the 3 main categories of controlled medications nonmedically used by AYAs. The intent of this clinical report is to provide an overview of the epidemiology, motives, sources, and risk factors of NMPDU among AYAs. This report also describes acute and long-term morbidity and mortality associated with NMPDU and discusses the importance of primary and secondary prevention to reduce the burden of NMPDU among AYAs. This report concludes with a series of recommendations on how pediatricians can address NMPDU with patients and their families.

Non-medical use of tranquilizers and sedatives by 15-16-year-old adolescents in Estonia, 2003–2019

Abstract Background Non-medical use of prescription drugs has become a global concern in recent decades. This study aimed to explore trends in non-medical tranquilizers and sedatives use (NTSU) among adolescents in Estonia from 2003 to 2019. Methods Utilizing data from the cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted in 2003-2019, study included 15-16-year-old Estonian schoolchildren (n = 11,328; 48.6% boys). Cochran-Armitage test was employed to assess changes in NTSU trends, with statistical significance set at p < 0.05. Prevalence rates and 95% CIs used as outcome measures. Results From 2003 to 2019, the lifetime prevalence of NTSU significantly increased for both genders, with girls consistently showing higher rates. Among boys, NTSU rose from 5.0% (95% CI 3.8-6.5) to 11.3% (95% CI 9.6-13.3), particularly among those reporting NTSU 1-2 times, from 3.0% (95% CI 2.1-4.2) to 8.2% (95% CI 6.7-9.9), p < 0.001. Similarly, for girls, NTSU rose from 12.6% (95% CI 10.7-14.7) to 17.5% (95% CI 15.4-19.7), p < 0.001. There was an increase among girls reporting NTSU 1-2 times from 7.5% (95% CI 6.0-9.2) to 10.6% (95% CI 9.0-12.4), p < 0.001, and those reporting NTSU three or more times, from 5.1% (95% CI 3.9-6.6) to 6.9% (95% CI 5.6-8.4), p = 0.017. Among boys reporting medical tranquilizers and sedatives use (MTSU), NTSU rose from 21.1% (95% CI 13.9 to 30.0) in 2003 to 41.4% (95% CI 32.3 to 50.9) in 2019, p = 0.006. However, there was no statistically significant change in NTSU among girls reporting MTSU, remaining at 44.1% (95% CI 36.0 to 52.4) in 2019, p = 0.951. Conclusions Study reveals a significant increase in lifetime NTSU from 2003 to 2019, with girls consistently showing higher prevalence. Targeted interventions are needed to address adolescent non-medical prescription drug use, particularly among girls. Moreover, substantial NTSU among those reporting MTSU highlights the need to monitor and address non-medical usage in this subgroup. Key messages • Estonian adolescent non-medical tranquilizers and sedatives use surged from 2003 to 2019, particularly among girls, highlighting the need for targeted interventions. • The high prevalence of non-medical tranquilizer and sedative use among those reporting medical tranquilizer and sedative use underscores the necessity for vigilant monitoring.

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.

Substance use and its association with mental health among Swiss medical students: A cross-sectional study.

Studies on mental health and substance use among medical students indicated worrying prevalence but have been mainly descriptive. To evaluate the prevalence of substance use in a sample of medical students and investigate whether mental health variables have an influence on substance use. The data were collected as part of the first wave of the ETMED-L, an ongoing longitudinal open cohort study surveying medical students at the University of Lausanne (Switzerland). N = 886 students were included and completed an online survey including measures of mental health (depression, suicidal ideation, anxiety, stress, and burnout) and use of and risk related with several substances (tobacco, alcohol, cannabis, cocaine, stimulants, sedatives, hallucinogens, opioids, nonmedical prescription drugs, and neuroenhancement drugs). We evaluated the prevalence of use of each substance and then tested the association between mental health and substance use in an Exploratory Structural Equation Modeling framework. Statistical indices indicated a four-factor solution for mental health and a three-factor solution for substance use. A factor comprising risk level for alcohol, tobacco, and cannabis use - which were the most prevalent substances - was significantly associated with a burnout factor and a factor related to financial situation and side job stress. There was a significant association between a factor comprising depression, anxiety, and suicidal ideation and a factor related to the use of sedatives, nonmedical prescription drugs and neuroenhancement drugs. Although their use was less prevalent, a factor comprising the risk level of stimulants and cocaine use was significantly but more mildly related to the burnout factor. A factor comprising stress related to studies and work/life balance as well as emotional exhaustion was not related to substance use factors. In this sample of medical students, the prevalence of substance use was substantial and poorer mental health status was related with higher substance use risk levels.

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.

Prescription Stimulants in College and Medical Students: A Narrative Review of Misuse, Cognitive Impact, and Adverse Effects

Stimulants are effective in treating attention-deficit/hyperactivity disorder (ADHD). Psychiatrist Charles Bradley first made this discovery in 1937 when he found that children treated with amphetamines showed improvements in school performance and behavior. Between 1995 and 2008, stimulants to treat ADHD increased six-fold among American adults and adolescents at an annual rate of 6.5%. Stimulants without a prescription, known as nonmedical use or misuse, have also increased. The highest rates of nonmedical prescription drug misuse in the United States are seen most notably in young adults between 18 and 25 years, based on data from the Substance Abuse and Mental Health Services Administration in 2021. Aside from undergraduate students, nonmedical prescription stimulant use is prevalent among medical students worldwide. A recent literature review reported the utilization of stimulants without a prescription in 970 out of 11,029 medical students. The percentages of medical students across the country misusing stimulants varied from 5.2% to 47.4%. Academic enhancement, reported in 50% to 89% of college students with stimulant misuse, is the most common reason for nonmedical stimulant use. With the increasing use of stimulants among adolescents and adults, it is unclear what long-term outcomes will be since little data are available that describe differences in how side effects are experienced for prescribed and non-prescribed users. The present narrative review focuses on these adverse effects in this population and the reasonings behind misuse and nonmedical use.

Physical Activity, Dietary Habits and Factors Associated with Depression Among Medical Students of Sindh, Pakistan, During the COVID-19 Pandemic.

ObjectiveTo find out the association of physical activity, dietary habits and factors associated with depression among medical students of Sindh, Pakistan, during the coronavirus disease 2019 (COVID-19) pandemic.MethodsAn online cross-sectional study was conducted between June and August, 2020, on medical students from three medical institutions of Sindh, Pakistan. The study comprised three structured questionnaires related to demographic details, physical activity, dietary and sleep habits, COVID-19 pandemic-associated factors and patient health questionnaire, PHQ-9. A total of 864 students completed the questionnaires and participated in the study. The data was analysed on SPSS version 23.ResultsOur study showed that 244 (28.2%) medical students had mild depression, 192 (22.2%) had moderate depression, 80 (9.3%) had moderately severe depression and 80 (9.3%) had severe depression during the COVID-19 pandemic. Out of 864 students, 268 (31%) had no depression. Socioeconomic status, body mass index (BMI), chronic disease/comorbidity, addiction and non-medical prescription drug use were found to be statistically significant predictors of depression among medical students. On multilogistic regression analysis, physical activity, social media/app use and sleeping habits during COVID-19 were associated with depression (p-value < 0.05).ConclusionThe COVID-19 pandemic adversely affected physical activity and sleeping habits in association with depression among medical students. Promoting healthy eating habits, adequate physical activity, and a healthy lifestyle, particularly among students during lockdowns, is a critical component of coping with mental stress and depression. The findings of this study will aid in future research and campaign design in preparation for future pandemics and lockdowns.

Factors Contributing to Cognitive Enhancement (CEM) and Psychostimulant Medication (PSM) Use Among First Year Medical Students

Medical students perceive elevated levels of stress within their pre‐clerkship years in part due to select curricular factors such as grading scale or method of content delivery (e.g. traditional or integrated). Medical students cope with these stressors in a variety of ways. Alcohol and nicotine use are among the top coping methods. There are many changes being made to the medical curriculum to alleviate this perception of stress and increase effectiveness of the curriculum. An additional manifestation of perceived stress is the exhibition of non‐medical prescription drug use. Non‐medical prescription drug use (NMPDU) of cognitive enhancement (CEM) and psychostimulant medications (PSM) (i.e. Adderall) is associated with elevated perceived levels of stress within both the undergraduate college and practicing physician populations. The prevalence of non‐medical prescription drug use of CEM/PSMs among medical students is scarcely documented, while the perception of stress is heavily documented. This pilot study sought to address this gap in the literature by describing the prevalence of NMPDU of CEM/PSMs among first year medical students at an American allopathic institution in addition to perceived stress levels and the potential factors contributing to it. Ten students (less than 10% response rate) completed a questionnaire regarding CEM/PSM use, alcohol and nicotine use, sleep and study habits, and perceived stress. Student responses indicated presence of CEM/PSM use, with four of those students reporting non‐prescription use. “School” was the top reason for taking CEM/PSMs and the number one contributor to perceived stress. Additionally, half of the respondents reported an increase in use within their first year of medical school. The results, while limited, confirm presence of NMPDU of CEM/PSMs within this population, with potential correlations with levels of perceived academic stress. This work provides initial insights from which future work can build to analyze the relationship between NMPDU and curricular factors which may shed light on additional benefits to curricular redesign or evidence to necessitate proactive measures to prevent the phenomenon of NMPDU within the medical student population.

Nonmedical prescription drug use among female adolescents: the relative influence of maternal factors, social norms, and perceptions of risk and availability

Increasing understanding of the risk and protective factors for adolescent nonmedical use of prescription drugs (NMUPD) could inform prevention efforts. Several correlates have been identified, including parental factors, perceptions about use and accessibility, social norms, and age. However, these constructs have rarely been simultaneously examined using paired data from parents and adolescents. We aimed to examine the relative influence of these correlates among dyads (N = 349) of mothers and adolescent daughters. Using multiple logistic regression, daughters’ past NMUPD and inclination for future NMUPD were regressed onto descriptive norms for friend use, perceived drug accessibility and risk of harm from use, daughter age, mothers’ disapproval about use, mothers’ past NMUPD and inclination for future NMUPD, and the mother-daughter relationship quality. Akaike weights and lasso regressions were also estimated to evaluate the relative importance of each correlate. Higher descriptive norms for friend use, older age, and mothers’ inclination for NMUPD were risk factors for daughters’ NMUPD, while a closer mother-daughter relationship and mothers’ disapproving attitudes towards NMUPD were protective factors. The three analysis approaches were corroborative. Results suggest friend descriptive norms, mother-daughter relationship quality, and mothers’ attitudes about NMUPD are important prevention targets.

Within-Person Predictors of Same-Day Alcohol and Nonmedical Prescription Drug Use Among Youth Presenting to an Urban Emergency Department

Simultaneous alcohol and nonmedical prescription drug use (NMPDU) increases acute risks (e.g., overdose) associated with each; understanding social, substance use, and mental health predictors of same-day use may suggest intervention targets. At an urban emergency department, research assistants recruited youth ages 14-24 reporting past-6-month substance use (n = 599; 58.8% male). Participants self-administered validated measures of alcohol consumption, cannabis use severity (quantity and consequences), mental health symptoms, and social influences at baseline and at four biannual follow-ups. In addition, participants completed Timeline Followback calendars that assessed same-day use of alcohol and prescription drugs. We used negative binomial regression with person-level fixed effects to isolate within-person predictor effects on same-day use frequency. Between 6.0% (baseline) and 8.6% (6-month follow-up) of youth reported same-day alcohol use and NMPDU across follow-ups. Within-person increases in alcohol consumption, cannabis use severity, and depression and anxiety symptoms all corresponded to greater same-day alcohol and NMPDU frequency, with consistent findings across genders. Increased positive peer behaviors corresponded to decreased same-day use frequency among males but not females. Decreased parental support and increased delinquent peer exposures corresponded to greater same-day use frequency among females but not males. Substance use and mental health symptom escalation are robust predictors of greater same-day use frequency, whereas the roles of social factors appear gender-specific. Interrupting worsening trajectories of substance use and mental health symptoms, and enhancing social support and reducing delinquent peer exposures, may reduce same-day use frequency.

Large-Scale Social Media Analysis Reveals Emotions Associated with Nonmedical Prescription Drug Use.

The behaviors and emotions associated with and reasons for nonmedical prescription drug use (NMPDU) are not well-captured through traditional instruments such as surveys and insurance claims. Publicly available NMPDU-related posts on social media can potentially be leveraged to study these aspects unobtrusively and at scale. We applied a machine learning classifier to detect self-reports of NMPDU on Twitter and extracted all public posts of the associated users. We analyzed approximately 137 million posts from 87,718 Twitter users in terms of expressed emotions, sentiments, concerns, and possible reasons for NMPDU via natural language processing. Users in the NMPDU group express more negative emotions and less positive emotions, more concerns about family, the past, and body, and less concerns related to work, leisure, home, money, religion, health, and achievement compared to a control group (i.e., users who never reported NMPDU). NMPDU posts tend to be highly polarized, indicating potential emotional triggers. Gender-specific analyses show that female users in the NMPDU group express more content related to positive emotions, anticipation, sadness, joy, concerns about family, friends, home, health, and the past, and less about anger than males. The findings are consistent across distinct prescription drug categories (opioids, benzodiazepines, stimulants, and polysubstance). Our analyses of large-scale data show that substantial differences exist between the texts of the posts from users who self-report NMPDU on Twitter and those who do not, and between males and females who report NMPDU. Our findings can enrich our understanding of NMPDU and the population involved.

Comparison of non -Prescribed use of Tranquilizer with Stimulants Drugs among Medical Students

Objective: The goal of this study to look at the patterns of drug use among medical students. Methodology: All medical students enrolled in the Bakhtawer Amin Medical &amp; Dental College Multan, from first to fifth year were included in this study. The sample size was calculated using a single population proportion formula. The sample consisted of 200 students drawn from various batches and chosen using a stratified random selection procedure Results: The total study participants were 200 medical students of different years in which 139(70%) were males and 61(30%) were females. The participants having age range 18-25 years and maximum number of students were fall in age group 21-25 [117(58.5%)]. The results of the study showed that 76% used tranquilizer and 68% of the students used Stimulants without prescription as p-value 0.004 showing statistical significant difference in the use of both types of drugs. Student used tranquilizer and stimulants once a month as 32% vs 37% with significant p-value 0.034. Conclusion: The fourth-year students had the highest rate of drug usage. During the evaluation, the majority of students were drug users; there was no sign of physical dependency. The topic of non-prescribed drug usage among medical students is examined in this study. More research is needed to investigate national trends of drug addiction among medical students, as well as to find and reinforce protective variables. Supporting children with a non-prescription usage necessitates the development of strategies. Keywords:Nonmedical prescription drug use; Nonmedical prescription stimulant use; Nonmedical prescription tranquilizer use; Trends.

Simultaneous determination of scopolamine and butylscopolamine in pharmaceutical and beverage samples by capillary zone electrophoresis

Scopolamine is a natural tropane alkaloid widely used for medicinal purposes due to its anticholinergic and antispasmodic effects. However, this compound is also used as a potent sedative that facilitates sexual crimes when it is intentionally mixed into drinks. Butylscopolamine – active ingredient of buscopan® – is a safer compound derived from scopolamine and commonly used for treatments of abdominal pain and intestinal spasms. Although scopolamine can be purchased only with medical prescription, it has been reported cases where scopolamine can be produced from butylscopolamine (non-medical prescription drug) by simple heating, which increases the risk of contamination or enable easy access to scopolamine. The present study describes, for the first time, a method based on capillary electrophoresis with capacitively coupled contactless conductivity detection for rapid (∼17 injections h−1) and simultaneous quantification of scopolamine and butylscopolamine using a buffer solution composed by 20 mmol L−1 butyric acid and 7 mmol L−1 NaOH (pH = 4.5). The developed method presents several desirable characteristics: (i) simple sample preparation step (dissolution, filtration and dilution in water), (ii) wide linear range (10 to 1000 µmol L−1), (iii) adequate recovery values (104 ± 6% and 99 ± 6% for scopolamine and butylscopolamine, respectively) and, (iv) adequate limits of detection (LOD): 2.4 and 2.8 µmol L−1 for scopolamine and butylscopolamine, respectively. The method has been successfully applied as fast screening tool for detection of scopolamine (psychoactive compound) in adulterated beverages and butylscopolamine (anti-muscarinic drug) in pharmaceutical formulations. Most importantly, the CE method has great potential as simple, rapid and, low-cost diagnostic tool to discern between both compounds.

Social norms of college students engaging in non-medical prescription drug use to get high: What’s sex got to do with it?

Background: Relationships exist between perceived peer and own use of alcohol, cannabis, and tobacco, particularly when peers and participants are sex-matched. We investigated sex influences on social norms effects for college students’ non-medical prescription drug use (NMPDU). Methods: N = 1986 college students reported on their perceptions of male and female peers’ NMPDU frequency and their own past-month NMPDU. Results: Approximately 3% of students self-reported past month NMPDU, with no sex differences. In a linear mixed model, participants who engaged in NMPDU perceived significantly more frequent peer use. Female participants perceived more frequent peer NMPDU than did male participants, particularly when perceiving male peers’ NMPDU. Significant positive correlations were found between perceived peer NMPDU frequency and participants’ own NMPDU for all peer-participant sex combinations, with no evidence for stronger correlations with sex-matched pairs. Conclusions: While social norm interventions may be effective for college student NMPDU, sex-matching of these interventions is likely unnecessary.

Towards an understanding of how stress and resources affect the nonmedical use of prescription drugs for performance enhancement among employees

Based on assumptions of the Job Demands-Resources model, we investigated employees’ willingness to use prescription drugs such as methylphenidate and modafinil for nonmedical purposes to enhance their cognitive functioning as a response to strain (i.e., perceived stress) that is induced by job demands (e.g., overtime, emotional demands, shift work, leadership responsibility). We also examined the direct and moderating effects of resources (e.g., emotional stability, social and instrumental social support) in this process. We utilized data from a representative survey of employees in Germany (N = 6454) encompassing various job demands and resources, levels of perceived stress, and willingness to use nonmedical drugs for performance enhancement purposes. By using Structural Equation Models, we found that job demands (such as overtime and emotional demands) and a scarcity of resources (such as emotional stability) increased strain, consequently directly and indirectly increasing the willingness to use prescription drugs for cognitive enhancement. Moreover, emotional stability reduced the effect of certain demands on strain. These results delivered new insights into mechanisms behind nonmedical prescription drug use that can be used to prevent such behaviour and potential negative health consequences.

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.

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.

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.