Internet gaming disorder (IGD) and nonmedical prescription drug use (NMPDU) are prevalent, co-occurring concerns among young adults. Although prior research links problematic gaming and substance misuse, few studies have examined this relationship in non-college populations or whether student status modifies this association. This study examined the relationship between Gaming Addiction Scale (GAS) score and NMPDU among 1022 Rhode Island young adults aged 18 to 25. In the total sample, 44.6% identified as cisgender heterosexual female, 42.4% as sexual or gender minority (SGM), and 13.0% as cisgender heterosexual male. Multivariable logistic regression estimated the adjusted association between GAS scores and NMPDU, and an interaction term between GAS and student status was tested. Overall, 12.1% reported lifetime NMPDU. Higher GAS scores were associated with increased odds of NMPDU (adjusted odds ratio [AOR] = 1.05; 95% confidence interval [CI]: 1.01-1.09). Student status alone was not significantly associated with NMPDU; however, a significant interaction was observed between GAS and student status (AOR = 1.09, 95% CI: 1.01-1.18, p = 0.031). Higher GAS scores were positively associated with NMPDU, with student status strengthening this association. Findings support screening for problematic gaming, particularly among students, and integrated prevention strategies addressing both behavioral and substance-related risks.

Background While non-medical use of prescription drugs (NMUPD) differs across sex and age groups, little is known about how NMUPD differs based on overlapping socioeconomic, health, and substance use characteristics. Methods We identified patterns in the probability of NMUPD using chi-square automatic interaction detection (CHAID) analysis. Eighteen sociodemographic, health, and substance use variables were sourced from the 2023 Canadian Substance Use Survey from 32,586 respondents aged 15 and older. Results Overall, 2.2% of our sample engaged in NMUPD. Illegal drug use, self-rated mental health, disability, and student status emerged as key predictors of NMUPD. In a model without specific prescription drug use indicators, we observed the highest probability of NMUPD among individuals who used illegal drugs, particularly youth and young adults with a disability (25.0%). In a model with three specific prescription drug use indicators, males who used illegal drugs, prescription stimulants, and prescription opioids had the highest probability of NMUPD (74.5%). Conclusion Our findings show clear patterns in NMUPD among this general population sample, especially related to illegal drug use, age, sex, disability, and mental health. It is important to consider how sociodemographic, health, and substance use factors work together to shape risks of NMUPD.

The nonmedical use of prescription drugs (NMUPD) through channels outside the healthcare system has emerged as a significant public health issue; however, its clinical implications in overdose cases remain underexplored in Japan. This study aimed to elucidate the prevalence and characteristics of NMUPD in patients with acute drug overdose. In this observational study, we retrospectively studied patients with overdose who were admitted to a tertiary emergency department in Japan between April 2017 and March 2024. Patients were categorized into the NMUPD group (obtained drugs via nonmedical routes, such as family, acquaintances, the Internet, and unauthorized workplace access) and prescribed group. Demographic, clinical, and overdose-related variables were compared between the groups. Statistical analyses included the chi-square and Mann-Whitney U tests, with multiple imputation for missing data. Among the 416 patients with overdose, 7.9% met the NMUPD criteria. The primary sources of NMUPD were family members, followed by friends/acquaintances, Internet purchases, and unauthorized pharmacy access. The NMUPD group showed significantly higher rates of alcohol coingestion (p = 0.029) and absence of psychiatric diagnoses (p = 0.009). Benzodiazepines predominated in both groups, with frequent use of non-benzodiazepine and antidepressants. This study revealed that NMUPD occurs even within Japan's tightly regulated healthcare system, primarily via informal sources such as patients' families and friends. NMUPD was linked to alcohol coingestion and limited psychiatric follow-ups. NMUPD involved several commonly prescribed psychotropic drug classes rather than a single class.

The impact of prescription drug monitoring programs on functional health.

Racial and ethnic disparities in opioid overdose deaths in the US have widened in recent years, potentially driven by inequitable access to naloxone. This study evaluated engagement across the naloxone care cascade, a framework encompassing awareness, access, training, possession, and use of naloxone. Using a nationally representative US sample, we analyzed data from 57,719 adults who completed the 2024 Survey of Non-Medical Use of Prescription Drugs to characterize differences by race and ethnicity in the degree of contact with any component of the naloxone care cascade. Black, Hispanic, and Asian adults had significantly lower engagement across all steps of the cascade compared with White adults. These trends were similar among a subgroup of adults with recent illicit or nonmedical opioid use. Culturally tailored, equity-focused strategies are needed to address the systemic drivers of racial and ethnic disparities in naloxone engagement.

Aims Gabapentin is not a federally controlled substance, yet multiple states have implemented gabapentin-specific policies in response to non-medical use (NMU). This study aims to compare prevalence of gabapentin NMU by state policy type and examine the association between gabapentin NMU and gabapentin-related state policy types. Methods Data come from the Survey of Non-Medical Use of Prescription Drugs, which employed an online cross-sectional survey in the U.S. in 2021. Weighted, estimated prevalence of gabapentin NMU was compared by gabapentin state policy type: a) Schedule V controlled substance with mandated Prescription Drug Monitoring Program (PDMP) reporting; b) unscheduled, but PDMP reporting is required; and c) no policy. Additionally, weighted logistic regression analysis was performed to reveal the association between past 12-month gabapentin non-medical use and gabapentin-related state policies. Results Gabapentin NMU was most prevalent in states where it is a controlled substance alongside mandatory PDMP reporting (prevalence 1.72% [1.41, 2.04]) compared to lower rates among states with mandatory PDMP reporting alone (1.43% [1.20, 1.67]) and states with no gabapentin policy (1.30% [1.18, 1.42]). Results of Tabel 4 show gabapentin NMU was significantly associated with past 12-month pain (OR: 3.80 [3.18, 4.53]), substance use treatment (OR: 2.89 [2.15, 3.89]), and receiving medication for opioid use disorder (OR: 1.95 [1.28, 2.97]). Conclusions These findings represent the first apparent estimates of prevalence of gabapentin NMU in the U.S. and underscore the need for continued research on the effects of gabapentin state policies, including impacts on individuals, the ongoing opioid crisis, and NMU and diversion.

Background: The inappropriate use of medications prescribed by physicians is complicated by the presence of misinformation and disinformation about substances, shaping attitudes, behaviors, and perceptions around the use of substances. Objectives: This study aims to explore the associations among “news-finds-me” (NFM) perceptions, substance misinformation beliefs, and nonmedical prescription drug use, with particular attention to how these associations vary by gender. Results: In order to understand these associations, we conduct a national survey in the U.S. among young adults aged 18-29 (N = 1201). The findings from a moderated mediation model show that participants with higher NFM perceptions tend to have greater substance use misinformation beliefs, which in turn, is associated with increased acceptance of nonmedical prescription drug use. Moreover, this association is moderated by gender such that the association is true only for males in our sample. Conclusions: This study suggests the broader implications of passive information consumption on substance misinformation belief and substance use behavior in case of males, suggesting that targeted strategies are necessary to address gender-specific differences.

Effects of compassion satisfaction, burnout, and secondary traumatic stress on current drug use among healthcare workers: Differences by occupational level.

ObjectivesThis study explores the drug use behaviour in the US general population in the early days of the COVID-19 pandemic with a focus on the relationship between sociopsychological factors, mobility...

The Role of Military Identity in Non-Medical Prescription and Illicit Drug Use Among Reserve and National Guard Soldiers

ABSTRACT Patterns of nonmedical prescription drug (NMPD) use, and relationships with intolerance frustration beliefs were examined in a sample of 765 French university students (mean age = 18.71 years, SD = 1.41). We analyzed self-reported use of NMPD and responses to a questionnaire assessing frustration intolerance beliefs (i.e. discomfort intolerance; entitlement; emotional intolerance and achievement frustration). TwoStep cluster analyses identified four patterns of NMPD use nonusers (82%), hypnotic users (8%), anxiolytic users (7%) and poly-NMPD users (3%). Compared with nonusers, poly-hypnotic users and anxiolytic users scored higher on emotional intolerance, and poly-NMPD users and anxiolytic users scored significantly higher on entitlement. Implications for prevention and clinical intervention are discussed.

BackgroundGiven the opioid overdose crisis, surveillance of evolving opioid use patterns is critical to the effective deployment of mitigation strategies. The National Survey on Drug Use and Health (NSDUH) provided the first annual US estimate of illicitly manufactured fentanyl (IMF) use in 2022. However, as a household survey, NSDUH may not capture the full extent of population heroin and IMF use. We compare estimates of past-year heroin and IMF use and correlates of use in NSDUH and the Survey of Non-Medical Use of Prescription Drugs (NMURx) survey which employ an alternate sampling strategy.MethodsWe conducted a cross-sectional analysis of the 2022 NSDUH and NMURx. NSDUH samples respondents using a probability-based approach targeting community-dwelling individuals, while NMURx samples respondents using an opt-in, online survey panel. US adults ages 18 years and older were included. The main outcomes were differences in the weighted percentage of population reporting past-year use of heroin, IMF, and either heroin or IMF between the surveys. Secondary outcomes were the patterns of association of past-year heroin or IMF use with comorbid substance use, treatment utilization, and demographic characteristics between the surveys. Data were analyzed March to June 2024.ResultsNSDUH (n = 47,100 respondents) had a lower proportion of respondents who identified as non-Hispanic White and graduated college, and a higher proportion with past week employment than NMURx (N = 59,041 respondents). Past-year use of heroin, IMF, and either heroin or IMF were lower in the NSDUH than the NMURx. NSDUH estimated 0.52% (95% CI: 0.40%, 0.69%) %) of the US population used either heroin or IMF in the past year compared to 1.05% (95% CI: 0.97%, 1.14 0) in NMURx. In regression models, stimulant and benzodiazepine use were consistently associated with increased heroin or IMF use across both surveys.Conclusions and relevanceThe estimated prevalence of heroin or IMF use was nearly 50% higher in the NMURx compared to NSDUH. These results highlight the importance of using complementary surveillance approaches to obtain accurate estimates of the prevalence and patterns of heroin or IMF use.

While risk perceptions affect various health behaviors, there is insufficient knowledge about how they are formed and change over time surrounding illicit substance use. This study investigates the role of prior use, social influences, and media information on changes in the risk perceptions of expected susceptibility and severity of side effects in the context of the nonmedical use of prescription drugs for cognitive enhancement. It also examines differential updating by testing for the potential conditioning effects of prior use and self-control. We use a three-wave panel design (N = 8,377) with a nationwide random sample of adults in Germany. Fixed-effect regression models show that prior use and positive media information lower both risk perceptions, while negative information from others and the media produce increases. Rare users compared to non- and frequent users were more sensitive to new information obtained through others, thus showing stronger changes in risk perceptions. Moreover, self-control partially moderated the magnitude of changes in both risk perceptions, for example, regarding side effects reported in the media, which affected individuals with low self-control more strongly. In sum, the results indicate that personal and vicarious information affect the updating of risk perceptions, while partial evidence exists for differential updating.

Non-medical prescription drug (NMPD) use is a significant public health issue, with increasing use among university students. Previous literature has focused on mental health and NMPD use; however, few studies have assessed the roles of well-being and world beliefs, and few have included drugs outside of stimulants, sedatives, and opioids. This study examines the relationships between NMPD, cannabis, and hallucinogen (NMPDCH) use and mental health, well-being, and world beliefs among young adults (N=513). Participants completed online questionnaires assessing demographics, depression, coping, religiosity, and NMPDCH use. Many reported using cannabis (48.5%), while less reported using stimulants (26.7%), sedatives (17.3%), opioids (10.8%), and hallucinogens (14.4%). Five logistic regressions assessed the relationships between mental health, well-being, religious practices and NMPDCH use. Demographic factors were controlled in analyses. Higher depression levels were associated with increased NMPD and cannabis use. Higher spirituality was associated with increased nonmedical stimulant, cannabis, and hallucinogen use, while increased religiosity was associated with reduced use for all substances except opioids. Attendance of worship services was associated with decreased cannabis and hallucinogen use. This study is one of the first to document the association between NMPDCH use and mental health, well-being, and religious practices among young adults. Results suggest that depression and spirituality were differentially predictive of NMPDCH use, while religiosity and attendance of worship services were protective factors against NMPDCH use (except opioids). This study supports future substance use prevention efforts focusing on mental health treatment and the role of religion and community in preventing substance use among young adults.

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.

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.

The complexity of the drug market and the constant updating of drugs have been challenging issues for drug regulatory authorities. With the emergence of new psychoactive substances (NPS) and the nonmedical use of prescription drugs, forensic and toxicology laboratories have had to adopt new drug screening methods and advanced instrumentation. Using high-performance liquid chromatography coupled with Orbitrap mass spectrometry, we developed a screening method for common NPS and other drugs. Two milliliters of mixed solvent of n-hexane and ethyl acetate (1:1, v:v) were added to 500 μL of blood or urine sample for liquid-liquid extraction, and methanol extraction was used for hair samples. The developed method was applied to 3897 samples (including 332 blood samples, 885 urine samples, and 2680 hair samples) taken from drug addicts in a province of China during 2019-2021. For urine and blood samples, the limits of detection (LODs) ranged from 1.68 pg/mL to 10.7 ng/mL. For hair samples, the LODs ranged from 3.30 × 10-5 to 4.21 × 10-3 ng/mg. The matrix effects of urine, blood, and hair samples were in the range of 47.6%-121%, 39.8%-139%, and 6.35%-118%, respectively. And the intra-day precision was 3.5%-6.0% and the inter-day precision was 4.18%-9.90%. Analysis of the actual samples showed an overall positive detection rate of 58.9%, with 5.32% of the samples indicating the use of multiple drugs.

A recent study has found that reductions in the nonmedical use of prescriptions by adolescents declined between 2009 and 2022 based partly on peer‐to‐peer diversions and perceived difficulty in obtaining such substances. While the results may be partially attributed to prescription guideline changes from the federal Centers for Disease Control and Prevention and to schools being closed during COVID, it's still essential to watch out for counterfeit pills, which can contain illicit and lethal fentanyl and other substances, according to authors of a research letter published in the July 24 online issue of JAMA. In “Adolescent Use, Diversion Sources, and Perceived Procurement Difficulty of Prescription Medications,” Sean Esteban McCabe, Ph.D., and colleagues discuss trends reported in the Monitoring the Future study (see ADAW https://onlinelibrary.wiley.com/doi/10.1002/adaw.34064), which showed a significant decrease in lifetime nonmedical use of prescriptions (23.66% of high school students in 2009 to 16% in 2022), as well as a decline in obtaining these medications from a friend (57.96% in 2009 to 26.87% in 2022) and in buying medications from a friend (44.35% in 2009 to 19.42% in 2022). The percentage of adolescents who said it would be impossible for them to obtain prescriptions for nonmedical use increased from 35.56% in 2009 to 48.96% in 2022. The problem — that lockdown of COVID from 2020 to 2022 and school closures making it difficult to even meet with friends — could affect these numbers, but the researchers expanding on the findings.

Individuals with a substance use disorder (SUD) often face barriers to accessing health care, resulting in unmet needs and delayed care. Hospital-based services have the potential to engage individuals with a SUD in ongoing treatment, but there is limited literature characterising this population. The Outcomes for Patients Accessing Addiction Care study was a prospective hospital-based cohort study conducted at St. Paul's Hospital in Vancouver, Canada. Participants were recruited from January 2018 to March 2020. Data were collected through an interviewer-administered questionnaire, including socio-demographic information, substance use history and mental health screening. The cohort included 536 participants, with 31% aged 30-39 years, 63% identifying as White and 74% reporting male sex at birth. Nearly half of the participants were either homeless or living in single room occupancy. Use of substances more than once per week was reported for tobacco/nicotine (86%), marijuana (43%), non-medical use of prescription drugs (29%), illicit stimulants (52%) and illicit opioids (61%). This preliminary report provides a description of a hospital-based cohort of individuals with a SUD accessing addiction care. The findings highlight demographic characteristics, mental health issues, substance use patterns and barriers to accessing services. Understanding these factors can inform the development of patient-centred interventions and improve engagement and retention in addiction care. Further research is needed to explore interventions and program effectiveness in this population.

Abstract Work-related stress has been well-examined among physicians, but little is known about how it might affect drug use or healthcare workers in lower-wage occupations characterized by high job demands and low occupational autonomy (e.g., medical assistants, nursing assistants). In March 2022, we collected data from a diverse sample of healthcare workers (N = 200). We separately examined the cross-sectional relationships between several work-related experiences (i.e., compassion satisfaction, burnout, and secondary traumatic stress) and measures of current drug use (i.e., non-medical use of prescription drugs [NMUPD], cannabis use, and illicit drug use). We then examined for differences occupational level (i.e., prescriber/administrator vs. other healthcare worker). In main effects models, greater burnout and secondary traumatic stress were both associated with higher odds of NMUPD, cannabis use, and illicit drug use (ps < 0.01). Greater compassion satisfaction was associated with lower odds of illicit drug use (p < 0.05), but not with NMUPD or cannabis use (ps > 0.05). There was a significant interaction between secondary traumatic stress and occupational level on NMUPD (p < 0.05) such that there was no relationship between secondary traumatic stress and NMUPD among prescribers/administrators, but the likelihood of NMUPD among other healthcare workers increased with greater secondary traumatic stress. Similar trend-level interactions were observed between secondary traumatic stress and occupational level on cannabis use (p < 0.10) and between burnout and occupational level on NMUPD. Burnout and secondary traumatic stress are systemic issues, and results suggest they may contribute to drug use. Healthcare workers in positions characterized by high demands and low autonomy may be especially vulnerable.