Prescription Drug Use Research Articles

Polysubstance Use in Early Adulthood: Patterns and Developmental Precursors in an Urban Cohort.

Polysubstance use (i.e., simultaneous or sequential use of different psychoactive substances) is associated with increases in the risk of severe health problems and social impairments. The present study leverages community-representative, long-term longitudinal data from an urban cohort to assess: (a) the prevalence and continuation of polysubstance use between adolescence and early adulthood; (b) different patterns of polysubstance use (i.e., combinations of substances) in early adulthood; and (c) childhood risk factors for polysubstance use in early adulthood. At age 20 (n = 1,180), respondents provided comprehensive self-reported information on past-year substance use, including use of legal and illicit substances (e.g., cannabinoids, stimulants, and hallucinogens), and nonmedical use of prescription drugs (e.g., opioids, tranquilizers). In adolescence (ages 13–17), limited versions of this questionnaire were administered. In childhood (ages 7–11), potential risk factors, including individual-level factors (e.g., sensation-seeking, low self-control, aggression, and internalizing symptoms) and social-environmental factors (e.g., social stressors, exposure to others’ substance use), were assessed. We fitted latent class models to identify classes of participants with different substance use profiles in early adulthood. The results show that polysubstance use increased between early adolescence and early adulthood. The continuation of polysubstance use was common (stability between all adjacent assessments: odds ratio >7). At age 20, more than one-third of participants reported polysubstance use (involving illicit substances, nonmedical use of prescription drugs, and cannabidiol). Four latent classes with polysubstance use were identified: (1) broad spectrum of substances; (2) cannabis and club drugs; (3) cannabis and the nonmedical use of prescription drugs; and (4) different cannabinoids. Risk factors for any polysubstance use included childhood sensation-seeking and exposure to others’ substance use; some childhood risk factors were differentially associated with the four classes (e.g., low self-control in childhood was associated with an increased likelihood of being in the broad spectrum class). The classes also differed with regard to socio-demographic factors. This study revealed that polysubstance use is a widespread and multifaceted phenomenon that typically emerges during adolescence. To facilitate the design of tailored prevention mechanisms, the heterogeneity of polysubstance use and respective socio-demographic and developmental precursors need to be considered.

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.

Self-Medication Practice with Antibiotics and Its Associated Factors Among Community of Bule-Hora Town, South West Ethiopia.

BackgroundSelf-medication with antibiotics is being practiced worldwide with high prevalence, mostly in developing countries. Several factors induce the practice of self-medication, such as irrational and uncontrolled dispensing of medicinal substances, difficulty accessing health-care systems, and cost of diagnosis. Thus, this study assessed the prevalence of self-medication with antibiotics, and its associated factors among the community of Bule-Hora town, South West Ethiopia.MethodsA community-based cross-sectional study design was used. All households residing in Bule Hora town were used as source population and households in the selected kebeles were included by using a systematic random sampling method. Eight hundred twenty-six study participants were selected for the study. Pre-tested structured questionnaires had been used to collect the required data. Then the collected data were checked for completeness and analyzed by using SPSS version 20. Odds ratios with 95% C.I. were used to measure the association between independent variables and outcome and variables with p-value <0.05 had been considered statistically significant.ResultsPrevalence of self-medication with antibiotics in the past 12 months prior to the data collection was found to be 38.9% [95% CI (1.56, 1.64)]. Being male (AOR = 1.53; 95% CI: 0.489, 0.869) with p value of 0.004, no health insurance scheme (AOR = 2.16; 95% CI: 0.274, 0.779) and availability of some drugs in shop (AOR = 12.98; 95% CI: 0.017, 0.353) with p value of 0.001 were found to be significantly associated with self-medication of antibiotics.ConclusionThe study revealed that more than one-third of the respondents practiced self-medication. Availability and irrational dispensing of some drugs in the shops were significantly associated with self-medication practice. Therefore, it is important to educate society on the appropriate use of drugs and discourage the use of prescription drugs without medication order.

Racial/ethnic variations in alcohol and cigarette use by pregnancy status among 20- to 44-year-old women, NHANES 2001-2018.

Objectives:This study examines alcohol consumption and smoking behaviors by pregnancy status and race/ethnicity in order to inform improved interventions designed to assist women of all races to avoid alcohol and tobacco use during pregnancy for their health and to prevent potential fetal exposure.Methods:This retrospective secondary data analysis utilized nationally representative National Health and Nutrition Examination Survey data between 2001 and 2018. Smoking and alcohol use were evaluated by race/ethnicity and pregnancy risk. Sexual behavior, reproductive health, and prescription drug use determined pregnancy risk, categorized as low pregnancy risk, at risk of becoming pregnant, and pregnant. Binary and multinomial multivariable logistic regression were used to examine associations.Results:The final sample consisted of 10,019 women of which 11.8% were Mexican American, 7.7% other Hispanic, 65.5% white, and 15% black (weighted percentages). White low pregnancy risk and pregnancy risk smoked most frequently in respective pregnancy risk groups (p < 0.001). Among pregnant women, smoking prevalence was highest among black women (14.0%, p < 0.01). Pregnancy risk women were more likely to smoke and pregnant women were less likely to smoke compared with low pregnancy risk. Low pregnancy risk and pregnancy risk Hispanics had a lower prevalence of binge drinking, but prevalence decreased less among pregnant Hispanics than other racial/ethnic groups. In adjusted analyses, pregnancy risk black women had more than 2 times the odds of combined smoking and alcohol consumption compared with low pregnancy risk black women.Conclusion:Women who may become pregnant need interventions and improved policy to prevent alcohol use and smoking. Culturally appropriate alcohol and smoking cessation interventions before pregnancy and improved contraception access are needed.

Risk factors and pharmacotherapy for chemotherapy-induced peripheral neuropathy in paclitaxel-treated female cancer survivors: A retrospective study in Japan.

Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting adverse reaction in cancer patients treated with several cytotoxic anticancer agents including paclitaxel. Duloxetine, an antidepressant known as a serotonin-noradrenalin reuptake inhibitor, is the only agent that has moderate evidence for the use to treat painful CIPN. The present retrospective cohort study aimed to analyze risk factors for paclitaxel-induced peripheral neuropathy (PIPN), and investigate ongoing prescription drug use for PIPN in Japan. Female breast and gynecologic cancer patients who underwent paclitaxel-based chemotherapy at a single center in Japan between January 2016 and December 2019 were enrolled in this study. Patients' information obtained from electronic medical records were statistically analyzed to test possible risk factors on PIPN diagnosis. Patients' age, total paclitaxel dose, the history of female hormone-related diseases, hypertension and body mass index (BMI), but not additional platinum agents, were significantly associated with increased PIPN diagnosis. Drugs prescribed for PIPN included duloxetine, pregabalin, mecobalamin and Goshajinkigan, a polyherbal medicine, regardless of poor evidence for their effectiveness against CIPN, and were greatly different between breast and gynecologic cancer patients diagnosed with PIPN at the departments of Surgery and Gynecology, respectively. Thus, older age, greater total paclitaxel dose, the history of estrogen-related diseases, hypertension and BMI are considered risk factors for PIPN in paclitaxel-based chemotherapy of female cancer patients. It appears an urgent need to establish a guideline of evidence-based pharmacotherapy for PIPN.

Stimulant Drugs of Abuse and Cardiac Arrhythmias.

Nonmedical use of prescription and nonprescription drugs is a worldwide epidemic, rapidly growing in magnitude with deaths because of overdose and chronic use. A vast majority of these drugs are stimulants that have various effects on the cardiovascular system including the cardiac rhythm. Drugs, like cocaine and methamphetamine, have measured effects on the conduction system and through several direct and indirect pathways, utilizing multiple second messenger systems, change the structural and electrical substrate of the heart, thereby promoting cardiac dysrhythmias. Substituted amphetamines and cocaine affect the expression and activation kinetics of multiple ion channels and calcium signaling proteins resulting in EKG changes, and atrial and ventricular brady and tachyarrhythmias. Preexisting conditions cause substrate changes in the heart, which decrease the threshold for such drug-induced cardiac arrhythmias. The treatment of cardiac arrhythmias in patients who take drugs of abuse may be specialized and will require an understanding of the unique underlying mechanisms and necessitates a multidisciplinary approach. The use of primary or secondary prevention defibrillators in drug abusers with chronic systolic heart failure is both sensitive and controversial. This review provides a broad overview of cardiac arrhythmias associated with stimulant substance abuse and their management.

Prescription drug survey of elderly patients with degenerative musculoskeletal disorders.

Elderly patients with musculoskeletal disorders are generally expected to receive many prescription drugs for non-musculoskeletal comorbidities and for alleviating chronic musculoskeletal pains. The aims of this study were to review the use of prescription drugs in elderly patients with elective surgeries for musculoskeletal disorders and to identify the factors associated with polypharmacy in elderly patients with musculoskeletal disorders. We retrospectively collected the clinical data of patients aged ≥65 years who underwent knee arthroplasty, total hip arthroplasty, or spinal surgery for lumbar or cervical degenerative disorders at our institution. The following data were evaluated: age, body mass index, sex, surgical site, prescription drugs used, American Society of Anesthesiologists physical status grade, and medical history, including hypertension, hyperlipidemia, diabetes, stroke, malignancy, and smoking. Polypharmacy was defined as the use of six or more drugs. In the present study, 767 consecutive patients were evaluated retrospectively. The prevalence of polypharmacy was >50% in the elderly patients with musculoskeletal disorders. The mean numbers of total drugs and pain relief medications were significantly higher in the lumbar surgery group than in the other surgery groups. Multivariable analysis revealed that the factors associated with polypharmacy were lumbar surgery, hypertension, hyperlipidemia, diabetes, and malignancy. This is the first study to cross-sectionally review the drugs prescribed to patients with degenerative musculoskeletal disorders. It clearly identified the factors associated with polypharmacy in elderly patients with degenerative musculoskeletal disorders. Particular attention should be paid to polypharmacy in elderly patients with lumbar degenerative disorders. Geriatr Gerontol Int 2022; 22: 121-126.

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.

The distribution of disease in the Republic of Suriname - a pharmacoepidemiological analysis using the claims database of the State Health Foundation of the year 2017

The patterns of prescription drug use in Suriname in the year 2017 have been determined with the purpose of obtaining indications about the distribution of disease in the country. The claims database of the State Health Foundation (Staatsziekenfonds, SZF) of Suriname was used for calculations of prescription rates of the fifty most prescribed drugs overall and after stratification according to gender, age, and residence of the insured persons. Information in the database had been de-identified, and the prescribed medicines had been coded according to the Anatomic Therapeutic Chemical Classification System. Statistically significant differences among the prescription rates were assessed with the two-sample test of proportions using normal theory method and x2 Goodness of Fit tests (p < 0.05). Additionally, the Bonferroni adjustment was used to adjust for type 1 error inflation resulting from multiple comparisons. Overall, drugs for the cardiovascular, respiratory, and musculo-skeletal systems had the highest prescription rates (p < 0.001). Furthermore, rates were generally higher in females than in males, in the older age groups than in younger individuals, and in the coastal regions compared to the country's interior (p < 0.001). These findings are largely in line with data found in the literature and support the use of this pharmacoepidemiological approach to assess the distribution of disease in Suriname. Key words: Suriname, distribution of disease, pharmacoepidemiology, claims database, prescription drugs.

Factors Influencing Racial and Ethnic Differences in Prescription Opioid Misuse Among Young Adolescents in the USA, 2009-2019.

Prescription opioid misuse (POM) is an important public health concern. Not many studies have evaluated factors influencing racial and ethnic differences in POM exclusively in young adolescents. We evaluated factors influencing the racial and ethnic differences in POM in a nationally representative sample of 8th- and 10th-grade (12-15years old) US adolescents. Data were from 107,786 adolescents who participated in the 2009-2019 Monitoring the Future survey. Logistic regression and mediation analysis were used to identify risk factors for POM and evaluate mediators of the association of race and ethnicity on the frequency of POM in the past year. From 2009 to 2019, the prevalence of POM in the past year decreased from 3.2% to 1.8% (p = 0.032), with significant differences in POM trends by race and ethnicity. Overall, the prevalence was higher among non-Hispanic White adolescents (3.2%) than Hispanic (2.5%) and non-Hispanic Black adolescents (1.6%), p < 0.001. After adjustment for demographic, substance use, lifestyle, and family-related factors, the odds of POM were lower among Black (odds ratio (OR) = 0.81, 95% confidence interval (CI): 0.66-0.98) and Hispanic adolescents (OR = 0.64, CI: 0.55-0.74) compared to White adolescents. Illicit drug use and misuse of other prescription drugs together explained 77.2% and 47.3% of the racial and ethnic disparities in POM among Black and Hispanic adolescents, respectively. In this study, significant racial and ethnic differences in the trends of POM were observed. Illicit drug use and misuse of other prescription drugs substantially explained the racial and ethnic disparities in POM among young adolescents.

Feigning Symptoms to Obtain Prescription Stimulants: A Vignette-Based Study on Its Conditions

This vignette-based study examined the willingness to feign symptoms to obtain a prescription following an analysis on who might use prescription stimulants to enhance performance ( N = 3,468). It experimentally manipulated three factors: the social disapproval of prescription stimulant use for enhancement purposes, the physicians’ diagnostic efforts, and the medical condition (attention-deficit/hyperactivity disorder and narcolepsy); respondent characteristics of self-control, personal morality, and self-efficacy were also measured. Our results showed that social disapproval of prescription drug use, a personal morality that disapproves of drug use, high self-control, and high self-efficacy were negatively associated with the willingness to use. Willingness increased especially in situations of social approval when there was a stronger personal approval of drug use, or surprisingly when physicians’ diagnostic efforts were higher. The feigning willingness was lower in situations of social disapproval and when personal morality disapproved of feigning. Thus, personal and situational characteristics are relevant to understand both behaviors.

Healthcare Resource Utilization and Costs of Medicare Fee for Service Beneficiaries Newly Diagnosed with Moderate to Severe Non-Advanced Systemic Mastocytosis

Healthcare Resource Utilization and Costs of Medicare Fee for Service Beneficiaries Newly Diagnosed with Moderate to Severe Non-Advanced Systemic Mastocytosis

High Times for U.S. Employees: Human Resource Management Considerations in Addressing Marijuana Legalization in U.S. Organizations

Recent changes in state laws have legalized marijuana use for their state citizens. Originally by 2016, twenty-six states, the District of Columbia, and Puerto Rico had legalized marijuana for medical use (State Medical Marijuana Laws, 2016). In the 2020 elections eighteen states, two U.S. territories, and the District of Columbia legalized recreational use of cannabis. We now have thirty-six states, four U.S. territories, and D.C. who have legalized medical use of the drug use (State Medical Marijuana Laws, 2021). This however creates some major issues for Human Resource professionals due to the fact that federal law still considers marijuana use illegal. This creates a confusing situation for organizations and especially Human Resource professionals who must create and enforce policies on the use of prescription and non-prescription drugs within the work environment. The purpose of this research is to determine if medical marijuana should be protected in the workplace and under what conditions. Based on the literature three research questions were posed and three hypotheses were tested based on analyzing data from a survey questionnaire that was completed by 57 working adults. Results indicate that they support the use of medical marijuana as a viable medical treatment and companies should recognize and support this medical remedy. Results indicate employees should be protected in their use of marijuana under the FMLA. Results also indicate marijuana should also be considered for long-term and permanent illnesses under the ADA. Implications are employees see marijuana in a positive light, as a viable medical treatment, and expect human resource management to support policies that allow for use of marijuana.

Variation In Use And Content Of Prescription Drug Step Therapy Protocols, Within And Across Health Plans.

Insurers limit the use of certain prescription drugs by requiring step therapy-that is, by allowing access only after alternatives have been tried and have failed. Using data from seventeen of the largest US commercial health plans, we examined step therapy protocols that determined patients' eligibility for specialty drugs and identified ten diseases that are often subject to that requirement. Overall, plans applied step therapy in 38.9percent of drug coverage policies, with varying frequency across plans (20.6-57.5percent). Of the protocols for the ten diseases, 34.0percent were consistent with corresponding clinical guidelines, 55.6percent were more stringent, and 6.1percent were less stringent. Trials of alternatives not included in the clinical guidelines were required in 4.2percent of protocols, and the consistency of protocols varied within and across plans. These findings raise questions about potentially overly restrictive step therapy protocols, as well as concerns that variability across health plans makes protocols onerous for patients and practitioners alike. The findings thus suggest the need for state and federal legislative initiatives to help ensure appropriate prescription drug use.

Characterization of deceased drug users in Denmark based on treatment status: A nationwide retrospective autopsy study

BackgroundMany drug users are not receiving treatment for their drug use. Little is known about drug users not receiving treatment, as they are difficult to identify and recruit for research. MethodsWe identified 479 autopsied decedents with illegal/unmarketed drug or opioid agonist treatment positive toxicological screenings from 2015 to 2016 in Denmark. Toxicological screenings from autopsy, and information on treatment status at time of death, health care utilization, educational attainment, employment status and prescription drug use from Danish national health registers were used for comparison between groups. ResultsDrug users not in treatment constituted 63.3% of the study population and died at a younger age than those in treatment (41 vs. 44 years). Fatal overdose was the most common cause of death in both groups. Nearly thrice as many drug users not in treatment died from somatic causes compared with drug users in treatment (18.2% vs. 6.8%). On average, drug users not in treatment received fewer prescriptions prior to their deaths than those in treatment, but non-prescribed medications were equally prevalent among both groups (74.3% vs. 81.3%) except for non-prescribed methadone which was significantly less prevalent among drug users not in treatment (33.3% vs. 42.6%). ConclusionTwo-thirds of decedents were not in treatment at time of death. Drug users not in treatment died more often from somatic causes compared to those in treatment. Decedents had equal amounts of non-prescribed psychotropic medication in the blood, but non-prescribed methadone was more common among those in treatment at the time of death.

An Interrupted Time-series Evaluation of the Association Between State Laws Mandating Prescriber Use of Prescription Drug Monitoring Programs and Discontinuation of Chronic Opioid Therapy in US Veterans.

Most states have recently passed laws requiring prescribers to use prescription drug monitoring programs (PDMPs) before prescribing opioid medications. The impact of these mandates on discontinuing chronic opioid therapy among Veterans managed in the Veterans Health Administration (VA) is unknown. We assess the association between the earliest of these laws and discontinuation of chronic opioid therapy in Veterans receiving VA health care. We conducted a comparative interrupted time-series study in the 5 states mandating PDMP use before August 2013 (Ohio, West Virginia, Kentucky, New Mexico, and Tennessee), adjusting for trends in the 17 neighboring control states without such mandates. We modeled 25 months of prescribing for each state centered on the month the mandate became effective. We included Veterans prescribed long-term outpatient opioid therapy (305 of the preceding 365 d). Our outcomes were discontinuation of chronic opioid therapy (primary outcome) and the average daily quantity of opioids per Veteran over the following 6 months (secondary outcome). We included 250 monthly cohorts with 225,665 unique Veterans and 3.4 million Veteran-months. Baseline discontinuation rates before the PDMP mandates were 0.4%-2.7% per month. Kentucky saw a discontinuation increase of 1 absolute percentage point following its PDMP mandate which decreased over time. The other 4 states had no significant association between their mandates and change in opioid discontinuation. There was no evidence of decreasing opioid quantities following PDMP mandates. We did not find consistent evidence that state laws mandating provider PDMP use were associated with the discontinuation of chronic opioid therapy within the VA for the time period studied.

Prescription Drug and Cannabis Use among Recent Latinx Immigrants Pre- and Post-Immigration to the US

ABSTRACT Introduction: Shifts in the sociopolitical context of Latin America have led to steep increases in recent Latinx immigrants (RLI) arriving in the US within the context of forced migration. Yet, little is known about how adverse experiences of RLIs before and after immigration may impact their health including drug use. The purpose of this study was to examine prescription drug and cannabis use before and just after immigration among RLIs and how this drug use is influenced by pre-and post-immigration factors. Methods: This study utilized baseline data from a study examining pre- to post-immigration drinking and driving trajectories among RLI in the United States (US). Baseline criteria included: self-identifying as a Latinx immigrant, 18 − 34 years old, who recently immigrated from a Latin American country. Multivariate logistic regression was conducted to determine predictors of drug use both prior to and after immigrating. Results: There were 540 RLI, 50.2% male and 47.8% subjected to forced migration. Prescription and illicit drug use decreased post-immigration with sedatives being the most common. Higher levels of education was associated with increased odds of pre-immigration prescription drug use and cannabis use. Those experiencing forced migration were more likely to engage in prescription drug use before and after immigration, while no associations were found for cannabis use. Conclusion: Findings suggest a need for increased substance use and mental health services among RLIs arriving within the context of forced migration. More research is needed to understand the trajectories of drug use among RLI as their time in the US increases.

Sexual enhancement expectancy, non-medical use of prescription drugs, and sexual risk behaviors in college students

Background: American young adults have a high risk of sexually transmitted infections. Sexual risk behaviors may be influenced by psycho-behavioral factors, including substance use and sexual enhancement expectancy. Existing research suggested that substance use may mediate the relationship between sexual enhancement expectancy and sexual risk behaviors. The substance use literature also suggested that non-medical use of prescription drugs (NMUPD) was highly prevalent in college students and was associated with sexual risk. However, limited studies have examined NMUPD-related sexual enhancement expectancy. The current study examined the relationship among sexual enhancement expectancy, NMUPD, and sexual risk behaviors in college students. Methods: Online data were collected in 2016 from 453 US college students with lifetime NMUPD. All participants reported their (1) past-three-month NMUPD, (2) NMUPD sexual enhancement expectancy, and (3) sexual risk behaviors. Structural equation modeling was employed for data analysis. Results: Findings suggested significant associations of NMUPD with sexual enhancement expectancy and sexual risk behaviors. Sexual enhancement expectancy was indirectly associated with sexual risk behaviors through NMUPD. Conclusions: College students’ sexual risk behaviors appear to be indirectly influenced by sexual enhancement expectancy through NMUPD. Future sexual risk reduction interventions should attend to sexual enhancement expectancy and NMUPD.