Misuse Of Prescription Painkillers Research Articles

Prescription Painkiller Misuse in Hispanic and non-Hispanic Adults Ages 50 and Older: Trends and Correlates in a National Sample, 2015–2019

Background: Older adults, an increasingly diverse segment of the United States population, are a priority population for prescription painkiller misuse. This study documents trends and correlates of prescription painkiller misuse among Hispanic and non-Hispanic adults ages 50 and older. Methods: A secondary analysis of adults 50 years and older across 5 cohorts using the 2015–2019 National Survey on Drug Use and Health (unweighted n = 16,181, 8.5% Hispanic, and 54% female). Logistic regression modeling with complex survey design was used to examine trends in prescription painkiller misuse. Results: Over time, the prevalence of past year painkiller misuse significantly decreased for Hispanic respondents (56.1% relative decrease, p = 0.02); elevated proportions were observed across strata of demographic characteristics. Conclusions: Variability in the prevalence of painkiller misuse may be explained by demographic characteristics. Further, these results emphasize the importance of addressing comorbid recreational marijuana use when designing interventions to address painkiller misuse for older adults.

Race, Adolescent Socioeconomic Status, and Lifetime Non-Medical Use of Prescription Painkillers: Evidence from the National Longitudinal Study of Adolescent to Adult Health.

The misuse of prescription painkillers is a major contributor to the ongoing drug overdose epidemic. This study investigated variability in non-medical use of prescription painkillers (NMUPP) by race and early-life socioeconomic status (SES) in a sample now at increased risk for opioid overdose. Data from two waves of the National Longitudinal Study of Adolescent to Adult Health (n = 11,602) were used to calculate prevalence of reported NMUPP by Wave 4 (2008; mean age 28), and to assess variation by race and by equivalized household family income at Wave 1 (1994/5). Predicted values for prevalence of NMUPP were modelled, adjusting for age, sex, parental education, and region. Race and SES in adolescence were associated with later reported NMUPP. A gradient was seen in prevalence by SES (adjusted: family income quartile 1 = 13.3%; quartile 2 = 13.8%; quartile 3 = 14.8%; quartile 4 = 16.0%; trend p-value = 0.007). Prevalence was higher among males. Racial/ethnic differences in prevalence were seen (non-Hispanic white (NHW) = 18.5%; non-Hispanic black (NHB) = 5.8%; Hispanic = 10.5%; Other = 10.0%). SES differences were less pronounced upon stratification, with trend tests significant only among females (p = 0.004), and marginally significant among Hispanic males (p = 0.06). Early-life SES was associated with reported lifetime NMUPP: the higher the family income in adolescence, the greater the likelihood of NMUPP by young adulthood. Variations in NMUPP by income paled in comparison with racial/ethnic differences. Results point to a possible long-enduring association between SES and NMUPP, and a need to examine underlying mechanisms.

Mental health, pain, and risk of drug misuse: A nationwide cohort study

Evidence suggests that rising drug misuse, particularly of prescription painkillers, is more closely linked with period increases in reported pain among Americans of the same age range than with deterioration in mental health, but it is unclear whether those cross-sectional associations reflect causal effects of pain and mental health on drug misuse. Using data from the 1995-96, 2004-05, and 2013-14 waves of a nationwide cohort study, we evaluate the effects of pain and mental health on subsequent misuse of prescription painkillers and sedatives. Logistic regression is applied to model drug misuse (separately for painkillers and sedatives) as a function of predictors measured at the previous wave; respondents who reported misuse of that drug type at the prior wave are excluded from the analysis. Mental health is an important predictor of both painkiller and sedative misuse, whereas pain plays a much bigger role in painkiller misuse. Frequency of joint aches and stiffness has the strongest effect on subsequent painkiller misuse, although mental health yields substantial incremental predictive ability above and beyond pain. Negative affect, positive affect, and psychological well-being have notable effects on sedative misuse, while pain (particularly backache) makes only a small incremental contribution to sedative misuse. We suspect that increases over time in pain levels may have played a bigger role than mental health in explaining the rise in prescription painkiller misuse and may have contributed to growing misuse of sedatives. In contrast, deteriorating mental health was probably more important in explaining the rise of sedative misuse.

Changes in mental health, pain, and drug misuse since the mid-1990s: Is there a link?

Drug-related mortality in the US grew dramatically in recent years, while mental health deteriorated among disadvantaged Americans and reported levels of pain increased over the same period. Here we investigate whether increased prevalence of drug misuse between the mid-1990s and early-2010s is associated with higher levels of mental distress and pain. Our results demonstrate higher drug misuse over this period, particularly for older and for socioeconomically disadvantaged Americans. After adjusting for sociodemographic characteristics, we estimate that the prevalence of drug misuse increased by 19 percentage points among those aged 50-76 in the bottom percentile of socioeconomic status (SES). Misuse increased much more at older than at younger ages for all drug types except sedatives, which increased to a similar degree in both age groups. Compared with measures of mental health, pain consistently accounted for a greater share of the period differential in drug misuse among both age groups and across all drug types. Misuse of prescription painkillers exhibited the largest difference in the contributions of pain versus mental health: among older individuals with the lowest SES, pain explained three times as much of the period trend as mental health (60% vs. 19%). Pain was more closely linked with the rise in misuse of prescription painkillers than other drugs. Mental health is a strong correlate of drug misuse (particularly sedative use), but growing drug misuse since the mid-1990s was more strongly linked with rising levels of reported pain than with deterioration in mental health. Pain could be a key factor underlying the association between trends in mental health and drug use: higher levels of pain may contribute to both mental distress and drug misuse. Given that pain, mental distress, and drug misuse are intertwined, successful intervention may require addressing all three factors.

Solving the Opioid Crisis: Respiratory Depression by Opioids as Critical End Point

Solving the Opioid Crisis: Respiratory Depression by Opioids as Critical End Point

Prescription painkiller misuse and the perceived risk of harm from using heroin

Prescription opioid pain reliever misuse is associated with initiation of heroin use. The perceived risk of harm from substance use is a key factor in initiation. We hypothesized that prescription pain reliever misuse is associated with a lower perceived risk of harm from trying heroin and from regular use. Using the 2015-6 National Survey on Drug Use and Health (NSDUH), we evaluated the perceived risk of trying and regularly using heroin among heroin never-users. We estimated logistic regressions to assess the association between past-year prescription pain reliever misuse with the perceived risk of heroin initiation and regular use, adjusting for potential confounders. The sample contained 84,312 adults and 27,814 adolescents. Four percent of adults and 3.7% of adolescents reported past-year prescription pain reliever misuse. 87.9% of adults and 65.9% of adolescents perceived trying heroin as a great risk. Pain reliever misuse was associated with a significantly lower odds of perceiving great risk of harm from trying heroin (adults: AOR = 0.760, 95%CI 0.614-0.941, p = 0.013; adolescents: AOR = 0.817, 95%CI 0.672-0.993, p = 0.042). Both age groups were more likely to report perceiving regular heroin use as a great risk of harm compared to trying heroin once or twice, but only adults showed significant association with of pain reliever misuse. (AOR = 0.539 95%CI 0.390-0.744, p < 0.001). Past-year prescription pain reliever misuse was associated with lower perceived risk of harm from heroin initiation and regular use. Further understanding of risk perception and the association with heroin initiation might inform development of primary prevention interventions.

School racial composition and lifetime non-medical use of prescription painkillers: Evidence from the national longitudinal study of adolescent to adult health

To investigate the possible effects of middle and high school racial composition on later reporting of lifetime non-medical use of prescription painkillers (NMUPP) in young adulthood, and to explore whether there is evidence of variability by individual race/ethnicity in such effects. Using data from Wave 1 (1994/5) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we categorized the sample's 52 middle schools and 80 high schools as majority (>50%) non-Hispanic white, majority non-Hispanic black, or neither. We used two-level hierarchical modeling to explore associations between individual- and school-level race at Wave 1 and lifetime prescription painkiller misuse reported at Wave 4. We included a cross-level interaction between individual race and school racial composition to assess variability in school-level associations by race. Overall crude prevalence of lifetime NMUPP in majority white schools (17.9%) was over three times that of prevalence in majority black schools (4.8%), and also higher than prevalence in schools neither predominantly black nor predominantly white (12.4%). Lifetime misuse among blacks in majority white schools was more prevalent (5.2%) than among blacks in black schools (2.8%), as was misuse among whites in white schools (19.3%) compared to their white peers in black schools (15.7%). Two-level random intercept Poisson regression results suggest that attendance in a majority black secondary school lowered a participant's risk of lifetime NMUPP (compared to attending a majority white school: RR=0.66, p = 0.03). Compared to blacks in black schools, blacks in white schools had twice the risk of prescription painkiller misuse (p = 0.004) over a decade later, and whites in white schools had 5.5 times the risk (p = 0.01). The risk ratio comparing whites in black schools to whites in white schools was not significant (RR: 1.30; p = 0.37). We found evidence of an effect of school racial composition on the risk of misusing prescription painkillers over a decade later, over and above individual race, with higher risk of misuse reported among participants who had attended white schools. Black participants who had attended predominantly white schools were, on average, twice as likely to report lifetime misuse of prescription painkillers compared to blacks who had attended black schools.

Racial/ethnic variation in mental health correlates of substance use among college students

ABSTRACTThis study investigated mental health indicators, substance use, and their relationships, by race/ethnicity. A probability sample of 1,053 students at two California universities self-reported their frequency of substance use and rated their experience with indicators of mental health. One-way analysis of variance (ANOVA), chi-square tests, and multivariate censored regression models were estimated to examine which indicators of mental health were associated with each substance use form by race/ethnicity. Results from the one-way ANOVA and chi-square tests showed differences in substance use prevalence and mental health by race/ethnicity. For example, students who identified as White demonstrate a higher prevalence for every form of substance use in comparison to the Asian, Latino, and “All other” categories. Results from the regression showed, among Whites, inattention was associated with prescription stimulant misuse, and psychological distress was associated with marijuana use. Among Latinos, inattention was associated with cocaine and prescription stimulant use. Among Asians, psychological distress was associated with tobacco use and the misuse of prescription painkillers. Findings highlight the need to ensure subpopulations receive needed services.

Drug-Use Data Reveal Some Progress But Also Alarming Trends

Back to table of contents Previous article Next article Clinical and Professional NewsFull AccessDrug-Use Data Reveal Some Progress But Also Alarming TrendsVabren WattsVabren WattsSearch for more papers by this authorPublished Online:3 Nov 2016https://doi.org/10.1176/appi.pn.2016.10a14AbstractThe 2015 National Survey on Drug Abuse and Health highlights improvements and areas of concern related to the current status of mental health and mental health care in the United States.While there has been a decline in alcohol and cigarette use among people aged 12 to 25 from 2014 to 2015, the incidence of mental illness has increased. Moreover, there continues to be a large disparity between the number of people who need substance use treatment and access it: of the 21.7 million people aged 12 and older who needed such treatment, only 3 million received it. These are the latest findings released by the Substance Abuse and Mental Health Services Administration from the 2015 National Survey on Drug Abuse and Health (NSDUH).“The data paint a picture of great concern for our mental health care system and what is being delivered to people with mental health problems,” said SAMHSA Principle Deputy Administrator Kana Enomoto, M.A., at a press conference. “Our country must redouble its efforts to provide evidence-based prevention and treatment services in every community to ensure all Americans get the help and hope they need to lead healthy and productive lives.”The data were released during the 27th annual observance of National Recovery Month in September, a month dedicated to making the public aware that “behavioral health is essential to health, prevention works, treatment for substance use and mental disorders is effective, and people can and do recover from these disorders.” The survey included information from approximately 67,500 people throughout the country, aged 12 and older, who were surveyed on illicit drug use and mental health status within the past year. The survey found that overall rates for current (past month) cigarette smoking dropped from 20 percent in 2014 to 19.4 percent in 2015. The drop was even greater in people aged 12 to 25, from an average of 21.4 percent to 15.5 percent. Similar trends were observed pertaining to rates for alcohol use. Prevalence of current alcohol use among people 12 and older decreased from 52.7 percent in 2014 to 51.7 percent in 2015, and rates for alcohol use disorder decreased from 6.4 percent to 5.9 percent in the same period. Adolescents aged 12 to 17 had the largest decrease in current alcohol use, dropping from 11.5 percent to 9.6 percent from 2014 to 2015, while young adults aged 18 to 25 had the largest decrease in alcohol use disorder, from 12.3 percent to 10.9 percent.Marijuana use among people aged 12 and older remained relatively stable from 2014 to 2015, at about 8 percent. Levels of heroin use and cocaine use also remained stable compared with the previous year.For the first time, the NSDUH collected data on misuse of prescription painkillers and found that 3.8 million people aged 12 and older misused such drugs.“We know that evidence-based prevention efforts are the most effective way to reduce drug use,” said Michael Botticelli, director of National Drug Control Policy, at a press conference. “That is why the president has repeatedly called for $1.1 billion in new funding for states to expand access to treatment. Every day that passes without congressional action to provide these additional resources is a missed opportunity to save lives.”Botticelli emphasized that efforts to pressure Congress to expand such treatment is of utmost importance to those involved in mental health services.Regarding other types of mental illness, the NSDUH found that in 2015, 43.4 million (17.9 percent) adults aged 18 and older experienced some form of mental illness in the past year, with 9.8 million adults experiencing serious mental illness. These findings were comparable to 2014 data. There was a slight increase in rates for any mental illness among people aged 18 to 25, rising from 20.1 percent in 2014 to 21.7 percent in 2015. Young adults also had a slight uptick in depressive episodes, increasing from 9.3 percent in 2014 to 10.3 in 2015. An estimated 34.2 million adults aged 18 or older received mental health care in the past 12 months in 2015, including 6.4 million adults with past-year serious mental illness. “These findings emphasize the importance of intervening early to identify signs and symptoms of mental health problems,” said Enomoto. “Getting people to the treatment that they need as soon as possible is the right step toward treatment and recovery.” ■The NSDUH report can be accessed here. ISSUES NewArchived

Painkiller Misuse among Appalachians and in Appalachian Counties in Kentucky

Abstract The misuse of prescription medications is a growing problem in Kentucky (Bunn and Slavova 2012). However, the burden of prescription drug abuse is not borne equally throughout the commonwealth. This article will discuss the issue of prescription painkiller misuse and present original research on self-reported use and perception of use to demonstrate the wide disparity between Appalachians and residents of Appalachian counties and statewide averages. The issue of prescription drug misuse in Appalachian Kentucky has been studied, but this study aims to shed light on the breadth of the issue for the general population, not just users. To understand public awareness of opioid overdoses, the 2012 Kentucky Health Issues Poll (KHIP) asked adults in Kentucky about their awareness of the issue, their personal experience with prescription drug misuse, and their indirect experience with the issue. In two out of three measures (awareness and indirect experience), residents of Appalachian counties and adults of Appalachian heritage reported significantly higher percentages of awareness of the problem and friends and family members who misuse prescription pain medicine. Health policy and actions individual readers can take to reduce the risk of painkiller misuse are discussed.

Influences of motivational contexts on prescription drug misuse and related drug problems

Prescription drug misuse has emerged as a significant problem among young adults. While the effects of motivational contexts have been demonstrated for illicit drugs, the role of motivational contexts in prescription drug misuse remains understudied. Using data from 400 young adults recruited via time-space sampling, we examined the role of motivational contexts in the frequency of misuse of three prescription drug types as well as drug-related problems and symptoms of dependency. Both negative and positive motivations to use drugs are associated with increases in prescription drug misuse frequency. Only negative motivations are associated directly with drug problems and drug dependence, as well as indirectly via prescription pain killer misuse. Addressing positive and negative motivational contexts of prescription drug misuse may not only provide a means to reduce misuse and implement harm reduction measures, but may also inform the content of treatment plans for young adults with prescription drug misuse problems.

Substance use over the military–veteran life course: An analysis of a sample of OEF/OIF veterans returning to low-income predominately minority communities

This paper presents an overview of substance use patterns of recent veterans returning to low-income predominately minority communities over four periods of the military-veteran career. Respondent driven sampling (RDS) was used so that unbiased estimates could be obtained for the characteristics of the target population. The majority of participants had used marijuana but no other illegal drugs. In the military, marijuana use was substantially lower and alcohol was the drug of choice; the majority were binge drinkers and nearly half were heavy drinkers. While deployed, alcohol and marijuana use were both lower, though some participants (6%) initiated the misuse of prescription painkillers. After separating from the military and returning to civilian life, heavy drinking was much lower, marijuana use increased, and some veterans misused prescription painkillers (7%). Further research based on these data will examine these distinct periods of substance use, contexts of use, related substance and mental health problems, treatment use and avoidance, and civilian reintegration.

Ontario takes aim at painkiller abuse

Some might call them tentative steps. But two high-level action committees — the Opioid Public Policy Project and the Narcotics Advisory Panel — were created earlier this year to address the rampant misuse of prescription painkillers and lower the rising number of Ontarians seeking treatment for