Use Of Prescription Sedatives Research Articles

The Effect of Veteran Status and Chronic Pain on Past 30-Day Sedative Use Among Community-Dwelling Adult Males.

Given the high sedative prescription rate, the sedative-associated morbidity, and mortality nationally (especially among veterans), we aimed to test the hypothesis that veteran status in the presence of chronic pain would be associated with greater sedative use when compared with nonveteran status. The study participants were recruited by Community Health Workers (CHWs) through the ongoing community engagement program (HealthStreet) at the University of Florida. CHWs collected information on sociodemographic factors, health status, and past 30-day drug use patterns. The study sample comprised 4,732 male participants, of which 21% were veterans, 58% were Blacks and 8.4% had used prescription sedatives in the past 30 days. Veterans (vs nonveterans) were twice as likely to have used prescription sedatives in the past 30 days in the presence of chronic pain. Veterans with chronic pain are a high-risk population for current prescription sedative use.

EPH42 Long Working Hours and the Use of Prescription Sedatives Among the U.S. Labor Force

The demands of a round-the-clock service and globalized society have led to an increase in long working hours. This trend has been accompanied by a corresponding rise in sleep disorders. Additionally, sedative-tranquilizers have been reported as the third most commonly misused drug class in the U.S. Given the prevalence of long working hours among the U.S. working population, it is expected that there will be a continued increase in the use of sleep aid medications among this population, along with an associated increase in substance abuse to aid sleep.

Correlates of Self-Reported Medicinal Cannabis Use for Physical Health, Mental Health, and Sleep-Related Conditions in a Population-Based Survey of Canadian Youth

Medicinal cannabis use (MCU) among youth is correlated with frequent cannabis use and multiple substance use and health-related indicators. This study examined whether correlates of self-reported MCU among youth varied as a function of the primary health condition for which cannabis is used. Data were drawn from the 2017 Canadian Tobacco, Alcohol, and Drugs Survey. Youth (ages 15-24) who reported past-year cannabis use were included in these analyses. Regression analyses (controlling for age and sex) compared youth reporting only nonmedicinal cannabis use (NMCU only, n = 2,082) to youth reporting MCU for physical health conditions (n = 227), mental health conditions (n = 271), or insomnia (n = 98). Relative to youth reporting NMCU only, youth reporting MCU for physical or mental health conditions had greater odds of reporting daily cannabis use, cannabis problems, vaporization and oral ingestion of cannabis, and tobacco use. Youth reporting MCU for physical health reasons also had greater odds of both illicit drug use and prescription pain medication use, whereas youth reporting MCU for mental health reasons had greater odds of prescription sedative use. Youth in both the physical health and mental health MCU groups reported poorer health and mental health compared with the NMCU-only group. Youth reporting MCU for insomnia had greater odds of cannabis problems relative to youth in the NMCU-only group, but there were no other differences between these groups. Findings provide new insight into the correlates of MCU among youth in the Canadian population, suggesting that these correlates vary as a function of the primary reason for MCU.

Prescription Opioid Use Among a Community Sample of Older and Younger Women.

Background: Women bear a heavier burden of the consequences related to prescription opioid use compared to their male counterparts; however, there has been little attention in the literature regarding prescription opioid use among women. We aimed to examine risk factors for prescription opioid use among women. Methods: Demographics, health status, and substance use data, including prescription opioid use, were collected through a community engagement program, HealthStreet, during a health needs assessment. Women older than 18 years were classified by opioid use: past 30-day, lifetime, but not past 30-day, or no lifetime prescription opioid use. Descriptive statistics and chi-square tests were calculated, and multinomial logistic regression was used to calculate adjusted odds ratios (aORs; confidence interval [CI]). Results: Among 5,549 women assessed, 15% reported past 30-day use and 41% reported lifetime use of prescription opioids. While prescription sedative use was the strongest risk factor for past 30-day use among younger women (aOR = 4.84; 95% CI, 3.59-6.51), past 6-month doctor visits was the strongest risk factor for past 30-day use among older women (aOR = 4.15; 95% CI, 2.62-6.60). Conclusions: We found higher rates of prescription opioid use in this community sample of women compared to national rates. Risk factors for recent prescription opioid use (past 30-day use) differed among older and younger women. Clinicians should be more vigilant about prescribing opioids as the medical profile for women may change through age, especially the co-prescribing of opioids and sedatives.

Sex differences in prescription opioid use patterns assessed through a community engagement program in Florida

BackgroundMorbidity and mortality attributed to prescription opioids are a crisis in the US and spreading globally. Sex differences related to these conditions have not been adequately assessed. MethodsThrough our community engagement program, data on demographics, health status, and substance use, including prescription opioids (e.g., Vicodin®, Oxycodone), were collected from community members in Florida (primarily North Central Florida) during a health needs assessment. Participants over 18 years of age were classified by opioid use: past 30-day, lifetime but not past 30-day, or no lifetime prescription opioid use. Descriptive statistics and chi-square tests were calculated, and multinomial logistic regression was used to calculate adjusted odds ratios (aOR; CI). Analyses were conducted for men and women separately to examine sex specific effects. ResultsAmong 9221 community members assessed, the mean age was 45 years, 60% were female, and 58% were black. Respondents who endorsed past 30-day use and lifetime use were more likely to be female. Prescription sedative use was the strongest risk factor for past 30-day (aOR = 3.96; 95% CI, 3.35–4.68) and lifetime (aOR = 2.67; 95% CI, 2.34–3.04) prescription opioid use, regardless of sex. Other factors including marijuana use and history of cancer were significantly associated with prescription opioid use; they varied by sex. ConclusionsThe risk factors identified in this community sample provide additional information not accounted for by national studies. Future examinations of the consequences of concomitant opioid and sedative use, especially among women, are needed.

Medical and nonmedical use of prescription sedatives and anxiolytics: Adolescents' use and substance use disorder symptoms in adulthood

ObjectivesThis study assessed the longitudinal associations between medical and nonmedical use of prescription sedatives/anxiolytics (NMPSA) during adolescence (age 18) and substance use disorder (SUD) symptoms during adulthood (age 35). MethodsMultiple cohorts of nationally representative samples of U.S. high school seniors (n=8373) were surveyed via self-administered questionnaires and followed longitudinally from adolescence (age 18, 1976–1996) to adulthood (age 35, 1993–2013). ResultsAn estimated 20.1% of adolescents reported lifetime medical or nonmedical use of prescription sedatives/anxiolytics. Among adolescents who reported medical use of prescription sedatives/anxiolytics, 44.9% also reported NMPSA by age 18. Based on multivariate analyses that included age 18 sociodemographic and other substance use controls, medical use of prescription sedatives/anxiolytics without any history of NMPSA during adolescence was not associated with SUD symptoms in adulthood relative to adolescents with no prescription sedative/anxiolytic use. In contrast, adolescents with a history of both medical and nonmedical use of prescription sedatives/anxiolytics and adolescents who reported only NMPSA had between two to three times greater odds of SUD symptoms in adulthood relative to adolescents with no prescription sedative/anxiolytic use and those who reported only medical use of prescription sedatives/anxiolytics. ConclusionsOne in every five U.S. high school seniors reported ever using prescription sedatives/anxiolytics either medically or nonmedically. This study provides compelling evidence that the medical use of prescription sedatives/anxiolytics (without any NMPSA) during adolescence is not associated with increased risk of SUD symptoms in adulthood while any NMPSA during adolescence serves as a signal for SUDs in adulthood.

High levels of self-reported prescription opioid use by HIV-positive individuals

ABSTRACTPrescription medication use (other than antiretroviral therapy (ART)) is highly prevalent among people living with HIV. Prescription medications may be used medically or non-medically: non-medical use includes using more medication than prescribed, using medication prescribed to someone else, or using medication for a purpose other than its prescribed use. During 12 weeks in 2014–2015, we characterized medical and non-medical prescription medication use among HIV-positive patients attending an academic medical center (n = 149) and a community clinic (n = 105). Separately for the past year and the past month, these 254 participants self-reported their use of prescription opioids, sedatives, stimulants, anti-anxiety medications, antipsychotic medications, and erectile dysfunction medications. Respondents were largely male (91%), aged 40 or older (61%), identified as gay or bisexual (79%), and were men who have sex with men (85%). ART use was nearly universal (95%). Nearly half (43%) of participants reported medical use of prescription opioids; 11% of the opioid use was reported as non-medical use. Anti-anxiety medication use was also frequent, and differed by site: 41% of community-clinic responders reported medical use of anti-anxiety medications compared to 23% of hospital clinic respondents who reported medical use. Prescription sedative use was also approximately twice as high among community-clinic participants, with medical use reported by 43% of respondents and non-medical use by 12%; in comparison, at the hospital clinic, sedative use was reported by 18% (medical) and 7% (non-medical) of participants. Stimulant use was rare in both sites. No demographic characteristic was significantly associated with medical or non-medical use of any prescription medication. The current focus of many studies on only non-medical prescription medication use not only underestimates the widespread exposure of HIV-positive individuals to these drugs, but may also underestimate potential adverse effects of prescription medications in this population.

Will the health care home help to reduce the health cost for drug users in Medicaid?

Aims: U.S. prescription drug use is common, second only to marijuana use. Kentucky continues with high rates of non-medical prescription use, particularly prescription opioids in Appalachian Kentucky. Prescription opioid abuse is associated with increasing arrests. However, there is little systematic examination of prescriptionopioiduse in criminal justice settings. The aimof this study is to examine prescription opioid use levels among Kentucky prisoners to understand other drug use and related behavior. Methods: The ASSIST and TCU Drug Screeners were administered to 337 prisoners. After consent, subjects entered protocols as part of the NIDA CJDATS 2 cooperative agreement. Analysis examined past 3 month drug use and problem behaviors for 3 levels of prescription opioid use: daily (n=86), some (n=91) and none (n=160). ANCOVA and logistic regressions were performed controlling for group differences in age, gender, race, and rural residence. Results: Daily prescription opioid users were younger (34.2), more female (39.5%), more white (90.7%) and more rural (58.5%). Daily users significantly reported more use of prescription sedatives (71.3% vs. 56% and 15%, p=< .000) than those in the no use or some use categories. There were no differences in other drug use patterns except for those who reported some use of prescription stimulants (p=< .003) and hallucinogens (p=< .035). Daily users weremore likely to inject drugs, rate their druguse asmore serious, rate themselves asmore dependent on drugs, and report that treatment is important. However, there was no difference in previous treatment history. Conclusions: Findings suggest that daily users of prescription opioids in the criminal justice system are at greater risk for additional substanceuseand relatedproblems. Theyarealsomore likely to report the importance of treatment. Implications for treatment planning, community re-entry and treatment will be discussed. Financial support: CJDATS 2 is funded by NIDA in collaboration with SAMSHA and DOJ.

Prescription opioid abuse and related behavior among prisoners

Aims: U.S. prescription drug use is common, second only to marijuana use. Kentucky continues with high rates of non-medical prescription use, particularly prescription opioids in Appalachian Kentucky. Prescription opioid abuse is associated with increasing arrests. However, there is little systematic examination of prescriptionopioiduse in criminal justice settings. The aimof this study is to examine prescription opioid use levels among Kentucky prisoners to understand other drug use and related behavior. Methods: The ASSIST and TCU Drug Screeners were administered to 337 prisoners. After consent, subjects entered protocols as part of the NIDA CJDATS 2 cooperative agreement. Analysis examined past 3 month drug use and problem behaviors for 3 levels of prescription opioid use: daily (n=86), some (n=91) and none (n=160). ANCOVA and logistic regressions were performed controlling for group differences in age, gender, race, and rural residence. Results: Daily prescription opioid users were younger (34.2), more female (39.5%), more white (90.7%) and more rural (58.5%). Daily users significantly reported more use of prescription sedatives (71.3% vs. 56% and 15%, p=< .000) than those in the no use or some use categories. There were no differences in other drug use patterns except for those who reported some use of prescription stimulants (p=< .003) and hallucinogens (p=< .035). Daily users weremore likely to inject drugs, rate their druguse asmore serious, rate themselves asmore dependent on drugs, and report that treatment is important. However, there was no difference in previous treatment history. Conclusions: Findings suggest that daily users of prescription opioids in the criminal justice system are at greater risk for additional substanceuseand relatedproblems. Theyarealsomore likely to report the importance of treatment. Implications for treatment planning, community re-entry and treatment will be discussed. Financial support: CJDATS 2 is funded by NIDA in collaboration with SAMSHA and DOJ.

Prevalence and correlates of nonmedical prescription opiate and nonmedical prescription sedative use among a group of adolescents and young adults with current drug use in an urban emergency department

Prevalence and correlates of nonmedical prescription opiate and nonmedical prescription sedative use among a group of adolescents and young adults with current drug use in an urban emergency department

Positive posttraumatic stress disorder screens among first-time medical cannabis patients: Prevalence and association with other substance use

Twenty-one states and the District of Columbia have passed legislation allowing for the use of medical cannabis for those individuals with qualifying medical conditions, which include posttraumatic stress disorder (PTSD) for a growing number of states. Little information is available regarding PTSD among medical cannabis patients. This study seeks to provide initial data on this topic by examining the prevalence and correlates of positive PTSD screens among a sample of patients seeking medical cannabis certification for the first time (n=186). Twenty-three percent (42/186; 95% confidence interval [CI] =17%–29%) of the patients in the study sample screened positive for PTSD. Moreover, the group that screened positive for PTSD had higher percentages of lifetime prescription opioid, cocaine, prescription sedative, and street opioid use, as well as a higher percentage of recent prescription sedative use, than the group that screened negative for PTSD. These findings highlight the relatively common use of other substances among medical cannabis patients with significant PTSD symptoms, even when compared with other patients seeking medical cannabis for the first time. As a growing number of states include PTSD among the list of qualifying medical conditions for medical cannabis, additional research is needed to better characterize the longitudinal relationship between medical cannabis use and PTSD symptoms.

How mindfulness changed my sleep: focus groups with chronic insomnia patients.

BackgroundChronic insomnia is a major public health problem affecting approximately 10% of adults. Use of meditation and yoga to develop mindful awareness (‘mindfulness training’) may be an effective approach to treat chronic insomnia, with sleep outcomes comparable to nightly use of prescription sedatives, but more durable and with minimal or no side effects. The purpose of this study was to understand mindfulness training as experienced by patients with chronic insomnia, and suggest procedures that may be useful in optimizing sleep benefits.MethodsAdults (N = 18) who completed an 8-week mindfulness-based stress reduction (MBSR) program as part of a randomized, controlled clinical trial to evaluate MBSR as a treatment for chronic insomnia were invited to participate in post-trial focus groups. Two groups were held. Participants (n = 9) described how their sleep routine, thoughts and emotions were affected by MBSR and about utility (or not) of various mindfulness techniques. Groups were audio-recorded, transcribed and analyzed using content analysis.ResultsFour themes were identified: the impact of mindfulness on sleep and motivation to adopt a healthy sleep lifestyle; benefits of mindfulness on aspects of life beyond sleep; challenges and successes in adopting mindfulness-based practices; and the importance of group sharing and support. Participants said they were not sleeping more, but sleeping better, waking more refreshed, feeling less distressed about insomnia, and better able to cope when it occurred. Some participants experienced the course as a call to action, and for them, practicing meditation and following sleep hygiene guidelines became priorities. Motivation to sustain behavioral changes was reinforced by feeling physically better and more emotionally stable, and seeing others in the MBSR class improve. The body scan was identified as an effective tool to enable falling asleep faster. Participants described needing to continue practicing mindfulness to maintain benefits.ConclusionsFirst-person accounts are consistent with published trial results of positive impacts of MBSR on sleep measured by sleep diary, actigraphy, and self-report sleep scales. Findings indicate that mindfulness training in a group format, combined with sleep hygiene education, is important for effective application of MBSR as a treatment for chronic insomnia.

Nonmedical Prescription Opioid and Sedative Use Among Adolescents in the Emergency Department

Nonmedical prescription opiate use (NPOU) and nonmedical prescription sedative use (NPSU) are serious public health concerns. The objectives of this study were to determine the prevalence and emergency department (ED) visit characteristics and other correlates associated with past-year NPOU and NPSU among adolescents and young adults using the ED. Participants aged 14 to 20 presenting to the ED at the University of Michigan Medical Center between September 2010 and September 2011 were systematically recruited. A computerized self-report screening survey with validated items measuring past-year NPOU, NPSU, substance use, and violence was delivered to participants, and a retrospective chart review was performed. Of the 2135 participants (86.0% response rate), 222 (10.4%) reported either NPOU or NPSU. Among the 185 (8.7%) participants that reported NPOU, 14.6% had a current home prescription for an opioid and among the 115 (5.4%) with NPSU, 12.3% had a current home prescription for a sedative. After controlling for demographics (age, gender, race, public assistance), correlates of NPOU or NPSU included other substance use, and drinking and driving or riding with a drinking driver. Additional correlates of NPOU included receiving an intravenous opioid in the ED and for NPSU, dating violence, presenting to the ED for a noninjury complaint, and previous ED visit in the past year. Nearly 1 in 10 young people who use the ED for care report NPOU or NPSU, and only 12.3% and 14.6% report having current home prescriptions for sedatives and opioids. The ED represents a key location for screening and intervention efforts.

Non-Medical Prescription Sedative Use Among Adult Latina Mothers and Daughters

This study examines correlates of non-medical prescription sedative, tranquilizer, and hypnotics use (hereafter NPSU) among a non-clinical, community-based sample of adult Latina mother-daughter dyads. Participants were 316 Latina mothers and daughters enrolled in a study of intergenerational transmission of drug abuse and HIV/AIDS risk behaviors in South Florida. Interviewers administered a questionnaire containing study variables such as age, education, time in the U.S., Spanish language proficiency, health insurance status, wellness behaviors, perceived health condition, alcohol use, NPSU, and other drug use. Correlates of NPSU across mothers and daughters were determined using a dyadic model analysis. Daughters’ health status, age, wellness, and illicit drug use were associated with mothers’ NPSU. Mothers who reported being uninsured, having higher levels of education, and indicating poorer health statuses reported more NPSU. Daughters’ wellness behaviors, age, illicit drug use, and insurance status were associated with their NPSU. Insured mothers and mothers who engaged in illicit drug use had daughters who reported more NPSU. The study's findings provide a modest understanding of family dynamics surrounding NPSU, and it suggests that as women age and their perceived health status worsens, their NPSU may increase.

Characteristics of adults seeking medical marijuana certification

BackgroundVery little is known about medical marijuana users. The present study provides descriptive information on adults seeking medical marijuana and compares individuals seeking medical marijuana for the first time with those renewing their medical marijuana card on measures of substance use, pain and functioning. MethodsResearch staff approached patients (n=348) in the waiting area of a medical marijuana certification clinic. Chi-square and Wilcoxon signed rank tests were used to compare participants who reported that they were seeking medical marijuana for the first time (n=195) and those who were seeking to renew their access to medical marijuana (n=153). ResultsReturning medical marijuana patients reported a higher prevalence of lifetime cocaine, amphetamine, inhalant and hallucinogen use than first time patients. Rates of recent alcohol misuse and drug use were relatively similar between first time patients and returning patients with the exception of nonmedical use of prescription sedatives and marijuana use. Nonmedical prescription sedative use was more common among first time visitors compared to those seeking renewal (p<0.05). The frequency of recent marijuana use was higher in returning patients than first time patients (p<0.0001). Compared to first time patients, returning patients reported somewhat lower current pain level and slightly higher mental health and physical functioning. ConclusionsStudy results indicate that differences exist between first time and returning medical marijuana patients. Longitudinal data are needed to characterize trajectories of substance use and functioning in these two groups.

Universal screening for drug use in urban primary care

We describe universal screening in a large urban hospital-based primary care practice. Trained staff aimed to screen all adult patients presenting for primary care visits between July 2010 and February 2011. Screening included three items about past three-month drug use: frequency of heavy drinking (>3 standard drinks in a day for women and >4 for men); any use of prescription sedatives, opioids, or amphetamines without a prescription or in greater amounts than prescribed; and any use of illicit drugs. A convenience sample of those who screened positive for drug use was evaluated for eligibility to be in a study of brief counseling efficacy; enrollment resulted in further research assessment. During six months, 15,818 patients arrived for primary care appointments. Of these, 5549 (35%) were screened, 539 (10%) of whom reported heavy drinking (5.9% of those screened) or drug use (6.2% of those screened). Of the 539, 41% reported drug use only, 38% heavy drinking only, and 21% reported both. Of patients meeting eligibility criteria for the brief counseling study for drug use (current drug use, not pregnant, able to provide two contacts for follow-up, willing to return for research assessments, spoke English), 14% had lower risk scores (2 or 3) on the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Of those with scores of 4 or more (moderate risk), marijuana was the drug of most concern for 61%, cocaine for 19%, and opioids for 18%. Twenty-one percent reported prescription drug misuse, 31% used more than one drug, 20% had high-risk ASSIST scores (27+), and 48% met criteria for drug dependence. In-person universal screening in busy urban primary care settings reaches some but misses many. Drug use prevalence was 6.2%, most of which was marijuana, and many of those screened had drug dependence. Most drug use would have been missed if drug screening had been done only for those who screened positive for heavy drinking.

The Reliability of Reports of Recent Psychoactive Substance Use at the Time of Admission to an Acute Mental Health Unit

The aim of this study was to examine the accuracy of patients’ accounts of their psychoactive substance use in the week before admission to an acute mental health unit. Fifty consecutively admitted patients undertook a semistructured clinician-administered questionnaire for recent substance use. The results of the interview were compared to the results of gas chromatography mass spectrometry/ mass spectrometry. No patient refused to participate, 46 patients were able to complete the interview, and 48 patients provided a blood sample. Six patients had unreported cocaine or amphetamine in their blood. Cannabis and opiates were not detected in the blood of most of the patients who reported using these drugs. The self-reports of the use of prescription sedatives were inaccurate, but self-reports of recent use of caffeine, nicotine, antidepressants, antipsychotics, and carbamazepine had good overall reliability. Patient reports of recent illicit substance use at the point of admission were found to be unreliable, which may result in incorrect diagnosis and suboptimal treatment of both mental illness and substance-related disorders.

Escalation of drug use in early-onset cannabis users vs co-twin controls.

Previous studies have reported that early initiation of cannabis (marijuana) use is a significant risk factor for other drug use and drug-related problems. To examine whether the association between early cannabis use and subsequent progression to use of other drugs and drug abuse/dependence persists after controlling for genetic and shared environmental influences. Cross-sectional survey conducted in 1996-2000 among an Australian national volunteer sample of 311 young adult (median age, 30 years) monozygotic and dizygotic same-sex twin pairs discordant for early cannabis use (before age 17 years). Self-reported subsequent nonmedical use of prescription sedatives, hallucinogens, cocaine/other stimulants, and opioids; abuse or dependence on these drugs (including cannabis abuse/dependence); and alcohol dependence. Individuals who used cannabis by age 17 years had odds of other drug use, alcohol dependence, and drug abuse/dependence that were 2.1 to 5.2 times higher than those of their co-twin, who did not use cannabis before age 17 years. Controlling for known risk factors (early-onset alcohol or tobacco use, parental conflict/separation, childhood sexual abuse, conduct disorder, major depression, and social anxiety) had only negligible effects on these results. These associations did not differ significantly between monozygotic and dizygotic twins. Associations between early cannabis use and later drug use and abuse/dependence cannot solely be explained by common predisposing genetic or shared environmental factors. The association may arise from the effects of the peer and social context within which cannabis is used and obtained. In particular, early access to and use of cannabis may reduce perceived barriers against the use of other illegal drugs and provide access to these drugs.