Risk For Prescription Drug Misuse Research Articles

Work-family interface on hazardous alcohol use and increased risk for prescription drug misuse among diverse working parents in STEM

ABSTRACT Background Science, Technology, Engineering, and Mathematics (STEM) industries are competitive and can be stressful work environments leading to an increase in substance misuse. Little is known on the role of work-related risk and protective factors on substance misuse among working parents navigating multiple roles. Objectives This study aims to examine work-life balance as a protective factor and various risk factors (emotional exhaustion, work-family, family-work conflicts) for hazardous alcohol use and increased risk for prescription drug misuse among diverse working parents in STEM. Methods Participants (n = 1,228) were recruited via Qualtrics from across the US and the sample was racially ethnic and gender (50% men, 50% women) diverse. An overall path analysis was conducted to explore direct and indirect effects of work-life balance on hazardous alcohol use and increased risk for prescription drug misuse. Path analyses explored the racial-ethnic and gender differences across the overall model. Results Path analysis revealed that healthy work-life balance indirectly predicts decreased hazardous alcohol use (b = −.149, p = .004) and decreased risk for prescription drug misuse (b = −.185, p < .001). Exploration of the model across racial-ethnic and gender groups revealed that higher work-life balance indirectly predicts decreased hazardous alcohol use for Black and Asian Americans, but not for Latinos and Whites; and higher work-life balance indirectly predicts decreased hazardous alcohol use for men, but not women. Conclusions Identifying the work-family interface can help providers understand prevention, risk-reduction practices, and interventions for hazardous alcohol use and prescription drug misuse among diverse working parents in STEM.

Personality to Prescription Drug Misuse in Adolescents: Testing Affect Regulation, Psychological Dysregulation, and Deviance Proneness Pathways.

Background: Fifteen to 25-year-olds are the age group most likely to misuse prescription drugs. Few studies have tested theory-driven models of adolescent risk for prescription drug misuse. Moreover, rarely are distinct pathways to different forms of prescription drug misuse considered.Methods: We tested mediational paths from personality to mental health symptoms to prescription drug misuse, informed by etiological models of addiction. We specified pathways from particular personality traits to unique forms of prescription drug misuse via specific mental health symptoms. We used semi-longitudinal data collected across two waves of the Co-Venture Trial. Our sample included students from 31 Canadian high schools tested in Grade 9 (n = 3,024) and again in Grade 10 (n = 2,869; 95% retention). Personality (hopelessness, anxiety sensitivity, impulsivity, sensation seeking) was assessed in Grade 9. Mental health symptoms (depression, anxiety, ADHD, conduct disorder) and prescription drug misuse (opioids, sedatives/tranquilizers, stimulants) were assessed at both time points.Results: Consistent with the negative affect regulation model, hopelessness was specifically associated with opioid misuse via depressive symptoms, and anxiety sensitivity was specifically associated with sedative/tranquilizer misuse via anxiety symptoms. Consistent with positive affect regulation, sensation seeking was directly associated with stimulant misuse. Consistent with the psychological dysregulation model, impulsivity was associated with stimulant misuse via ADHD symptoms. And consistent with the deviance proneness model, impulsivity was also associated with unconstrained (i.e., all three forms of) prescription drug misuse via conduct disorder symptoms.Conclusions: Screening for adolescents high in hopelessness, anxiety sensitivity, sensation seeking, or impulsivity and providing them with personality-matched cognitive-behavioral interventions may be helpful in preventing or mitigating prescription drug misuse. Our results point to the specific mental health symptoms that are important to target in each of these personality-matched interventions.

Academic factors associated with college students’ prescription stimulant misuse in daily life: An ecological analysis of multiple levels

Objective To identify academic factors pertaining to college students, calendar timing, and particular moments that are uniquely associated with elevated likelihood of prescription stimulant misuse (intentions and actual behavior) in daily life. Participants: Participants were 297 freshmen and sophomores at a large public university in the United States in 2017–2019. Methods: Participants completed survey measures during lab visits and ecological momentary assessment procedures in daily life. Hypotheses were tested using multilevel models that accounted for the nested data and demographic covariates. Results: Student, calendar-based, and momentary academic factors were uniquely associated with stimulant misuse intentions in daily life. Real-time academic events, beyond the proportion of academic events experienced, emerged as a robust predictor of misuse behavior. Within-person links between real-time momentary predictors and misuse behavior were moderated by finals week timing. Conclusions: Findings offer implications for prevention and intervention strategies for college students at risk for prescription drug misuse.

Evaluating Emergency Department Opioid Prescribing Behaviors After Education About Mandated Use of the Pennsylvania Prescription Drug Monitoring Program.

Prescription drug monitoring programs (PDMPs) are among the most promising state-level interventions to improve opioid prescribing, inform clinical practice, and protect patients at risk for prescription drug misuse, overdose, and death. In 2016, Pennsylvania launched an initiative mandating all prescribers to search the PDMP for each patient when the patient is prescribed controlled substances. The primary aim of this project was to support the Pennsylvania PDMP mandate by educating emergency department (ED) providers regarding the opioid epidemic and use of the PDMP and measure opioid prescriptions posteducation. Secondary aims were to evaluate provider knowledge and identify barriers to PDMP use. This quality improvement project was conducted through a retrospective chart review of patients 18-85 years old discharged from the ED with a chief complaint of pain. A pretest and a posttest measured provider knowledge change after an education program and assessed barriers to PDMP use. Numbers of opioid prescriptions written at discharge were examined. Provider knowledge scores increased significantly (p = .000). Barriers to PDMP use focused on access and process issues. A statistically significant decrease was observed in opioid prescriptions written (p = .002) during the project. An education program increased ED providers' knowledge of the opioid epidemic and the Pennsylvania PDMP mandate and identified barriers to use. A decrease in opioid prescriptions written may have been associated with improved knowledge and suggests that providers can change prescribing behaviors. More research is needed in this area, and future projects may want to focus on prescriber attitudes toward PDMP usefulness.

A Systematic Review of the Prevention and Treatment of Prescription Drug Misuse.

This is a review and evaluation of the current clinical guidelines and empirical literature in relation to the Department of Defense (DoD) policies and directives regarding prescription drug misuse (PDM). Sources were 11 clinical guidelines and consensus statements, 20 DoD Directives and the published literature from 2000 to 2012. Articles were included if they specifically focused on the prevention or treatment of PDM. DoD directives were evaluated in relation to the clinical guidelines and the relevant research literature. Empirical evidence supporting the directives was limited. There is little empirical evidence for the prevention and treatment of PDM and the majority of published guidelines and studies focus on prescription opioids. Important limitations include the lack of information about appropriately identifying and managing persons at risk for PDM. More research is needed to identify and recommend effective mechanisms for the prevention and treatment of PDM.

Prescription Drug Misuse and Gender

In recent years, prescription drug misuse has become a serious public health issue. A number of studies in this area have identified females to be at an increased risk for prescription drug misuse during adolescence. Guided by Agnew's general strain theory, the current research examined the relationship between prescription drug misuse and gender during adolescence. We used data from the 2010 National Survey on Drug Use and Health, a sample representative of the non-institutionalized population of the United States. Logistic regression models were estimated to examine the relationship between gender, prescription drug misuse, strain, and depression. The findings indicated that females were at an increased for prescription drug misuse. We also found support for general strain theory, as strain and depression were significantly related to prescription drug misuse. In addition, we found evidence that strain was gendered in that elements of general strain theory accounted for the relationship between prescription drug misuse and gender.

Prescription Drug Misuse Among Asian-American Adults: Results From a National Survey

Asians have low levels of substance use compared with other groups in the United States. Given the increase in Asian population, we believe it is important to study substance use in this population. Data from the 2002–2003 National Latino and Asian American Study are examined to address two questions. First, which Asian ethnic subgroup is at greatest risk for prescription drug misuse? Second, is acculturation significantly correlated with prescription drug misuse among Asians? Findings indicate that Filipinos are at the greater risk for prescription drug misuse. Also, Asians who are more acculturated are at greater risk for prescription drug misuse.