Strain and Prescription Drug Misuse in the United States Military

Background: The United States Institute of Medicine (IOM) published reports in 1999 and 2011 identifying drug use as a priority area for sexual minority health research, specifically focused on mechanisms contributing to drug use disparities and the development of tailored interventions. Limited research has prioritized sexual minority women (SMW) with the majority of substance use research among sexual minorities focused on adolescents and men who have sex with men. This scoping review will characterize the research literature related to illicit drug use and prescription drug misuse among SMW and sub-groups within the SMW population. Through this, we will identify: (1) specific substances used; (2) patterns of substance use; (3) risk and protective factors; (4) prevention interventions; and (5) drug treatment programs specific to SMW. Methods/Design: This review will include studies with empirical data of illicit or prescription drug misuse among sexual minority women. Peer-reviewed quantitative research conducted in the United States and published in English from 2011-Present will be included. We will search Medline, PsycINFO, and Web of Science databases for relevant articles. Two independent reviewers will screen abstracts and relevant full-text studies for eligibility. Data will be extracted from eligible articles and results will be presented in narrative and tabular form as appropriate. Discussion: This work will identify gaps of knowledge in the research pertaining to illicit or prescription drug misuse among sexual minority women since the 2011 US IOM report. As a result of this work, we will propose directions for future research to address identified gaps.

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Protective Effects of Perceived Control on Prescription Drug Misuse 10-years Later in the MIDUS Study

Innovation in Aging ◽

10.1093/geroni/igab046.3119 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 862-862

Author(s):

Sara Miller ◽

David Almeida

Keyword(s):

Prescription Drug ◽

Perceived Control ◽

Problem Drinking ◽

The United States ◽

Drug Misuse ◽

Control Beliefs ◽

Protective Effects ◽

Prescription Drug Misuse ◽

Personal Mastery ◽

Drinking Status

Abstract The current study examined if control beliefs predict prescription drug misuse (PDM) 10-years later and how problem drinking status moderates this relationship. PDM refers to taking medications without a prescription or in a manner not intended by the prescriber. Older adults are especially vulnerable to PDM due to drug sensitivity, comorbid health conditions, and high rates of polypharmacy. Participants were adults (n=2162, 56% female, mean age=54, range=30-84) who completed Waves 2 and 3 of the Midlife Development in the United States (MIDUS) study. At Wave 2, participants reported on two subscales of perceived control (personal mastery and constraints) and past 12-month problem drinking behaviors. At Wave 3, participants reported past 12-month PDM of five substances (painkillers, sedatives, stimulants, tranquilizers, and depression medications). Results indicated that at Wave 3, 10% of the sample reported misusing at least one prescription drug in the past year. Logistic Regression analysis revealed that problem drinking was associated with higher odds of PDM (p<0.001), and perceived control was associated with lower odds of PDM (p<0.05) after controlling for previous PDM and sociodemographic, health behavior, and health status covariates. However, there was an interaction effect such that perceived control was not protective for those individuals who engaged in problem drinking at Wave 2 (p<0.05). Future analyses will explore the meaning of this interaction. Identifying psychosocial protective factors, such as perceived control, predicting PDM will be critical for designing interventions that prevent the adverse consequences of PDM among this population.

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Is Medical Marijuana Legalization Associated With Prescription Drug Misuse, Illicit Drug Use, or Combination of Both Among Adults in the United States?

Journal of Drug Issues ◽

10.1177/0022042620942152 ◽

2020 ◽

Vol 50 (4) ◽

pp. 566-578

Author(s):

Yen-Han Lee ◽

Yen-Chang Chang ◽

Ching-Ti Liu ◽

Stephan Arndt

Keyword(s):

Drug Use ◽

Prescription Drug ◽

Illicit Drug ◽

Multinomial Logistic Regression ◽

Medical Marijuana ◽

Illicit Drug Use ◽

The United States ◽

Drug Misuse ◽

Prescription Drug Misuse ◽

Marijuana Legalization

This research focuses on associations of medical marijuana legalization with prescription drug misuse, illicit drug use, and a combination of both behaviors. Using three waves of the National Survey of Drug Use and Health (NSDUH, 2016–2018), adult participants (age ≥ 18) were selected for the final study sample ( n = 127,438). Multinomial logistic regression was adjusted for biological, socioeconomic, and substance use measurements. Results from multinomial regression demonstrated that medical marijuana legalization was positively associated with illicit drug use (relative risk ratio [RRR] = 1.33, 95% confidence interval [CI] = [1.17, 1.51]; p < .01) and both prescription drug misuse and illicit drug use (RRR = 1.14, 95% CI = [1.05, 1.25]; p < .01) among U.S. adults. It is recommended to design policy interventions to counter illicit drug use and a combination of both prescription drug misuse and illicit drug use as the result of medical marijuana legalization.

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Online Conversation Monitoring to Understand the Opioid Epidemic: Epidemiological Surveillance Study

JMIR Public Health and Surveillance ◽

10.2196/17073 ◽

2020 ◽

Vol 6 (2) ◽

pp. e17073

Author(s):

Joshua C Black ◽

Zachary R Margolin ◽

Richard A Olson ◽

Richard C Dart

Keyword(s):

United States ◽

Social Media ◽

The United States ◽

Drug Misuse ◽

Epidemiological Surveillance ◽

Surveillance Systems ◽

Prescription Drug Misuse ◽

Health Crisis ◽

Online Social Media ◽

Traditional Surveillance

Background Between 2016 and 2017, the national mortality rate involving opioids continued its escalation; opioid deaths rose from 42,249 to 47,600, bringing the public health crisis to a new height. Considering that 69% of adults in the United States use online social media sites, a resource that builds a more complete understanding of prescription drug misuse and abuse could supplement traditional surveillance instruments. The Food and Drug Administration has identified 5 key risks and consequences of opioid drugs—misuse, abuse, addiction, overdose, and death. Identifying posts that discuss these key risks could lead to novel information that is not typically captured by traditional surveillance systems. Objective The goal of this study was to describe the trends of online posts (frequency over time) involving abuse, misuse, addiction, overdose, and death in the United States and to describe the types of websites that host these discussions. Internet posts that mentioned fentanyl, hydrocodone, oxycodone, or oxymorphone were examined. Methods Posts that did not refer to personal experiences were removed, after which 3.1 million posts remained. A stratified sample of 61,000 was selected. Unstructured data were classified into 5 key risks by manually coding for key outcomes of misuse, abuse, addiction, overdose, and death. Sampling probabilities of the coded posts were used to estimate the total post volume for each key risk. Results Addiction and misuse were the two most commonly discussed key risks for hydrocodone, oxycodone, and oxymorphone. For fentanyl, overdose and death were the most discussed key risks. Fentanyl had the highest estimated number of misuse-, overdose-, and death-related mentions (41,808, 42,659, and 94,169, respectively). Oxycodone had the highest estimated number of abuse- and addiction-related mentions (3548 and 12,679, respectively). The estimated volume of online posts for fentanyl increased by more than 10-fold in late 2017 and 2018. The odds of discussing fentanyl overdose (odds ratios [OR] 4.32, 95% CI 2.43-7.66) and death (OR 5.05, 95% CI 3.10-8.21) were higher for social media, while the odds of discussing fentanyl abuse (OR 0.10, 95% CI 0.04-0.22) and addiction (OR 0.24, 95% CI 0.15-0.38) were higher for blogs and forums. Conclusions Of the 5 FDA-defined key risks, fentanyl overdose and death has dominated discussion in recent years, while discussion of oxycodone, hydrocodone, and oxymorphone has decreased. As drug-related deaths continue to increase, an understanding of the motivations, circumstances, and consequences of drug abuse would assist in developing policy responses. Furthermore, content was notably different based on media origin, and studies that exclusively use either social media sites (such as Twitter) or blogs and forums could miss important content. This study sets out sustainable, ongoing methodology for surveilling internet postings regarding these drugs.

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Preventing Prescription Drug Misuse: A Regulatory Perspective in the United States, Europe, and India

International Journal of Drug Regulatory Affairs ◽

10.22270/ijdra.v9i4.502 ◽

2021 ◽

Vol 9 (4) ◽

pp. 46-52

Author(s):

Dhruvi B Thakker ◽

Kalpana G Patel

Keyword(s):

United States ◽

Regulatory System ◽

The United States ◽

Drug Misuse ◽

Prescription Drug Misuse ◽

Regulatory Oversight ◽

Pharmaceutical Supply Chain ◽

Post Marketing Surveillance ◽

Post Marketing ◽

The Times

Prescription medicines, such as analgesics, stimulants, steroids, anti-depressants, psychotropics, and certain antibiotics are commonly mishandled in a variety of ways, including overdosing, abuse, diversion, and drug trafficking. Because of the considerable risk to public health, they are subject to strict regulatory oversight. The drugs possess abuse potential at specific dose and hence prone to abuse therefore they are categorized as Controlled substances. Therefore, they are subject to constant vigilance over the pharmaceutical supply chain. The complete clinical data as well as post marketing surveillance study of such drugs are critical to be in place as per the regulatory requirements. The countries have kept up with the times by constantly updating the system with regulatory laws and strategies to prevent cases of misuse. The current review will give a quick summary of how prescription medications and prohibited substances are regulated in the United States, Europe, and India. It will also emphasize current trends in drug usage, as well as the issues that these countries face and the preventive policies implemented to manage and prevent drug misuse. It will also make recommendations for new regulatory initiatives to address the current drug- misuse-related concerns. As a result, a review of the regulatory system in various countries will present current challenges and new lessons for countries around the globe.

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Prescription Drugs and the US Workforce: Results from a National Safety Council Survey

January 2018 - Pain Physician ◽

10.36076/ppj.2020/23/1 ◽

2020 ◽

Vol 1;23 (1;1) ◽

pp. 1-16 ◽

Cited By ~ 2

Author(s):

Alaa Abd-Elsayed

Keyword(s):

Chronic Pain ◽

Drug Abuse ◽

Prescription Drug ◽

Prescription Drugs ◽

Workplace Violence ◽

The United States ◽

Drug Misuse ◽

Prescription Drug Abuse ◽

Prescription Drug Misuse ◽

National Safety Council

Background: The cost of chronic pain in the United States is extremely high. Opioids are one of the most common medications prescribed for the treatment of chronic pain, and their misuse and addiction have been of concern. It has been found that opioids are frequently abused and negatively impact the American workforce. Objectives: The objective of this study was to obtain data on US employers’ concerns and priorities, perceptions of prescription drug abuse, perceived impact of prescription drug use on the workplace, identification of and response to drug abuse, perceived ability to handle prescription drug abuse in the workplace, and workplace initiatives, employee assistance programs, employee drug testing, workplace prescription drug training, insurance coverage of alternative treatment, and overall preparedness to deal with the issue. Study Design: This research used an employer proprietary questionnaire created by members of the National Safety Council in cooperation with market research experts at B2B International. Setting: Employers surveyed via an online survey represent diverse industries and geographical areas. Methods: The research was conducted using a proprietary questionnaire. Participants were recruited from a sample of verified panelists through Research Now, and fieldwork was conducted online by B2B International. This report is on 501 interviews that each represent a US employer with 50 or more employees. The employers sampled are extremely diverse in not only size and industry, but also geography and centralization. Results: Our results showed that 67% of employers reported concerns related to prescription drug misuse, which was comparable to workplace violence and more concerning than the use of illegal drugs. Sixty-one percent reported concerns related to prescription opioids, which was a higher concern than using anti-anxiety medications, stimulants, and even heroin. Limitations: Survey study with descriptive analysis with limited sample. Conclusions: Prescription drug misuse and abuse concern American employers. Their side effects are clear, but employers are less likely to acknowledge their detrimental business effect. Employers report being unprepared for dealing with issues related to this; however, the firms with programs in place feel more prepared to deal with misuse and abuse. Key words: Prescription drugs, US workforce, chronic pain

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Online Conversation Monitoring to Understand the Opioid Epidemic: Epidemiological Surveillance Study (Preprint)

10.2196/preprints.17073 ◽

2019 ◽

Author(s):

Joshua C Black ◽

Zachary R Margolin ◽

Richard A Olson ◽

Richard C Dart

Keyword(s):

United States ◽

Social Media ◽

The United States ◽

Drug Misuse ◽

Epidemiological Surveillance ◽

Surveillance Systems ◽

Prescription Drug Misuse ◽

Health Crisis ◽

Online Social Media ◽

Traditional Surveillance

BACKGROUND Between 2016 and 2017, the national mortality rate involving opioids continued its escalation; opioid deaths rose from 42,249 to 47,600, bringing the public health crisis to a new height. Considering that 69% of adults in the United States use online social media sites, a resource that builds a more complete understanding of prescription drug misuse and abuse could supplement traditional surveillance instruments. The Food and Drug Administration has identified 5 key risks and consequences of opioid drugs—misuse, abuse, addiction, overdose, and death. Identifying posts that discuss these key risks could lead to novel information that is not typically captured by traditional surveillance systems. OBJECTIVE The goal of this study was to describe the trends of online posts (frequency over time) involving abuse, misuse, addiction, overdose, and death in the United States and to describe the types of websites that host these discussions. Internet posts that mentioned fentanyl, hydrocodone, oxycodone, or oxymorphone were examined. METHODS Posts that did not refer to personal experiences were removed, after which 3.1 million posts remained. A stratified sample of 61,000 was selected. Unstructured data were classified into 5 key risks by manually coding for key outcomes of misuse, abuse, addiction, overdose, and death. Sampling probabilities of the coded posts were used to estimate the total post volume for each key risk. RESULTS Addiction and misuse were the two most commonly discussed key risks for hydrocodone, oxycodone, and oxymorphone. For fentanyl, overdose and death were the most discussed key risks. Fentanyl had the highest estimated number of misuse-, overdose-, and death-related mentions (41,808, 42,659, and 94,169, respectively). Oxycodone had the highest estimated number of abuse- and addiction-related mentions (3548 and 12,679, respectively). The estimated volume of online posts for fentanyl increased by more than 10-fold in late 2017 and 2018. The odds of discussing fentanyl overdose (odds ratios [OR] 4.32, 95% CI 2.43-7.66) and death (OR 5.05, 95% CI 3.10-8.21) were higher for social media, while the odds of discussing fentanyl abuse (OR 0.10, 95% CI 0.04-0.22) and addiction (OR 0.24, 95% CI 0.15-0.38) were higher for blogs and forums. CONCLUSIONS Of the 5 FDA-defined key risks, fentanyl overdose and death has dominated discussion in recent years, while discussion of oxycodone, hydrocodone, and oxymorphone has decreased. As drug-related deaths continue to increase, an understanding of the motivations, circumstances, and consequences of drug abuse would assist in developing policy responses. Furthermore, content was notably different based on media origin, and studies that exclusively use either social media sites (such as Twitter) or blogs and forums could miss important content. This study sets out sustainable, ongoing methodology for surveilling internet postings regarding these drugs.

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Prescription Drug Misuse: Taking a Lifespan Perspective

Substance Abuse Research and Treatment ◽

10.1177/1178221820909352 ◽

2020 ◽

Vol 14 ◽

pp. 117822182090935

Author(s):

Ty S Schepis ◽

Dalton L Klare ◽

Jason A Ford ◽

Sean Esteban McCabe

Keyword(s):

Prescription Drug ◽

Minority Groups ◽

Longitudinal Research ◽

Age Groups ◽

The United States ◽

Drug Misuse ◽

Health Concern ◽

Prevalence Rates ◽

Prescription Drug Misuse ◽

Polysubstance Use

Prescription drug misuse (PDM), or medication use without a prescription or in ways not intended by the prescriber, is a notable public health concern, especially in the United States. Accumulating research has characterized PDM prevalence and processes, but age-based or lifespan changes in PDM are understudied. Given age-based differences in the medical or developmental concerns that often underlie PDM, it is likely that PDM varies by age. This review summarizes the literature on PDM across the lifespan, examining lifespan changes in prevalence, sources, motives and correlates for opioid, stimulant, and tranquilizer/sedative (or benzodiazepine) PDM. In all, prevalence rates, sources and motives vary considerably by age group, with fewer age-based differences in correlates or risk factors. PDM prevalence rates tend to decline with aging, with greater use of physician sources and greater endorsement of self-treatment motives in older groups. Recreational motives (such as to get high) tend to peak in young adulthood, with greater use of peer sources or purchases to obtain medication for PDM in younger groups. PDM co-occurs with other substance use and psychopathology, including suicidality, across age groups. The evidence for lifespan variation in PDM is strongest for opioid PDM, with a need for more research on tranquilizer/sedative and stimulant PDM. The current literature is limited by the few studies of lifespan changes in PDM within a single sample, a lack of longitudinal research, little research addressing PDM in the context of polysubstance use, and little research on minority groups, such as sexual and gender minorities.

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