Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample

Abstract Background The use of cannabis as medicine (CaM) both prescribed and non-prescribed has increased markedly in the last decade, mirrored in a global shift in cannabis policy towards a more permissive stance. There is some evidence that cannabis functions as a substitute for prescription drugs, particularly opioids; however, more knowledge is needed on the motives of substitution users, their patterns of use, and perceived effects of substitution use. Aims To explore who substitutes prescription drugs with cannabis, the type of prescription drugs substituted and the type of cannabis used, and the impact that substitution with cannabis has on prescription drug use as well as the motives for substitution in terms of experienced effects and side effects. Methods A self-selected convenience sample was recruited through social media, public media, and patient organizations to take part in an anonymous online survey. Inclusion criteria were 18 years or older and use of cannabis (prescribed or non-prescribed) with a medical purpose. Results The final sample included 2.841 respondents of which the majority (91%) used non-prescribed cannabis, and more than half (54.6%) had used CaM with the purpose of replacing a prescribed drug. Compared to non-substitution users, substitution users were more likely to be women and to use CaM in the treatment of chronic pain and other somatic conditions. Pain medication (67.2%), antidepressants (24.5%), and arthritis medication (20.7%) were the most common types of drugs replaced with CaM. Among substitution users, 38.1% reported termination of prescription drug use, and 45.9% a substantial decrease in prescription drug use. The most frequent type of cannabis used as a substitute was CBD-oil (65.2%), followed by ‘hash, pot or skunk’ (36.6%). More than half (65.8%) found CaM much more effective compared to prescription drugs, and 85.5% that the side effects associated with prescription drug use were much worse compared to use of CaM. Conclusion CaM is frequently used as a substitute for prescription drugs, particularly opioids. More research is needed on the long-term consequences of use of CaM, including the impact from low and high THC cannabis products on specific somatic and mental health conditions.

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Recreational Prescription Drug Use Among College Students

NASPA Journal ◽

10.2202/0027-6014.1569 ◽

2006 ◽

Vol 43 (1) ◽

Cited By ~ 2

Author(s):

Ethan A Kolek

Keyword(s):

Drug Use ◽

Prescription Drug ◽

Undergraduate Students ◽

Prescription Drugs ◽

Drug Users ◽

Research University ◽

Future Research ◽

Negative Consequences ◽

Prescription Drug Use ◽

Other Substances

The purpose of this study was to explore recreational prescription drug use among undergraduate students. Although anecdotal accounts on this subject abound, empirical research is extremely limited. Data from a survey of a random sample of 734 students at a large public research university in the Northeast were examined. Results indicate that a substantial proportion of students reported having used prescription drugs for recreational purposes in the year prior to survey administration. Recreational prescription drug use was positively associated with the use of other substances including alcohol. Recreational prescription drug users were also more likely than other drug users to report negative consequences as a result of their drug use. Implications for future research and for student affairs are discussed.

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Prescription Drug and Healthcare Use Among Swedish Patients Treated with Antidepressants

Annals of Pharmacotherapy ◽

10.1177/106002809502900602 ◽

1995 ◽

Vol 29 (6) ◽

pp. 566-572 ◽

Cited By ~ 17

Author(s):

Kerstin Al Bingefors ◽

Dag Gl Isacson ◽

Lars Von Knorring ◽

Björn Smedby

Keyword(s):

Drug Use ◽

Ambulatory Care ◽

Prescription Drug ◽

Prescription Drugs ◽

Antidepressant Treatment ◽

Antidepressant Drugs ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

Prescription Drug Use

Objective: To analyze healthcare and prescription drug use among patients taking and those not taking antidepressant drugs in a Swedish community. Design: Cross-sectional study. Setting: General population of the rural Swedish municipality Tierp of approximately 20 000 inhabitants. Participants: All residents of Tierp aged 25 years or older during 1988. Main Outcome Measures: Mean number of ambulatory care visits, hospital bed days, and prescriptions per person; proportion of those taking prescription drugs in different pharmacologic classes. Results: Patients treated with antidepressant drugs had a significantly (p < 0.05) greater use of ambulatory care, hospital care, and prescription drugs than those who did not take antidepressants in the study population. They also had an increased frequency of use of prescription drugs from virtually all pharmacologic classes. Furthermore, the risk for polypharmacy was high in patients treated with antidepressant medications. Conclusions: Those who took antidepressant drugs consumed more health services and prescription drugs than did those not taking an antidepressant. Patients receiving antidepressant treatment may be at serious risk for iatrogenic disease and should be evaluated carefully with respect to concomitant drug use.

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The Impact Of Medicare Part D On Prescription Drug Use By The Elderly

Health Affairs ◽

10.1377/hlthaff.26.6.1735 ◽

2007 ◽

Vol 26 (6) ◽

pp. 1735-1744 ◽

Cited By ~ 119

Author(s):

Frank R. Lichtenberg ◽

Shawn X. Sun

Keyword(s):

Drug Use ◽

Prescription Drug ◽

Medicare Part D ◽

The Elderly ◽

Medicare Part ◽

Part D ◽

Prescription Drug Use ◽

The Impact

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Prescription Drug Use among Ambulatory Elderly in a Swedish Municipality

Annals of Pharmacotherapy ◽

10.1177/106002809302700918 ◽

1993 ◽

Vol 27 (9) ◽

pp. 1120-1125 ◽

Cited By ~ 33

Author(s):

Tove M. Jörgensen ◽

Dag G.L. Isacson ◽

Mats Thorslund

Keyword(s):

Drug Use ◽

Prescription Drug ◽

Prescription Drugs ◽

Rural Areas ◽

Total Population ◽

The Elderly ◽

Geographic Area ◽

Prescription Drug Use ◽

Analgesic Agents ◽

The Difference

OBJECTIVE: To analyze prescription drug use among the elderly in a Swedish municipality. METHODS: The municipality of Tierp, located in mideastern Sweden, is a well-defined geographic area that includes both rural areas and a few small, industrial towns. All people aged 65 years and older (n=4769) as of 1986 in a total population of 21000 inhabitants were included in the study. Their drug use was studied by registering all prescriptions filled by the pharmacies in the area. RESULTS: Most of the elderly (>70 percent) obtained at least one prescription during the year studied. Drug use was more common among women than men. However, the difference between men and women was much smaller among those aged 85 years or more. The drugs most commonly prescribed were cardiovascular, psychotropic, and analgesic agents. Furthermore, the study showed that simultaneous use of several drugs was quite common. One-fourth of all people aged 65 years and older used drugs from at least four different pharmacologic groups. CONCLUSIONS: Our results revealed widespread use of prescription drugs among the elderly. An important finding was extensive drug use among men aged 85 years or more. This age group is increasing and there is need for further studies of its medication use.

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Computerised data bases on prescription drug use and health care in the community of Tierp, Sweden: Experiences and challenges from a study of antidepressant-treated patients

Norsk Epidemiologi ◽

10.5324/nje.v11i1.530 ◽

2009 ◽

Vol 11 (1) ◽

Author(s):

Kerstin Bingefors

Keyword(s):

Health Care ◽

Clinical Practice ◽

Drug Use ◽

Prescription Drug ◽

Data Base ◽

Prescription Drugs ◽

Data Availability ◽

Font Size ◽

Data Bases ◽

Prescription Drug Use

ABSTRACTMuch of our knowledge of drugs originates from clinical trials of drug efficacy performed on stringentlyselected patient groups, often without multiple concurrent diseases. However, the effectiveness of treatmentunder conditions of use in ordinary clinical practice may be very different to conditions in therandomised clinical trial. Use of large computerised data bases and record linkage has thus becomeincreasingly common in pharmacoepidemiologic research. The greatest advantages of using routinelycollected data are the minimisation of study costs and time required to complete a study, considerationsthat are particularly relevant for longitudinal studies. The advantages of using data bases also include thepossibility of obtaining large sample sizes and to retrospectively study long-term outcomes. The risk forrecall bias, a significant problem in interviews and questionnaires, is also reduced. However, computeriseddata bases also have some potentially serious disadvantages, primarily in the areas of data validityand data availability. The Tierp study, including individually based data bases of prescription drug use,will be used here as an example of research. In this paper an example of a comprehensive data base studyconcerning health care and drug utilisation in depressed patients is presented. Methodological considerationsin data base research are discussed in relation to experiences from the antidepressant study. A wellplanned and research oriented computerised data base on prescription drugs represents an important toolin the study of the outcome of drug treatment in real world clinical practice.

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Pharmacare in Canada: The paediatric perspective

Paediatrics & Child Health ◽

10.1093/pch/pxz176 ◽

2020 ◽

Vol 25 (2) ◽

pp. 113-118 ◽

Cited By ~ 1

Author(s):

Tom McLaughlin ◽

Geert ‘t Jong ◽

Andrea Gilpin ◽

Charlotte Moore Hepburn

Keyword(s):

Drug Use ◽

Prescription Drug ◽

Prescription Drugs ◽

Cost Savings ◽

Children And Youth ◽

Paediatric Drug ◽

Prescription Drug Use ◽

Child Friendly ◽

Health Canada

Abstract Canada’s drug insurance system is one of the most expensive in the world, yet millions of Canadians still struggle to access necessary medications. As a result, provincial, territorial, and federal governments are considering public pharmacare policy proposals to ensure that all Canadians can access the medications they need. Pharmacare policies offer an opportunity to prioritize children and youth, whose unique drug needs have long been neglected. Prescription drug use is common in this population, with approximately half of Canadian children and youth requiring at least one prescription in any given year. Drug use remains concentrated, however, among those with complex, chronic, and serious diseases. Children and youth rely heavily on compounded and off-label prescription drugs, which impacts safety, efficacy, palatability, and cost. Reimbursement decision-making bodies do not appropriately value the unique benefits of paediatric drugs, including child-friendly formulations, improved quality of life for children and families, and cost-savings outside the healthcare system. Regardless of the pharmacare model ultimately implemented, ensuring universal, comprehensive, and portable prescription drug coverage for all children and youth is essential. To accomplish this, paediatric drug experts should develop a national, evidence-informed formulary of paediatric drugs. Health Canada should also improve processes to make commercial paediatric drugs and child-friendly formulations more available and accessible. The federal government must also support paediatric drug research and development to this end.

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Association of Injection Practices and Overdose With Drug Use Typologies: A Latent Class Analysis Among People Who Inject Drugs in Baltimore, 2017

AIDS Education and Prevention ◽

10.1521/aeap.2019.31.4.344 ◽

2019 ◽

Vol 31 (4) ◽

pp. 344-362 ◽

Cited By ~ 2

Author(s):

Rachel E. Gicquelais ◽

Becky L. Genberg ◽

Jacquie Astemborski ◽

David D. Celentano ◽

Gregory D. Kirk ◽

...

Keyword(s):

Drug Use ◽

Prescription Drug ◽

Prescription Drugs ◽

Latent Class ◽

People Who Inject Drugs ◽

Community Based ◽

Prescription Drug Use ◽

Overdose Mortality ◽

Behavior Profiles ◽

Injection Practices

Increasing overdose mortality and new HIV outbreaks in the U.S. highlight the need to identify risk behavior profiles among people who inject drugs (PWID). We characterized latent classes of drug use among a community-based sample of 671 PWID in Baltimore during 2017 and evaluated associations of these classes with sharing syringes, obtaining syringes from pharmacies or syringe services programs (SSPs), and nonfatal overdose in the past 6 months. We identified three classes of current drug use: infrequent use (76% of participants), prescription drug use (12%), and heroin and/or cocaine injection (12%). PWID in the heroin and/or cocaine injection and prescription drug use classes had higher odds of both overdose and sharing syringes (relative to infrequent use). PWID in the prescription drug use class were 64% less likely to obtain syringes through SSPs/pharmacies relative to heroin and/or cocaine injection. Harm reduction programs need to engage people who obtain prescription drugs illicitly.

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Prescription opioid use in the rural Appalachia: A community-based study

Journal of Opioid Management ◽

10.5055/jom.2008.0010 ◽

2018 ◽

Vol 4 (2) ◽

pp. 63 ◽

Cited By ~ 15

Author(s):

Jennifer R. Havens, PhD, MPH ◽

Robert Walker, MSW, LCSW ◽

Carl G. Leukefeld, DSW

Keyword(s):

Drug Use ◽

Prescription Drug ◽

Prescription Drugs ◽

Pain Treatment ◽

Prescription Opioid ◽

Snowball Sampling ◽

Opioid Use ◽

Prescription Drug Use ◽

Nonmedical Use ◽

Opioid Users

Objective: The purpose of this study is to describe the sample characteristics and methods for a study of rural medical and nonmedical prescription opioid users with a history of OxyContin® use.Design and Setting: Snowball sampling was used to recruit 221 rural Appalachian residents. Participants included those under medical supervision for pain (n = 101) as well as those self-reporting nonmedical use of prescription opioids (n = 120). Participants were given an interviewer-administered questionnaire.Outcome measures: Data relating to demographics, illicit and nonmedical prescription drug use, medical, legal, family, and psychiatric status, as well as pain history were collected. The primary outcomes of interest were differences in past 30 day prescription drug use between pain patients and nonmedical opioid users.Results: A significantly greater proportion of those treated for pain reported using oxycodone and hydrocodone prescribed by a physician in the prior 30 days (p < 0.001); however, more than third of pain participants also reported nonmedical use of OxyContin®, methadone, hydrocodone, benzodiazepines, and marijuana in the prior 30 days.Conclusions: A large proportion of rural opioid users who reported being treated for pain also reported nonmedical use of prescription drugs. Similarly, among the nonmedical users, half of those reported experiencing pain that interfered with their daily life. These results suggest that many rural prescription drug users are being either incorrectly or perhaps inadequately treated for chronic nonmalignant pain. Therefore, developing educational materials and training for rural physicians about pain treatment (including drug seeking behavior) is proposed.

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What Does the Community Say: Key Informant Perceptions of Rural Prescription Drug Use

Journal of Drug Issues ◽

10.1177/002204260703700302 ◽

2007 ◽

Vol 37 (3) ◽

pp. 503-524 ◽

Cited By ~ 31

Author(s):

Carl Leukefeld ◽

Robert Walker ◽

Jennifer Havens ◽

Cynthia A. Leedham ◽

Valarie Tolbert

Keyword(s):

Drug Use ◽

Prescription Drug ◽

Health Care Providers ◽

Prescription Drugs ◽

Drug Misuse ◽

Care Providers ◽

Key Informants ◽

Prescription Drug Use ◽

Entry Points ◽

Nonmedical Use

This article presents data from four groups of rural Key Informants—Community leaders, educators, health care providers and justice/law enforcement officials—to understand the nonmedical use and misuse of prescription drugs. Seventy key informants were purposively selected from two counties in Appalachian Kentucky. Key informants indicated that the nonmedical use of prescription drugs is complex and has historical roots. Two pathways, or entry points, into the nonmedical use and misuse of prescription drugs were identified: physical pain and recreational use. Data show trends with regard to drug use patterns, drug use education, involvement with the criminal justice system and the role of economics in the prescription drug use problem. Key Informants underscored a common theme that the rural prescription drug problem was fueled by a cultural acceptance of drug misuse. Recommendations are presented for services and research.

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