IMPORTANCE: Recent information on the trends in past-year alcohol abstinence and marijuana abstinence, co-use of alcohol and marijuana, alcohol use disorder, and marijuana use disorder among US young ...adults is limited. OBJECTIVES: To assess national changes over time in past-year alcohol and marijuana abstinence, co-use, alcohol use disorder, and marijuana use disorder among US young adults as a function of college status (2002-2018) and identify the covariates associated with abstinence, co-use, and marijuana use disorder in more recent cohorts (2015-2018). DESIGN, SETTING, AND PARTICIPANTS: This study examined cross-sectional survey data collected in US households annually between 2002 and 2018 as part of the National Survey on Drug Use and Health. The survey used an independent, multistage area probability sample for all states to produce nationally representative estimates. The sample included 182 722 US young adults aged 18 to 22 years. The weighted screening and weighted full interview response rates were consistently above 80% and 70%, respectively. MAIN OUTCOMES AND MEASURES: Measures included past-year abstinence, alcohol use, marijuana use, co-use, alcohol use disorder, marijuana use disorder, prescription drug use, prescription drug misuse, prescription drug use disorder, and other drug use disorders based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. RESULTS: The weighted sample comprised 51.1% males. Between 2002 and 2018, there was an annual increase in past-year alcohol abstinence among young adults (college students: 0.54%; 95% CI, 0.44%-0.64%; non–college students: 0.33%; 95% CI, 0.24%-0.43%). There was an annual increase in marijuana use from 2002 to 2018 (college: 0.46%; 95% CI, 0.37%-0.55%; non-college: 0.49%; 95% CI, 0.40%-0.59%) without an increase in marijuana use disorder for all young adults. Past-year alcohol use disorder decreased annually (college: 0.66%; 95% CI, 0.60%-0.74%; non-college: 0.61%; 95% CI, 0.55%-0.69%), while co-use of alcohol and marijuana increased annually between 2002 and 2018 among all young adults (college: 0.60%; 95% CI, 0.51%-0.68%; non-college: 0.56%; 95% CI, 0.48%-0.63%). Young adults who reported co-use of alcohol and marijuana or met criteria for alcohol use disorder and/or marijuana use disorder accounted for 82.9% of young adults with prescription drug use disorder and 85.1% of those with illicit drug use disorder. More than three-fourths of those with both alcohol use disorder and marijuana use disorder reported past-year prescription drug use (78.2%) and illicit drug use (77.7%); 62.2% reported prescription drug misuse. CONCLUSIONS AND RELEVANCE: The findings of this study suggest that US colleges and communities should create and maintain supportive resources for young adults as the substance use landscape changes, specifically as alcohol abstinence, marijuana use, and co-use increase. Interventions for polysubstance use, alcohol use disorder, and marijuana use disorder may provide valuable opportunities for clinicians to screen for prescription drug misuse.
Although recent spikes in overdose deaths are largely attributable to heroin and fentanyl, prescription opioids still account for a significant percentage of overdose deaths. Additionally, overdose ...deaths are not a problem solely for adults; roughly 8% of all overdose deaths occur in persons aged 15 to 24. In addition to identifying factors that increase risk for misuse and negative outcomes among adolescents, research must examine the causal mechanisms that link these factors to increased risk. Finally, the extant research must serve as the foundation for prevention/intervention strategies and identify treatments that are effective among adolescents with opioid use disorders.
•The current research examine prescription opioid misuse among U.S. Black adults.•A number of factors were only related to prescription opioid misuse among Blacks.•Gender was a significant correlate, ...with males being more likely to report misuse.•Respondents who received government assistance were more likely to report misuse.•Educational attainment was negatively associated with prescription opioid misuse.
Prescription drug misuse, especially opioid misuse, has become a public health crisis in the US. While much research attention has been focused on prescription drug misuse, a number of notable gaps in the literature remain. The current research addresses one of these gaps by examining racial/ethnic variation in prescription opioid misuse among adults.
We use data from the 2015 NSDUH to identify correlates of prescription opioid misuse among Black respondents aged 18 and older. The NSDUH defines prescription drug misuse as the use of prescription drugs in any way a doctor did not direct respondents to use them, including (a) without a prescription of their own; (b) in greater amounts, more often, or longer than told to use; or (c) in any other way a doctor did not tell respondents to use the drug.
Findings indicate that Black respondents have a very similar prevalence rate of prescription opioid misuse compared to White respondents. A number of factors (i.e., gender, socioeconomic status, educational attainment) were significantly correlated with prescription opioid misuse only among Black respondents. In addition, many factors (i.e., depression, general health, other illicit drug use, being approached by a drug dealer) were significantly associated with prescription opioid misuse among both Black and White respondents.
The current research identified a number of unique correlates of prescription opioid misuse among Black adults. To more effectively deal with the current public health crisis, research must identify risk factors among various groups within the population.
Ford presents an editorial on the study by Carrasco-Garrido et al. that assessed trends in misuse of prescription tranquilizers, sedatives, and sleeping pills over time in a school-based sample of ...adolescents in Spain. Their results showed that the prevalence of misuse increased significantly from 2004-2014, that girls had a higher prevalence of misuse than boys, and that the use of alcohol and other drugs was a strong correlate of misuse. The research is important in that it shines a light on a class of prescription drugs that have been overlooked and risks associated with the misuse of sedatives and tranquilizers.
Criminal legal system (CLS) exposed adults experience higher rates of substance use, substance use disorder (SUD), and overdose. As most CLS exposed adults are not incarcerated, it is important to ...focus on CLS exposure across the carceral continuum.
This research used pooled data from adult respondents (N=206,314) in the National Survey on Drug Use and Health (2015-2019). Survey weighted descriptive statistics and Poisson regression were used to estimate prevalence of polysubstance use (i.e., concurrent use) across CLS exposure types (i.e., arrest, probation, parole), identifying relevant correlates.
The prevalence of polysubstance use was higher among CLS exposed adults, and nearly two-thirds of CLS exposed adults who used multiple types of substances indicated having an SUD. Comparing CLS exposure types, polysubstance use was less likely among adults on probation (IRR=0.89, 95%CI=0.84,0.94) or parole (IRR=0.82, 95%CI=0.76,0.87) compared to those arrested. Polysubstance use was also more likely among adults on probation (IRR=1.09, 95%CI =1.01,1.17) compared to those on parole. While some characteristics (i.e., age, ethnicity, SUD) were consistently associated with polysubstance use across types of CLS exposure, other characteristics (i.e., sexual identity, marital status, suicidal ideation) were not.
There is heterogeneity in health risks as a function of CLS exposure type. Further research is needed to identify causal mechanisms and differences based on demographic characteristics. Given high levels of polysubstance use across CLS exposure types, a shift towards a more comprehensive approach in substance use epidemiology may facilitate building an evidence-base to maximize treatment related interventions to reduce polysubstance-involved overdoses.
•Polysubstance use is common among justice-involved adults.•Multiple substance use disorders are more common among justice-involved adults.•Adults with a past-year arrest have the highest rates of polysubstance use.•Adults on parole have the highest rates of multiple substance use disorders.•Age, sexual identity, and marital status are associated with polysubstance use.
The U.S. is in the midst of a public health crisis related to drug overdose deaths. Largely responsible for the dramatic increase in overdose deaths is the misuse of prescription drugs such as ...opioids and benzodiazepines. While much research attention has focused on correlates of prescription drug misuse in recent years, notable gaps in the literature remain. The current research addresses one of these gaps by examining the relationship between disability status and prescription drug misuse.
We examine data from the 2015 National Survey on Drug use and Health, a leading source of epidemiological data on drug use in the United States that added questions related to disability status to the 2015 survey. The current research assessed the relationship between disability status (i.e. activities of daily living and instrumental activities of daily living) and prescription drug misuse (i.e. opioids and benzodiazepines) among adults.
Findings from multinomial logistic regression analysis showed that a disability related to activities of daily living was correlated with opioid misuse, while a disability associated with instrumental activities of daily living was associated with benzodiazepine misuse and misuse of both. In addition, health related measures had a greater impact on the relationship between disability status and prescription drug misuse than did the social engagement/isolation measures.
Findings indicated that disability status is a significant correlate of prescription drug misuse. However, this relationship was largely mediated by measures associated with poor health and social engagement/isolation.
•The current research examined disability status and prescription drug misuse.•Respondents with a disability were at increased odds of prescription drug misuse.•Poor health and social isolation were mediating variables for opioid misuse.•Disability status remained a significant correlate of benzodiazepine misuse.
Simultaneous co-ingestion of prescription medication (e.g., opioid, tranquilizer/sedative, stimulant) and alcohol is associated with overdose and elevated substance use, but no studies have examined ...prescription drug misuse (PDM) and alcohol co-ingestion in U.S. young adults (18-25 years), despite the high rates of PDM in this age group. We used the 2015-19 National Survey on Drug Use and Health (young adult N = 69,916) to examine prevalence of past-month PDM-alcohol co-ingestion, PDM characteristics, and sociodemographic, physical health, mental health, and substance use correlates. Logistic regression examined correlates, comparing those without past-year PDM, those with past-year but not past-month PDM, those with past-month PDM without alcohol co-ingestion, and those with past-month PDM and alcohol co-ingestion. An estimated 585,000 young adults engaged in any past-month PDM-alcohol co-ingestion, or between 32.7% (opioids) and 44.6% (tranquilizer/sedatives) of those who were engaged in past-month PDM. Co-ingestion varied by educational status and was more common in males and white or multiracial young adults. All PDM-involved groups had elevated odds of suicidal ideation and other psychopathology, but substance use and substance use disorder (SUD) odds were significantly higher in young adults with co-ingestion, versus all other groups. To illustrate, 41.1% with opioid-alcohol co-ingestion had multiple past-year SUDs, versus 2.0% in those without past-year PDM. Young adults with co-ingestion are particularly likely to have problematic alcohol use and higher rates of SUD. Counseling about the risks of PDM-alcohol co-ingestion and screening for co-ingestion among those at risk are warranted to limit poor outcomes.
Public Health Significance
Young adults who engage in prescription medication and alcohol simultaneous co-ingestion have significantly greater alcohol consumption and significantly higher rates of substance use disorders (SUDs), including multiple concurrent SUDs, than those engaged in prescription drug misuse (PDM) without co-ingestion. The estimated 585,000 U.S. young adults engaged in past-month PDM-alcohol co-ingestion need comprehensive and multidisciplinary treatment to reduce their risk for poor outcomes.
Although considerable research attention is paid to the misuse of controlled medications, a relatively small number of studies focus on prescription opioid misuse (POM) among racial/ethnic minority ...adolescents. This study aimed to determine the prevalence of POM among adolescents in the three largest racial/ethnic groups (Whites, Hispanics, Blacks) and identify demographic and psychosocial factors that increase the risk of POM. Additionally, the authors applied concepts from social bonding theory and social learning theory to determine the extent to which these concepts explain adolescent POM among each group. Using data from the 2012 National Survey of Drug Use and Health, multivariate logistic regression models were estimated to determine which factors were associated with an increased risk of POM. Results show that Blacks (6.08 %) have the highest prevalence rate of adolescent POM and risk factors vary by race/ethnicity. These findings are important in that they enhance the ability of prescribers to identify high-risk adolescent patients and help to make prevention interventions more culturally relevant.
The current research examines the association between bullying victimization, binge drinking, and marijuana use among adolescents. We seek to determine if this association varies based on the type of ...bullying experienced, traditional or cyberbullying. We used data from the 2013 Youth Risk Behavior Survey, a nationally representative sample of high school students in the United States. The dependent variables were binge drinking and marijuana use. Our key independent variable, bullying victimization, included both traditional and cyberbullying. We estimated logistic regression models, by gender, to examine the association between bullying victimization and substance use. About 25% of the sample reported bullying victimization, including 10.39% for only traditional, 5.47% for only cyber, and 9.26% for both. Traditional bullying was not significantly associated with binge drinking, but was negatively related to marijuana use. Being the victim of cyberbullying and both types of bullying was significantly associated with binge drinking and marijuana use. We also found important gender differences. The current research adds to a growing list of studies that suggests that cyberbullying is associated with more adverse outcomes than traditional bullying. Bullying prevention and intervention efforts should focus on reducing cyberbullying and providing adolescents with the skills needed to effectively deal with cyberbullying.
Abstract Background Prior research on prescription drug misuse has focused on identifying individual risk factors. While a few studies examine differences in misuse based on geographic residence, ...there is a lack of research that examines the relevance of neighbourhood characteristics. Methods The current research used data from the 2000 National Household Survey on Drug Abuse, a sample of respondents that was generalizable to the non-institutionalised population of the United States. Logistic regression models were estimated to examine the relationship between neighbourhood characteristics (e.g., social disorganisation, social capital, and social participation) and prescription drug misuse (e.g., any misuse, pain reliever misuse, sedative/tranquiliser misuse, and stimulant misuse) among adolescent respondents ages 12–17. Results Findings show that neighbourhood characteristics were significantly associated with any prescription drug misuse and also the misuse of prescription opioids. Adolescents in socially disorganised neighbourhoods and also those in neighbourhoods with lower levels of social capital were more likely to report prescription drug misuse. Interestingly, adolescents with greater levels of social participation were more likely to report prescription drug misuse. Conclusion These findings were largely consistent with prior research examining the significance of neighbourhood characteristics in relation to crime and deviance. In order to adequately address the ongoing prescription drug epidemic in the United States, policy makers must address the neighbourhood characteristics that are known to be associated with prescription drug misuse.
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