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background briefing
download the complete files as a pdf document (with the
exception of the Friedman article)
http://www.nlm.nih.gov/medlineplus/prescriptiondrugabuse.html
Webcast
of the National
Institute on Drug Abuse/American Medical Association Joint
Meeting Pain, Opioids, and Addiction: An Urgent Problem for
Doctors and Patients.
http://videocast.nih.gov/PastEvents.asp?c=1
Illicit use of opioid analgesics
by high school seniors
Sean Esteban McCabe, (Ph.D.), (MSW)a,*,
Carol J. Boyd, (Ph.D.), (RN)a,
Christian J. Teter, (Pharm.D.), (BCPP)b
aSubstance Abuse Research Center,
The University of Michigan, Ann Arbor, MI 48105, USA
bNortheastern University School of
Pharmacy and McLean Hospital Alcohol and Drug Abuse Treatment
Program, Boston, MA 02115, USA
Journal of Substance Abuse
Treatment 28 (2005) 225 230
Abstract
The illicit use of opioid analgesics
represents a growing problem among American adolescents. In
order to examine the correlates associated with the illicit use
of opioid analgesics, a nationally representative sample of
4,522 high school seniors from the 2002 Monitoring the Future
database was examined. Multivariate logistic regression
indicated that illicit users of prescription opioid analgesics
were significantly more likely to be male, White, and have lower
grade point averages. Illicit users of opioid analgesics also
reported higher rates of cigarette smoking, alcohol use,
marijuana use, other illicit drug use, and problem behaviors.
The present study provides evidence that the illicit use of
opioid analgesics represents a problem among American high
school seniors and effective prevention and intervention efforts
are needed.
Nonmedical use of prescription
opioids among U.S. college students: Prevalence and correlates
from a national survey
Sean Esteban McCabe a,*, Christian
J. Teter b, Carol J. Boyd a,
John R. Knight c, Henry Wechsler d
aUniversity of Michigan Substance
Abuse Research Center, 2025 Traverwood Dr., Suite C, Ann Arbor,
MI 48105-2194, United States
bNortheastern University School of
Pharmacy and McLean Hospital, Alcohol and Drug Abuse Treatment
Center,
206 Mugar Life Sciences Building,
Boston, MA 02115-5000, United States
cHarvard Medical School and
Childrens Hospital Boston, Center for Adolescent Substance
Abuse Research,
300 Longwood Avenue, Boston, MA
02115, United States
dHarvard School of Public Health,
Department of Society, Human Development and Health,
677 Huntington Avenue, Boston, MA
02115, United States
* Corresponding author. Tel.: +1 734
998 6510; fax: +1 734 998 6508.
E-mail address: plius@umich.edu
(S.E. McCabe).
Addictive Behaviors 30 (2005)
789805
Abstract
Objectives: This study
examined the prevalence rates and correlates of nonmedical use
of prescription opioid analgesics among U.S. college students in
terms of student and college characteristics.
Methods: This study analyzed
data from a nationally representative sample of 10,904 randomly
selected students attending 119 four-year colleges in 2001.
Results: The lifetime
prevalence of nonmedical prescription opioid use was 12% and the
past year prevalence was 7%. Approximately one in every four
colleges had a prevalence of 10% or higher for past year
nonmedical use of prescription opioids. Multivariate regression
analyses indicated nonmedical use was more likely to occur among
college students who were white, residents of fraternity and
sorority houses, attended more competitive colleges, earned
lower grade point averages, and reported higher rates of
substance use and other risky behaviors.
Conclusions: This study
provides evidence that the nonmedical use of prescription
opioids represents a problem on college campuses. These findings
have important implications for developing prevention.
Medical and Nonmedical Use of
Prescription Drugs among Secondary School Students
Sean Esteban McCabe, Ph.D., M.S.W.a,*,
Carol J. Boyd, Ph.D., M.S.N.a,b,
and Amy Young, Ph.D.c
aSubstance Abuse Research Center,
The University of Michigan, Ann Arbor, Michigan
bInstitute for Research on Women and
Gender, Nursing and Womens Studies, The University of Michigan,
Ann Arbor, Michigan
cDepartment of Psychology, Eastern
Michigan University, Ypsilanti, Michigan
Journal of Adolescent Health 40
(2007) 7683
Abstract
Purpose: The main
objective of this study was to assess the prevalence of medical
and nonmedical use of four categories of prescription drugs (opioid,
stimulant, sleeping, and sedative/anxiety medication) in a
racially diverse sample of secondary public school students in
the Detroit metropolitan area. A secondary objective was to
examine the association between the use of four categories of
prescription medications and illicit drug use and probable drug
abuse.
Methods: In 2005, a
Web-based survey was self-administered by 1086 secondary school
students in grades seven through 12.
Results: The sample
consisted of 54% female, 52% White, 45% African American, and 3%
from other racial categories. Forty-eight percent of the sample
reported no lifetime use of four categories of prescription
drugs (nonusers), 31.5% reported medically prescribed use only
(medical users), 17.5% reported both medical and nonmedical use
(medical/nonmedical users) and 3.3% reported nonmedical use only
(nonmedical users). Multivariate analyses indicated that
medical/nonmedical users and nonmedical users were significantly
more likely than nonusers to report illicit drug use and
probable drug abuse. Medical users generally reported similar or
increased odds of illicit drug use and probable drug abuse than
non-users.
Conclusions: These
findings provide evidence that nonmedical use of prescription
drugs represents a problem behavior among secondary school
students.
Incidence
and antecedents of nonmedical prescription opioid use in four US
communities: The Coronary Artery Risk Development in Young
Adults (CARDIA) prospective cohort study
Mark J. Pletcher
a,b,∗,
Stefan G. Kertesz c,e,
Stephen Sidney d,
Catarina
I. Kiefe c,e,
Stephen B. Hulley a
a
Department of Epidemiology and Biostatistics, University of
California, San Francisco, 185 Berry Street,
Suite
5700, San Francisco, CA 94107, United States
b
Division of General Internal Medicine, University of California,
San Francisco, CA 94143, United States
c
Division of Preventive Medicine, University of Alabama at
Birmingham, AL 35205, United States
d
Division of Research, Kaiser Permanente, Oakland, CA 94612,
United States
e Deep
South Center on Effectiveness, Veterans Affairs Medical Center,
Birmingham, AL 35205, United States
Drug
and Alcohol Dependence 85 (2006) 171176
Abstract
Background: Nonmedical use of
prescription opioids has emerged as a major public health
problem during the last decade, but direct measures of incidence
and predisposing factors are lacking.
Methods: We prospectively
measured incidence and antecedents of nonmedical prescription
opioid use in The Coronary Artery Risk Development in Young
Adults study among 2840-year-old African- and European-American
men and women with no prior history of nonmedical opioid use.
Results: Among 3163
participants, 23 reported new nonmedical prescription opioid use
in 20002001 (5-year incidence 0.7%; 95%CI: 0.41.0%). All 23
had previously reported marijuana use (p < 0.001).
Five-year incidence was significantly higher among
European-American men (OR = 3.3; 95%CI: 1.38.3), and among
participants reporting a history of amphetamine use (OR = 24;
95%CI: 6.983) or medical opioid use for treatment of pain (OR =
8.6; 95%CI: 2.530). These associations remained strong when
examined among marijuana users and after adjusting for
demographics, social factors, and other antecedent substance
use. Amphetamine use was the best single predictor of future
nonmedical use (sensitivity 87%, specificity 79%).
Conclusions: Initiation of
nonmedical prescription opioid use is generally rare in
2840-year-old adults, but is observed to be more common with a
previous history of substance abuse and legal access to opioids
through prescription by a physician.
Abuse
of prescription drugs and the risk of addiction
Wilson M. Compton∗,
Nora D. Volkow
National
Institute on Drug Abuse, National Institutes of Health,
Department of Health and Human Services,
6001
Executive Blvd., Bethesda, MD 20892, USA
Drug and Alcohol Dependence 83S
(2006) S4S7
Abstract
Abuse of
several categories of prescription drugs has increased markedly
in the United States in the past decade and is now at alarming
levels for certain agents, especially opioid analgesics and
stimulants. Prescription drugs of abuse fit into the same
pharmacological classes as their non-prescription counterparts.
Thus, the potential factors associated with abuse or addiction
versus safe therapeutic use of these agents relates to the
expected variables: dose, route of administration,
co-administration with other drugs, context of use, and
expectations. Future scientific work on prescription drug abuse
will include identification of clinical practices that minimize
the risks of addiction, the development of guidelines for early
detection and management of addiction, and the development of
clinically effective agents that minimize the risks for abuse.
With the high rates of prescription drug abuse among teenagers
in the United States, a particularly urgent priority is the
investigation of best practices for effective prevention and
treatment for adolescents, as well as the development of
strategies to reduce diversion and abuse of medications intended
for medical use.
Major
increases in opioid analgesic abuse in the United States:
Concerns and strategies
Wilson M. Compton∗,
Nora D. Volkow
National
Institute on Drug Abuse, 6001 Executive Boulevard, MSC 9589,
Bethesda, MD 20892-9589, USA
Drug
and Alcohol Dependence 81 (2006) 103107
Abstract
The
problem of abuse of and addiction to opioid analgesics has
emerged as a major issue for the United States in the past
decade and has worsened over the past few years. The increases
in abuse of these opioids appear to reflect, in part, changes in
medication prescribing practices, changes in drug formulations
as well as relatively easy access via the internet. Though the
use of opioid analgesics for the treatment of acute pain appears
to be generally benign, long-term administration of opioids has
been associated with clinically meaningful rates of abuse or
addiction. Important areas of research to help with the problem
of opioid analgesic abuse include the identification of clinical
practices that minimize the risks of addiction, the development
of guidelines for early detection and management of addiction,
the development of opioid analgesics that minimize the risks for
abuse, and the development of safe and effective non-opioid
analgesics. With high rates of abuse of opiate analgesics among
teenagers in the United States, a particularly urgent priority
is the investigation of best practices for treating pain in
adolescents as well as the development of prevention strategies
to reduce diversion and abuse.
The relationship between
past-year drinking behaviors and nonmedical use of prescription
drugs: Prevalence of co-occurrence in a national sample
Sean Esteban McCabe
a,∗,
James A. Cranford a,
Carol J. Boyd
b
a
Substance Abuse Research Center, The University of Michigan, Ann
Arbor, MI 48105-2194, USA
b
Institute for Research on Women and Gender, Substance Abuse
Research Center, The University of Michigan, Ann Arbor, MI
48105-2194, USA
Drug
and Alcohol Dependence 84 (2006) 281288
Abstract
This
study examined the relationship between past-year drinking
behaviors and nonmedical use of prescription drugs (NMUPD) in a
nationally representative sample. Prevalence estimates in the
United States were derived based on data collected from
face-to-face interviews using the National Epidemiologic Survey
on Alcohol and Related Conditions (NESARC) (n = 43,093
individuals aged 18 years and older). Nonmedical use of
prescription opioids, stimulants, tranquilizers, and sedatives
was more prevalent among individuals with alcohol use disorders
(AUDs) than those without AUDs. The odds of reporting NMUPD were
18 times higher among alcohol dependent participants compared to
past-year abstainers (OR = 18.2, 95% CI = 13.923.8). Although
individuals with AUDs constituted less than 9% of the total
sample, those with AUDs accounted for more than one in every
three nonmedical users of prescription drugs. The past-year
co-occurrence of AUDs and NMUPD was more prevalent among young
adults 1824 years of age than individuals 25 years and older.
More than one in every four young adults aged 1824 years who
met the criteria for past-year DSM-IV alcohol dependence also
reported past-year NMUPD. These findings suggest that the
treatment for AUDs should include a thorough assessment of NMUPD,
especially among young adults.
College on Problems of Drug Dependence taskforce on prescription
opioid non-medical use and abuse: position statement
James
Zacny a,*,
George Bigelow b, Peggy Compton c, Kathleen Foley d, Martin
Iguchi e,
Christine
Sannerud f
a
Department of Anesthesia and Critical Care, University of
Chicago, Box MC4028, 5841 S. Maryland Avenue, Chicago, IL 60637,
USA
b
Department of Psychiatry, Behavioral Biology Research Center,
Johns Hopkins University School of Medicine, Baltimore, MD
21224, USA
c School
of Nursing, University of California at Los Angeles, Los
Angeles, CA 90095, USA
d
Department of Neurology, Memorial Sloan-Kettering Cancer Center,
New York, NY 10021, USA
e Drug
Policy Research Center, RAND Corporation, Santa Monica, CA
90401, USA
f Office
of Diversion Control, Drug Enforcement Administration,
Washington, DC 20537, USA
Received
18 November 2002; received in revised form 2 December 2002;
accepted 12 December 2002
Drug
and Alcohol Dependence 69 (2003) 215_/232
The Changing Face of Teenage Drug
Abuse The Trend toward Prescription Drugs
Richard A. Friedman, M.D.
n engl j med 354;14 www.nejm.org
april 6, 2006
Sources of prescription drugs for illicit use
Sean Esteban McCabeT, Carol J. Boyd
University of Michigan, Substance
Abuse Research Center, 2025 Traverwood Dr.,
Suite C, Ann Arbor, MI 48105-2194,
United States
Addictive Behaviors 30 (2005)
13421350
Abstract
Objectives: This exploratory
study investigated the sources of four classes of abusable
prescription medications (sleeping, sedative/anxiety, stimulant,
and pain medications) that were used illicitly by undergraduate
students in the past year. The relationship between these
sources and other substance use was examined.
Methods: In the spring of
2003, a random sample of 9,161 undergraduate students attending
a large public Midwestern research university is selected to
self-administer a Web-based survey.
Results: The respondents
identified 18 sources of prescription drugs that were classified
into three broad categories: peer, family, and other sources.
The majority of respondents who were illicit users obtained
their prescription drugs from peer sources. Undergraduate
students who obtained prescription medication from peer sources
reported significantly higher rates of alcohol and other drug
use than students who did not use prescription drugs illicitly
or students who obtained prescription medication from family
sources.
Conclusions: The findings of
the present study offer strong evidence that undergraduate
students obtain abusable prescription drugs from their peers.
Greater prevention efforts are needed to reduce the illicit use
and diversion of prescription medication.
The relationship between
past-year drinking behaviors and nonmedical use of prescription
drugs: Prevalence of co-occurrence in a national sample
Sean Esteban McCabe
a,∗,
James A. Cranford a,
Carol J. Boyd
b
a
Substance Abuse Research Center, The University of Michigan, Ann
Arbor, MI 48105-2194, USA
b
Institute for Research on Women and Gender, Substance Abuse
Research Center, The University of Michigan, Ann Arbor, MI
48105-2194, USA
Drug and Alcohol Dependence 84
(2006) 281288
Abstract
This
study examined the relationship between past-year drinking
behaviors and nonmedical use of prescription drugs (NMUPD) in a
nationally representative sample. Prevalence estimates in the
United States were derived based on data collected from
face-to-face interviews using the National Epidemiologic Survey
on Alcohol and Related Conditions (NESARC) (n = 43,093
individuals aged 18 years and older). Nonmedical use of
prescription opioids, stimulants, tranquilizers, and sedatives
was more prevalent among individuals with alcohol use disorders
(AUDs) than those without AUDs. The odds of reporting NMUPD were
18 times higher among alcohol dependent participants compared to
past-year abstainers (OR = 18.2, 95% CI = 13.923.8). Although
individuals with AUDs constituted less than 9% of the total
sample, those with AUDs accounted for more than one in every
three nonmedical users of prescription drugs. The past-year
co-occurrence of AUDs and NMUPD was more prevalent among young
adults 1824 years of age than individuals 25 years and older.
More than one in every four young adults aged 1824 years who
met the criteria for past-year DSM-IV alcohol dependence also
reported past-year NMUPD. These findings suggest that the
treatment for AUDs should include a thorough assessment of NMUPD,
especially among young adults.
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