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1.
Addict Behav ; 147: 107818, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37540966

RESUMO

OBJECTIVE: This study aimed to determine the potential longitudinal impact of different cigarette and e-cigarette use trajectories among people aged 10-24 on prescription drug misuse of psychotherapeutic drugs. METHODS: Data came from waves 1-5 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2019; n = 14,454). Group-based trajectory modeling identified groups of adolescents and young adults based on cigarette and e-cigarette use across the five waves. Weighted logistic regression models were fit to examine the association of group membership with two outcomes at all waves: 1) misuse of opioids, sedatives, and/or tranquilizers, and 2) misuse of Ritalin and/or Adderall, adjusting for background characteristics. RESULTS: Five trajectory groups emerged: (1) non-use (77.7 %); (2) early-onset cigarette use with reducing use (4.6 %); (3) ever-increasing e-cigarette use (6.1 %); (4) stable dual use of cigarettes and e-cigarettes (3.2 %); and (5) accelerating dual use of cigarettes and e-cigarettes (8.4 %). In comparison to the non-use group, all other groups had significantly higher odds of misuse of opioids, tranquilizers, and/or sedatives and all but the early-onset cigarette use with reducing use group had significantly higher odds of misuse of Ritalin and/or Adderall by the end of wave 5. DISCUSSION: Patterns of cigarette and e-cigarette use in adolescent and young adult populations may serve as important indicators for concurrent and prospective prescription psychotherapeutic drug misuse. Findings highlight the need for cigarette and e-cigarette use prevention, harm reduction, and/or cessation efforts among adolescents and young adults.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Metilfenidato , Uso Indevido de Medicamentos sob Prescrição , Produtos do Tabaco , Tranquilizantes , Vaping , Humanos , Adolescente , Adulto Jovem , Vaping/epidemiologia , Analgésicos Opioides/uso terapêutico , Estudos Prospectivos , Tranquilizantes/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Prescrições
2.
Subst Use Misuse ; 58(12): 1544-1549, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37408461

RESUMO

Background: While prescription psychotherapeutic drug use (PPDU) and nicotine use pose substantial problems in isolation, they pose an increased risk in combination. This study aimed to estimate the prevalence of PPDU for young people, stratified by nicotine use status. A trend analysis was used to examine changes in PPDU and nicotine use over time. Methods: We used a cross-sectional population-based sample of young people aged 16-25 years (n = 10,454) from the National Health and Nutrition Examination Survey (NHANES, 2003-2018). For each data cycle, the prevalence of self-reported PPDU and nicotine including pain relievers, sedatives, stimulants, and tranquilizers was estimated. Using Joinpoint regression, we tested for significant changes in trends using a log-linear model and permutation test approach and produced the average data cycle percentage change (ADCPC). Results: From 2003 to 2018, 6.7% of young people had PPDU and 27.3% used nicotine. The prevalence of cigarette smoking decreased while other nicotine product use increased (p's < 0.001). Those who used nicotine were more likely to have PPDU (8.2%; 95% CI = 6.5%, 9.8%) vs. non-nicotine use (6.1%; 95% CI = 5.1%, 7.0%; p = 0.01). Results indicated a decreasing trend for nicotine use (ADCPC = -3.8, 95% CI = -7.2, -0.3; p = 0.04), but not for PPDU (ADCPC = 1.3; 95% CI = -4.7, 7.8; p = 0.61). On further examination, opioid use decreased, sedative use remained stable, and stimulant and tranquilizer use increased over time. Conclusions: From 2003 to 2018, young people who used nicotine had a higher prevalence of PPDU than those who did not. Clinicians should communicate the association between nicotine use and prescription drugs when prescribing or managing young patients' medications.


Assuntos
Uso Indevido de Medicamentos sob Prescrição , Tranquilizantes , Humanos , Estados Unidos/epidemiologia , Adolescente , Nicotina , Inquéritos Nutricionais , Estudos Transversais , Tranquilizantes/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Prescrições , Prevalência
3.
J Addict Med ; 17(3): 326-332, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37267178

RESUMO

OBJECTIVES: Prescription drug misuse (PDM) is a significant public health problem. As research has evolved, the definitions of misuse have varied over time, yet the implications of this variability have not been systematically studied. The objective of this study was to leverage a change in the measurement of PDM in a large population survey to identify its impact on the prevalence and correlates of this behavior. METHODS: Data from the National Survey on Drug Use and Health were compared before and after a change in the definition of PDM from one that restricted the source and motive for use to one that captured any misuse other than directed by a prescriber. Three-year cohorts were constructed, representing a restricted definition of PDM (2012-2014) and a broad definition of PDM (2015-2017). RESULTS: Segmented logistic regression models indicated a significant increase in PDM prevalence for all 3 drug types examined (opioids, tranquilizers, and sedatives). Although the magnitude of differences varied somewhat based on drug type, the broader definition was generally associated with older age, higher prevalence of health insurance, and higher odds of misusing one's own prescription. Some worsening of mental health indicators was observed, but results indicated few other clinical or substance use differences. CONCLUSIONS: Definitions of prescription drug misuse have a substantial impact on the prevalence of misuse and some impact on the characteristics of the population. Further research is needed to understand the optimal strategy for measuring this behavior, based on the scientific or public health question or interest.


Assuntos
Uso Indevido de Medicamentos sob Prescrição , Transtornos Relacionados ao Uso de Substâncias , Tranquilizantes , Humanos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Hipnóticos e Sedativos , Analgésicos Opioides/uso terapêutico
4.
Am J Drug Alcohol Abuse ; 49(4): 381-398, 2023 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-37310881

RESUMO

Background: Street-involved children and youth (SICY) who work and live on/of the streets are more likely to inject drugs and engage in psychoactive substance use.Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic determinants, and risk-taking associated with alcohol and drug use among SICY.Methods: Studies published in English related to alcohol and drug use among SICY were searched for from December 1 1985 to July 1 2022, on PubMed, Scopus, Cochrane, and Web of Science.Results: After full-text paper evaluation, 73 studies were included in the meta-analysis. Results indicated that lifetime prevalence rates were 44% (alcohol), 44% (crack), 33% (inhalants), 44% (solvents), 16% (tranquilizer/sedatives), 22% (opioids), and 62% (polysubstance use). The current prevalence rates were 40% (alcohol), 21% (crack), 20% (inhalants), 11% (tranquilizer/sedatives), and 1% (opioids). Also, life-time and current prevalence of alcohol and crack use, current prevalence of tranquilizer/sedative use, and life-time prevalence of polysubstance use were higher among older age groups. Life-time prevalence of tranquilizer/sedative use was lower among older age groups.Conclusions: The high prevalence of using alcohol, crack, and inhalants is a major issue because they are used extensively among different age groups, including minors. Such findings are beneficial for policymakers, health authorities, and professionals in developing programs aimed at minimizing inhalant use and other types of substance use harms among this group. It is important to accurately monitor this risk-exposed population to understand the mechanisms that might help protect them from high-risk substance use.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Tranquilizantes , Adolescente , Criança , Humanos , Analgésicos Opioides , Etanol , Hipnóticos e Sedativos , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
5.
Aging Ment Health ; 27(5): 1020-1027, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-35686721

RESUMO

OBJECTIVE: Individuals who are family history positive (FHP) for substance use problems have increased risk for substance use, substance use disorders (SUDs), and psychopathology. Links between FHP status and prescription drug misuse (PDM) have not been well investigated; this study examined PDM in adults 50 and older by FHP status. METHODS: Data were from the US NESARC-III (n = 14,667). Participants reported their opioid PDM, tranquilizer/sedative PDM, SUD, psychopathology, and family history status (i.e. first- and second-degree relatives with alcohol/substance use problems). Prevalence rates were estimated by FHP status, and logistic regressions compared FHP and family history negative (FHN) groups. RESULTS: FHP status was associated with significantly higher rates of PDM (e.g. past-year opioid PDM, FHP: 3.8%, FHN: 1.5%) and SUD from PDM (e.g. past-year SUD, FHP: 1.2%, FHN: 0.2%); also, prevalence varied by family history density, with the highest rates in those with three or more relatives with substance use problems (e.g. past-year opioid PDM: 5.5%). Overall, 32.2% of FHP individuals with past-year PDM had past-year co-occurring SUD and psychopathology diagnoses, versus 11.0% of FHN individuals. CONCLUSION: FHP status could inform treatment decisions in adults 50 and older with conditions for which prescription opioids or tranquilizer/sedatives are indicated.


Assuntos
Alcoolismo , Uso Indevido de Medicamentos sob Prescrição , Transtornos Relacionados ao Uso de Substâncias , Tranquilizantes , Humanos , Analgésicos Opioides/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Hipnóticos e Sedativos/uso terapêutico , Tranquilizantes/efeitos adversos
6.
Pharmacoepidemiol Drug Saf ; 32(6): 607-616, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36585814

RESUMO

PURPOSE: Investigate the association between anticholinergic (AC) and sedative (SED) drug burden before hospitalization and postdischarge institutionalization (PDI) in community-dwelling older patients acutely admitted to hospital. METHODS: A cross-sectional study using data from the Norwegian Patient Registry and the Norwegian Prescription Database. We studied acutely hospitalized community-dwelling patients ≥70 years during 2013 (N = 86 509). Patients acutely admitted to geriatric wards underwent subgroup analyses (n = 1715). We calculated drug burden by the Drug Burden Index (DBI), use of AC/SED drugs, and the number of AC/SED drugs. Piecewise linearity of DBI versus PDI and a knot point (DBI = 2.45) was identified. Statistical analyses included an adjusted multivariable logistic regression model. RESULTS: In the total population, 45.4% were exposed to at least one AC/SED drug, compared to 52.5% in the geriatric subgroup. AC/SED drugs were significantly associated with PDI. The DBI with odds ratios (ORs) of 1.11 (95% CI 1.07-1.15) for DBI < 2.45 and 1.08 (95% CI 1.04-1.13) for DBI ≥ 2.45. The number of AC/SED drugs with OR of 1.07 (95% CI 1.05-1.09). The AC component of DBI with OR 1.23 and the number of AC drugs with OR 1.13. In the subgroup, ORs were closer to 1 for AC drugs. CONCLUSIONS: The use of AC/SED drugs was highly prevalent in older patients before acute hospital admissions, and significantly associated with PDI. The number, or just using AC/SED drugs, gave similar associations with PDI compared to applying the DBI. Using AC drugs showed higher sensitivity, indicating that to reduce the risk of PDI, a clinical approach could be to reduce the number of AC drugs.


Assuntos
Vida Independente , Tranquilizantes , Humanos , Idoso , Hipnóticos e Sedativos , Antagonistas Colinérgicos , Estudos Transversais , Assistência ao Convalescente , Alta do Paciente , Hospitalização , Hospitais , Institucionalização , Sistema de Registros
7.
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1537194

RESUMO

Introduction: Non-prescription tranquilizers are a specific group of benzodiazepines, used as drugs that act on the central nervous system and have an extensive effect in patients with anxiety disorders and problems in sleep stages. Objective: To determine the prevalence of the year and month of consumption of tranquilizers without a medical prescription and the associated factors, in adolescents in school in Colombia. Methods: It is a cross-sec-tional study with an analytical scope. The universe of the study consisted of 3,243,377 students, from grades 7 to 11 (aged between 12 and 18 years), the valid surveys were 80,018. The adolescent who declared having used tranquilizers during the last 30 days and the last 12 months was considered a consumer. All variables were self-re-ported by adolescents. Results: The prevalence of tranquilizer use without medical prescription was 1.02% and 1.97% (month and year, respectively). Adolescents who presented disciplinary problems are the most predisposed to use during the last month with an OR 2.79 (95% CI: 2.20­3.53) and last year an OR of 2.77 (95 % CI: 2.34­3.27). Conclusions: There is a higher prevalence of the consumption of tranquilizers without medical prescription in women between 14 and 17 years of age, from mixed schools and it is associated with academic and disciplinary performance problems, in the last year. In addition, as age increases, the consumption of substances without a medical prescription increases


Introducción: Los tranquilizantes sin prescripción médica son un grupo específico de benzodiacepinas, usados como medicamentos que actúan sobre el sistema nervioso central y cuentan con un extenso efecto en pacientes con trastornos de ansiedad y problemas en las etapas del sueño. Objetivo: Determinar la prevalencia de año y mes de consumo de tranquilizantes sin prescripción médica y los factores asociados en adolescentes escolarizados de Colombia. Métodos: Estudio transversal con alcance analítico. El universo del estudio estuvo constituido por 3 243 377 estudiantes de los gados 7.º a 11.º (con edades entre 12 y 18 años). Las encuestas válidas fueron 80 018. Se consideró consumidor al adolescente que declaró haber consumido tranquilizantes durante los últimos 30 días y los últimos 12 meses. Todas las variables fueron autorreportadas por los adolescentes. Resultados: La prevalencia de consumo de tranquilizantes sin prescripción médica fue del 1,02 % y del 1,97 % (mes y año, respectivamente). Los adolescentes que presentaron problemas disciplinarios son los más predispuestos al consumo durante el último mes con un OR de 2,79 (IC95 %: 2,20-3,53) y último año un OR de 2,77 (IC95 %: 2,34-3,27). Conclusiones: Existe mayor prevalencia de consumo de tranquilizantes sin prescripción médica en mujeres entre los 14 y los 17 años, de colegios mixtos, y se encuentra asociada con problemas de rendimiento académico y disciplinarios, en el último año. Además, a medida que aumenta la edad, se incrementa el consumo de sustancias sin prescripción médica


Introdução: Os tranquilizantes isentos de prescrição são um grupo específico de benzodiazepínicos, usados como medicamentos que atuam no sistema nervoso central e têm um efeito extenso em pa-cientes com transtornos de ansiedade e problemas no estágio do sono. Objetivo: Determinar a prevalência anual e mensal do uso de tranquilizantes sem prescrição médica e os fatores associados em adolescentes em idade escolar na Colômbia. Métodos: Estudo transversal com escopo analítico. O universo do estudo consistiu em 3243377 alunos da 7ª à 11ª série (com idades entre 12 e 18 anos). Foram realizadas 80018 pesquisas válidas. Um adolescente foi considerado usuário, o qual relatou ter usado tranquilizantes nos últimos 30 dias e nos últimos 12 meses. Todas as variáveis foram autorrelatadas pelos adolescentes. Resultados: A prevalência do uso de tranquilizantes sem prescrição médica foi de 1,02% e 1,97% (mês e ano, respectivamente). Os adolescentes com problemas disciplinares apresentaram maior pro-babilidade de uso no último mês, com um OR de 2,79 (IC95%: 2,20-3,53) e no último ano, com um OR de 2,77 (IC95%: 2,34-3,27). Conclusões: Há uma maior prevalência de uso de tranquilizantes sem prescrição médica em mulheres de 14 a 17 anos, de escolas mistas, e isso está associado a problemas de desempenho acadêmico e disciplinar no último ano. Além disso, com o aumento da idade, aumenta o uso de substâncias sem prescrição médica.


Assuntos
Tranquilizantes , Benzodiazepinas , Estudos Transversais , Comportamento do Adolescente , Medicamentos sem Prescrição
8.
Psicol. ciênc. prof ; 43: e246584, 2023.
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1422412

RESUMO

Este relato de experiência, situado no campo do cuidado a pessoas usuárias de álcool e outras drogas em contextos marcados por violência, tem como objetivo explorar os limites, desafios e caminhos possíveis, em um Centro de Atenção Psicossocial Álcool e Drogas (Caps AD III), para a sustentação de um cuidado orientado pela compreensão das pessoas usuárias do Caps a partir da sua existência, sofrimento e relação com o corpo social, mesmo diante de comportamentos tidos como violentos. De caráter qualitativo, o percurso de pesquisa foi conduzido por meio de dois recursos metodológicos: o relato de experiência, referente à trajetória de uma das autoras no Programa de Residência Multiprofissional em Saúde Mental do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ), e a metodologia caso traçador ou usuário-guia. O trabalho de cuidar de pessoas expostas à necropolítica exige um posicionamento ético dos trabalhadores de saúde mental de engendrar processos de resistências e produção de vida. Pela radicalidade que é vivenciá-la, a violência comparece como um elemento dificultador desse trabalho para os profissionais, fazendo com que, diante do desamparo, por vezes utilizem lógicas disciplinares para conseguir lidar com esse fenômeno. Propõe-se abordar as cenas nomeadas como violentas nos Caps com base na noção de situação-limite, retirando a situação da malha de sentidos que acompanha a palavra e remete a práticas disciplinares e ao contexto da violência urbana. Essa mudança de paradigma abre a possibilidade de que os trabalhadores se incluam nas situações, as entendam como relacionadas à complexidade e à singularidade da existência das pessoas envolvidas e, assim, proponham soluções produtoras de vida.(AU)


This experience report, situated in the field of care for people who use alcohol and other drugs in contexts marked by violence, aims to explore the limits, challenges, and possible paths, at a Psychosocial Care Center for Alcohol and Drugs (CAPS AD III), to support care guided by the knowledge of CAPS users based on their existence, suffering, and relationship with the social body, even in the face of behaviors considered to be violent. The path of this qualitative research was conducted with two methodological resources: the experience report, referring to the trajectory of one of the authors at the Multiprofessional Residency Program in Mental Health at the Institute of Psychiatry at the Federal University of Rio de Janeiro (IPUB/UFRJ), and the methodology of case tracer or user-guide. The work of caring for people exposed to necropolitics requires an ethical positioning of mental health workers to build resistance processes and life production. Due to it is radical to experience, violence appears as a complicating element of this work for the professionals, forcing them to, due to the lack of support, occasionally use disciplinary reasoning to deal with this phenomenon. This study proposes to approach violent scenarios in the CAPS under the guise of limit-situation, withdrawing the situation from the web of meanings that accompany the word and refer to disciplinary actions and the context of urban violence. This paradigmatic change opens the path for workers to include themselves in these situations, to understand their relationship with the complexity and singularity of the existence of the implicated people, and thus offer solutions that produce life.(AU)


Este reporte de experiencia se sitúa en el área de la atención a las personas que consumen alcohol y otras drogas en contexto de violencia y tiene por objetivo explorar los límites, desafíos y caminos posibles en un Centro de Atención Psicosocial Alcohol y Drogas (Caps AD III), para ofrecer un cuidado a los usuarios basado en la comprensión de las personas usuarias del Caps considerando su existencia, sufrimiento y relación con el cuerpo social, incluso ante situaciones violentas. Esta es una investigación cualitativa que se basó en dos recursos metodológicos: el reporte de experiencia sobre la trayectoria de una de las autoras en el Programa de Residencia Multiprofesional en Salud Mental de la Universidad Federal de Río de Janeiro (IPUB/UFRJ) y de la metodología del caso trazador o usuario guía. La labor de asistir a las personas expuestas a la necropolítica requiere un posicionamiento ético de los profesionales de la salud mental de producir vida y procesos de resistencia. Por la radicalidad de la experiencia, la violencia es un obstáculo para el trabajo de los profesionales, lo que los llevan a actuar de forma disciplinaria para hacer frente a este fenómeno. Se propone aquí abordar las escenas violentas bajo la noción de situación límite en el Caps, sacando del contexto la red semántica que acompaña la palabra y alude a las prácticas disciplinarias y la violencia urbana. Este cambio de paradigma permite que los trabajadores se incluyan en las situaciones, las comprendan en relación con la complejidad y la singularidad de la existencia de las personas y propongan soluciones que produzcan vida.(AU)


Assuntos
Humanos , Masculino , Feminino , Violência , Saúde Mental , Reabilitação Psiquiátrica , Território Ocupado , Pobreza , Psicologia , Política Pública , Mudança Social , Serviço Social , Tabaco , Tranquilizantes , Inconsciência , Organização Mundial da Saúde , Alimentação de Emergência , Timidez , Neurociências , Brasil , Pessoas Mal Alojadas , Luto , Infecções Sexualmente Transmissíveis , Sistema Nervoso Central , Cocaína Crack , Crime , Morte , Redução do Dano , Populações Vulneráveis , Depressão , Transtornos Dissociativos , Prevenção de Doenças , Acolhimento , Euforia , Comportamento Exploratório , Relações Familiares , Prazer , Racismo , Discriminação Social , Abstinência de Álcool , Angústia Psicológica , Casas de Trabalho , Representação Social , Metabolismo , Antidepressivos
9.
J Clin Psychopharmacol ; 42(1): 43-50, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34928560

RESUMO

BACKGROUND: Valproic acid (VPA) is frequently used with clozapine (CLZ) as mood stabilizer and/or seizure prophylaxis. Valproic acid is known to reduce N-desmethylclozapine (N-DMC) but not CLZ levels. This leads to the hypothesis that VPA induces the CLZ metabolism via non-N-desmethylation pathways. Therefore, we aimed to investigate the effect of concurrent VPA use on the serum concentrations of a spectrum of CLZ metabolites in patients, adjusting for smoking. METHODS: In total, 288 patients with an overall number of 737 serum concentration measurements of CLZ and metabolites concurrently using VPA (cases, n = 22) or no interacting drugs (controls, n = 266) were included from a routine therapeutic drug monitoring service. Linear mixed model analyses were performed to compare the dose-adjusted concentrations (C/D) of CLZ, N-DMC, CLZ 5N/N+-glucuronides, and metabolite-to-parent ratios in cases versus controls. RESULTS: After adjusting for covariates, the N-DMC (-40%, P < 0.001) and N+-glucuronide C/Ds (-78%, P < 0.001) were reduced in cases versus controls, while the CLZ C/D was unchanged (P > 0.7). In contrast, the 5N-glucuronide C/D (+250%, P < 0.001) and 5N-glucuronide-to-CLZ ratios (+120%, P = 0.01) were increased in cases versus controls. CONCLUSIONS: Our findings show that complex changes in CLZ metabolism underly the pharmacokinetic interaction with VPA. The lower levels of N-DMC seem to be caused by VPA-mediated induction of CLZ 5N-glucuronide formation, subsequently leading to reduced substrate availability for N-desmethylation. Whether the changes in CLZ metabolism caused by VPA affects the clinical outcome warrants further investigation.


Assuntos
Clozapina/sangue , Esquizofrenia/sangue , Esquizofrenia/tratamento farmacológico , Tranquilizantes/sangue , Ácido Valproico/sangue , Adulto , Interações Medicamentosas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Subst Use Misuse ; 57(2): 316-327, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34903123

RESUMO

BACKGROUND: Prescription drug misuse (PDM) is a significant public health problem associated with mental health symptoms. OBJECTIVES: This project investigates the connections between PDM motivations and mental health to inform intervention efforts. METHODS: Using nationally representative adult data from the 2016-2018 National Survey on Drug Use and Health (N = 128,205; 53% female) this project investigated which motivations for misuse are related to past-year mental health problems including any mental illness, serious mental illness, major depressive episode, and suicidal thoughts. Complex samples logistic regression models of the main motivation of PDM for each mental health problem were conducted separately for each prescription drug class (i.e., opioids, tranquilizers, sedatives, and stimulants) while controlling for demographic characteristics. RESULTS: Adults that reported PDM were more likely than those with no PDM to endorse past year mental health problems. Compared to those that reported PDM of other medications, those misusing prescription opioids and tranquilizers to help with emotions and misusing sedatives to "relax or relieve tension" were more likely to have all categories of mental health problems. Those that misused prescription stimulants to "help study" had lower odds of all mental health problems. CONCLUSIONS: While there were differences based on prescription drug class, a range of motivations increased adults' likelihood to have mental health problems and common themes were found across drug classes. While causality is still undetermined, prevention and intervention efforts that are multifaceted and individualized, while broadly providing adults with other ways to cope with negative emotions are likely to help reduce PDM.


Assuntos
Estimulantes do Sistema Nervoso Central , Transtorno Depressivo Maior , Uso Indevido de Medicamentos sob Prescrição , Medicamentos sob Prescrição , Transtornos Relacionados ao Uso de Substâncias , Tranquilizantes , Adulto , Analgésicos Opioides/uso terapêutico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Feminino , Humanos , Hipnóticos e Sedativos/uso terapêutico , Masculino , Saúde Mental , Motivação , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
11.
J Addict Med ; 16(4): 470-474, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34775440

RESUMO

OBJECTIVES: This study aims to investigate racial-ethnic differences in reasons for misuse of prescription medications among a nationally representative sample of US adults. METHODS: We analyzed data from the 2015-2019 National Surveys on Drug Use and Health. The study population includes US adults (18-49 years old) who reported misuse of 3 types of prescription drugs (stimulants [n = 6139], sedatives and tranquilizers [n = 5643], and pain relievers [n = 8780]) for 3 reasons: medical-only (eg, to help with pain), recreational-only (eg, to get high), or combined medical and recreational reasons. Multinomial logistic regressions assessed the association between reasons of misuse of prescription medications and self-identified race-ethnicity. RESULTS: Misuse of the 4 types of prescription medications was primarily motivated by medical reasons (63%-80%). Compared to non-Hispanic Whites, non-Hispanic Blacks (nHB), and Hispanics (H) were less likely to report misuse of pain relievers for combined (nHB: adjusted relative risk ratio [aRRR] = 0.6, 95% confidence interval [CI]: 0.4, 0.7; H; aRRR = 0.7, 95% CI: 0.5, 0.9) or recreational reasons (nHB: aRRR = 0.8, 95% CI: 0.6, 1.0; H; aRRR = 0.7, 95% CI: 0.6, 0.9) rather than medical-only reasons. The odds of misuse of sedatives and tranquilizers for recreational-only reasons as opposed to medical-only reasons were higher among nHB (aRRR = 1.9, 95% CI: 1.3, 2.7) and H (aRRR = 1.9, 95% CI: 1.4, 2.4) than among non-Hispanic Whites. CONCLUSIONS: The increased misuse of prescription pain relievers for medical reasons among racial-ethnic minority groups demonstrates a continued need to investigate underlying structural factors driving these behaviors. The higher odds of sedative and tranquilizer misuse for recreational purposes among racial-ethnic minority groups warrant further investigation.


Assuntos
Uso Indevido de Medicamentos sob Prescrição , Medicamentos sob Prescrição , Tranquilizantes , Adolescente , Adulto , Etnicidade , Humanos , Hipnóticos e Sedativos , Pessoa de Meia-Idade , Grupos Minoritários , Dor/tratamento farmacológico , Prescrições , Estados Unidos/epidemiologia , Adulto Jovem
12.
Exp Clin Psychopharmacol ; 30(6): 797-808, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34410796

RESUMO

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. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Uso Indevido de Medicamentos sob Prescrição , Medicamentos sob Prescrição , Transtornos Relacionados ao Uso de Substâncias , Tranquilizantes , Masculino , Humanos , Adulto Jovem , Estados Unidos , Analgésicos Opioides , Prevalência , Hipnóticos e Sedativos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Uso Indevido de Medicamentos sob Prescrição/psicologia , Ingestão de Alimentos
13.
J Addict Med ; 16(1): e23-e29, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33758113

RESUMO

BACKGROUND: Adolescents' consumption of tranquilizers, sedatives, and sleeping pills (TSSp) has increased during the last few decades, and TSSp are currently among the substances with the lowest age-of-onset. We characterized current-use patterns of TSSp consumers by age when first taken. METHODS: This study used individualized secondary data retrieved from the 2016 Spanish State Survey on Drug Use in Secondary Education (16-18-year-olds), and included all subjects who reported having taken TSSp at any point, but excluded those who had started during the previous year (n = 1502). Logistic regression models were used to obtain adjusted odds ratios (aOR) for associations between early TSSp consumption (<14 years) and current TSSp use patterns, adjusted for sociodemographic factors. RESULTS: About 17.9% of respondents had taken TSSp (average age-of-onset = 13.7) and 45% of these without a prescription. TSSp consumption at <14 years was higher for males and nonrepeaters. Having begun to use TSSp < 14 years was associated with both higher probability of consumption in the last month (aOR = 1.41; 95%CI:1.12-1.77) and daily/almost daily consumption in the last month (aOR = 1.56; 95CI%:1.16-2.08). CONCLUSIONS: The results of this study show there is a high proportion of 16 to 18 TSSp student consumers - both prescribed and nonprescribed; it also establishes that early onset-of-use is associated with higher levels of intensive use later on.


Assuntos
Medicamentos Indutores do Sono , Transtornos Relacionados ao Uso de Substâncias , Tranquilizantes , Adolescente , Humanos , Hipnóticos e Sedativos/efeitos adversos , Masculino , Medicamentos Indutores do Sono/uso terapêutico , Estudantes , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Tranquilizantes/uso terapêutico
14.
Psychol Health ; 37(7): 903-916, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-33979239

RESUMO

OBJECTIVE: To measure the association between knowledge, attitudes and practices of personal misuse of tranquilizers among parents of schoolchildren in Beirut (Lebanon). DESIGN: We carried out a cross-sectional study in 1396 adults recruited from parents of students of eleven public and private schools, from primary schools to high schools, using a Knowledge, Attitude and Practices (KAP) questionnaire of personal use of tranquilizers. MAIN OUTCOME MEASURES: We assessed five patterns of tranquilizers' misuse: unprescribed use, shortened treatment, stored leftovers, doubled forgotten doses or taken when remembered, changed dose without medical recommendation, and a sixth composite outcome: 'any misuse'. RESULTS: Sixty-three (62.2%) of 91 parents who used tranquilizers reported at least one misuse pattern. Higher odds of 'any misuse' were observed among parents who reported taking tranquilizers to sleep better, to enjoy themselves with their families or to work better [2.35 ≤ adjusted interquartile odds ratio (aIqOR) ≤ 1.99]. Storing tranquilizers for future need was strongly associated with misuse [aIqOR: 5.00 (95% CI: 3.30, 7.59)]. Greater awareness about hazards of tranquilizers and the importance of therapeutic compliance was associated with lower odds of specific misuse patterns (0.50 ≤ aIqOR ≤ 0.72). CONCLUSIONS: Poor knowledge and medically disapproved attitudes increase the likelihood of practices of tranquilizer misuse.


Assuntos
Tranquilizantes , Adulto , Criança , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Líbano , Pais , Inquéritos e Questionários
16.
Int J Geriatr Psychiatry ; 36(12): 1867-1877, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34318511

RESUMO

OBJECTIVE: Substance use rates have increased in adults 50 years and older, and substance use in this population is associated with significant consequences. Given that little is known about their underlying substance use patterns, the objective was to identify latent classes of adults 50 years and older by past-year substance use, past-month substance use, and past-year substance use disorder (SUD) diagnosis. METHODS: The National Survey on Drug Use and Health is an annual nationwide cross-sectional U.S. survey. Participants were 35,229 civilian, non-institutionalized U.S. residents, 50 years and older. Past-year and past-month alcohol, tobacco, marijuana, heroin, cocaine, methamphetamine use, and opioid, stimulant, and tranquilizer/sedative prescription drug misuse (PDM) were captured, as was past-year DSM-IV SUD from these substances. Correlates included mental health, physical health, and healthcare utilization variables. RESULTS: Latent class analysis indicated four past-year or past-month substance use subgroups (Alcohol-Only, Alcohol-Tobacco-Marijuana, Cocaine-Polydrug, PDM-Polydrug), with SUD prevalence rising from 3.2% to 17.3%, 68.8%, and 78.5% by past-year subgroup; similarly, rates of past-year suicidal ideation increased from 2.1%, to 4.8%, 12.0%, and 20.4% by past-year subgroup. For SUD, there were three subgroups (Low Nicotine Dependence [ND], High Alcohol Use Disorder, Multiple SUDs). Over 90% of adults were in a low-risk subgroup (i.e., Alcohol-Only and Low ND), but members of Cocaine-Polydrug, PDM-Polydrug, or Multiple SUDs latent classes had high rates of mental and physical health concerns. CONCLUSIONS: Most adults 50 and older have lower risk profiles, but those engaged in PDM or cocaine use are heavily substance-involved and need screening and likely multi-disciplinary intervention.


Assuntos
Uso Indevido de Medicamentos sob Prescrição , Transtornos Relacionados ao Uso de Substâncias , Tranquilizantes , Analgésicos Opioides/uso terapêutico , Estudos Transversais , Humanos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
17.
Sci Rep ; 11(1): 13660, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34211003

RESUMO

Ganoderma lucidum is a medicinal mushroom used in traditional Chinese medicine with putative tranquilizing effects. However, the component of G. lucidum that promotes sleep has not been clearly identified. Here, the effect and mechanism of the acidic part of the alcohol extract of G. lucidum mycelia (GLAA) on sleep were studied in mice. Administration of 25, 50 and 100 mg/kg GLAA for 28 days promoted sleep in pentobarbital-treated mice by shortening sleep latency and prolonging sleeping time. GLAA administration increased the levels of the sleep-promoting neurotransmitter 5-hydroxytryptamine and the Tph2, Iptr3 and Gng13 transcripts in the sleep-regulating serotonergic synapse pathway in the hypothalamus during this process. Moreover, GLAA administration reduced lipopolysaccharide and raised peptidoglycan levels in serum. GLAA-enriched gut bacteria and metabolites, including Bifidobacterium, Bifidobacterium animalis, indole-3-carboxylic acid and acetylphosphate were negatively correlated with sleep latency and positively correlated with sleeping time and the hypothalamus 5-hydroxytryptamine concentration. Both the GLAA sleep promotion effect and the altered faecal metabolites correlated with sleep behaviours disappeared after gut microbiota depletion with antibiotics. Our results showed that GLAA promotes sleep through a gut microbiota-dependent and serotonin-associated pathway in mice.


Assuntos
Produtos Biológicos/farmacologia , Microbioma Gastrointestinal/efeitos dos fármacos , Reishi , Serotonina/metabolismo , Sono/efeitos dos fármacos , Tranquilizantes/farmacologia , Animais , Produtos Biológicos/química , Produtos Biológicos/isolamento & purificação , Ritmo Circadiano/efeitos dos fármacos , Masculino , Camundongos , Reishi/química , Transdução de Sinais/efeitos dos fármacos , Tranquilizantes/química , Tranquilizantes/isolamento & purificação
18.
Hum Psychopharmacol ; 36(6): e2803, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34237180

RESUMO

OBJECTIVE: To examine prevalence of past-month prescription drug misuse (PDM) and alcohol co-ingestion and its correlates in adults age 50 or older. METHODS: Data were from the 2015-2018 US National Survey on Drug Use and Health (n = 35,190). PDM-alcohol co-ingestion was defined as prescription opioid, tranquilizer/sedative, or stimulant misuse while "drinking alcohol or within a couple of hours of drinking." Co-ingestion prevalence was estimated, and logistic and negative binomial regressions examined the sociodemographic, physical health, mental health, substance use, and substance use disorder (SUD) correlates of co-ingestion. RESULTS: Over 344,000 adults aged 50 years or older (0.3%) engaged in past-month PDM-alcohol co-ingestion, or 27.4% of those with past-month PDM. Past-month co-ingestion was linked to greater past-month alcohol use frequency and elevated adjusted odds ratios (aORs) for all examined substance use outcomes (e.g., non-PDM SUD aOR = 21.8; 49.7% prevalence rate). The aOR for suicidal ideation was 506% higher in those with co-ingestion than those without past-year PDM. CONCLUSIONS: US adults aged 50 years or older with past-month PDM-alcohol co-ingestion are at high risk for SUD and concerning mental health symptoms. Screening for mental health and substance use treatment is warranted among aging adults with signs of PDM, especially involving co-ingestion.


Assuntos
Uso Indevido de Medicamentos sob Prescrição , Medicamentos sob Prescrição , Transtornos Relacionados ao Uso de Substâncias , Tranquilizantes , Adulto , Ingestão de Alimentos , Humanos , Pessoa de Meia-Idade , Uso Indevido de Medicamentos sob Prescrição/psicologia , Prevalência , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Estados Unidos/epidemiologia
19.
Cell Rep Med ; 2(5): 100281, 2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-34095883

RESUMO

Anxiety and stress-related conditions represent a significant health burden in modern society. Unfortunately, most anxiolytic drugs are prone to side effects, limiting their long-term usage. Here, we employ a bioinformatics screen to identify drugs for repurposing as anxiolytics. Comparison of drug-induced gene-expression profiles with the hippocampal transcriptome of an importin α5 mutant mouse model with reduced anxiety identifies the hypocholesterolemic agent ß-sitosterol as a promising candidate. ß-sitosterol activity is validated by both intraperitoneal and oral application in mice, revealing it as the only clear anxiolytic from five closely related phytosterols. ß-sitosterol injection reduces the effects of restraint stress, contextual fear memory, and c-Fos activation in the prefrontal cortex and dentate gyrus. Moreover, synergistic anxiolysis is observed when combining sub-efficacious doses of ß-sitosterol with the SSRI fluoxetine. These preclinical findings support further development of ß-sitosterol, either as a standalone anxiolytic or in combination with low-dose SSRIs.


Assuntos
Ansiolíticos/farmacologia , Transtornos de Ansiedade/tratamento farmacológico , Ansiedade/tratamento farmacológico , Sitosteroides/farmacologia , Animais , Medo/efeitos dos fármacos , Fluoxetina/farmacologia , Camundongos Endogâmicos C57BL , Atividade Motora/efeitos dos fármacos , Preparações Farmacêuticas/metabolismo , Córtex Pré-Frontal/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-fos/farmacologia , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Tranquilizantes/farmacologia
20.
Drug Alcohol Depend ; 225: 108793, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34087748

RESUMO

BACKGROUND: Tranquilizer misuse represents a growing international public health problem with heavy social and economic consequences. We aimed to identify the psychosocial determinants of this misuse practice, focusing on modifiable factors including knowledge and attitudes towards these medications. METHODS: A prospective cohort study involving 847 adults accompanying children in primary care clinics was carried out in Spain. A validated Knowledge, Attitudes and Practices (KAP) questionnaire on tranquilizer use was self-administered at baseline, and then participants were followed-up bimonthly. A misuse event was defined as unprescribed intake of tranquilizers, storing/sharing leftovers of tranquilizers, and/or not adhering to the prescribed treatment period, timing or dosage. Poisson regression models were applied to estimate adjusted Incidence Rate Ratios (IRRs) of misuse and their 95 % Confidence Intervals (CIs). FINDINGS: Individuals' personal attitudes towards tranquilizers and treating physicians are strongly associated with the misuse of these drugs. These attitudes include: individuals' acceptance of taking tranquilizers to improve sleeping [IRR: 5.10 (95 %CI: 2.74-9.48)], to work better [IRR: 2.04 (95 %CI: 1.05-3.99)], or for recreational purposes [IRR: 1.85 (95 %CI: 1.04-3.32)]; willingness to prolong the course of tranquilizer treatment without medical consultation [IRR: 2.45 (95 %CI: 1.46-4.13)]; agreeing on storing tranquilizers for possible future need [IRR: 5.07 (95 %CI: 2.73-9.40)]; and untrusting the physician's decision about tranquilizer prescription [IRR: 1.92 (95 %CI: 1.12-3.30)]. The level of knowledge is marginally associated with tranquilizer misuse. CONCLUSIONS: There is a strong association between individuals' attitudes towards tranquilizers and the misuse practices of these drugs. Educational interventional studies could help reduce the incidence of tranquilizer misuse.


Assuntos
Uso Indevido de Medicamentos sob Prescrição , Tranquilizantes , Adulto , Atitude , Criança , Estudos de Coortes , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Estudos Prospectivos , Espanha/epidemiologia
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