Prevalence and drug use correlates of extra-medical use of prescription medications for sleep among adults in the United States: Results of the 2015-2018 National Survey on Drug Use and Health.

BACKGROUND: This paper examines the epidemiology of extra-medical use of prescription medications for sleep among a nationally representative sample of U.S. adults. METHODS: We analyzed data from the 2015-2018 National Surveys on Drug Use and Health. The sample includes 3410 U.S. adults who reported extra-medical use of prescription medications for sleep. Multinomial logistic regression models identified correlates of type of drug used [i.e., sedatives and/or tranquilizers-only (ST-only), prescription pain relievers-only (PPR-only), or sedatives, tranquilizers, and prescription pain relievers (ST + PPR)], and logistic regression models identified correlates of reasons for extra-medical use (i.e., sleep-only vs. sleep and recreational). RESULTS: About 60% (95%CI = 58.9, 63.5) of the sample reported extra-medical use of ST-only, followed by PPR-only (29.9%, 95%CI = 27.5, 32.5), and ST + PPR (8.9%, 95%CI = 7.7, 10.4). Recreational use was reported by 28.4% (95% CI = 26.5, 30.4) of the sample. The odds of extra-medical use of PPR-only (aRRR = 3.1, 95%CI = 2.1, 4.5) and ST + PPR (aRRR = 1.9, 95%CI = 1.2, 3.1) as opposed to ST-only, were greater among Non-Hispanic Blacks than Non-Hispanic Whites. Compared to non-alcohol users, those with a past-12 months diagnosis of alcohol use disorder were more likely to use ST + PPR rather than ST-only (aIRR = 2.0, 95%CI = 1.1, 3.7). Non-Hispanic Blacks (aOR = 0.6, 95%CI = 0.4, 08) and individuals living in rural areas (aOR = 0.5, 95%CI = 0.3, 09) were less likely to report extra-medical use of prescription medications for recreational reasons than Non-Hispanic Whites and those residing in large metropolitan areas, respectively. CONCLUSIONS: Extra-medical use of PPR-only and ST + PPR as an aid to sleep, is prevalent among Non-Hispanic Blacks, young adults, and those residing in rural areas. Most individuals reported that extra-medical use of prescription medications was primarily motivated by sleep reasons, rather than by sleep and recreational reasons. Potential interventions include access to sleep treatments, education on the effectiveness and risk associated with extra-medical use and co-use of prescription medications for sleep, and research on sleep-related disparities.

Family structure and past-30 day opioid misuse among justice-involved children.

BACKGROUND: To prevent opioid-related overdose among high risk youth, research on the predictors of opioid misuse (OM) initiation among justice-involved children (JIC) is needed. Living in a single-parent household, an important adverse childhood experience, is prevalent among JIC and linked to substance abuse. It is hypothesized that JIC who live in single-parent households will have a higher likelihood of meeting criteria for past-30 day OM than those who live in two-parent households. METHODS: The data in this paper were obtained from the Florida Department of Juvenile Justice (FLDJJ). Cross-sectional data on 79,960 JIC from FLDJJ were examined. To test the hypothesis, multivariate logistic regression analyses were employed. RESULTS: Over 2,000 JIC in the sample met criteria for past-30 day (P30D) OM. Over 27.1% of those who met criteria for past-30 day OM lived in a two-parent household while 21.3% of those who were non-past-30 day users lived in two-parent households. Contrary to our hypothesis, JIC who lived in grandparent-only households were 28% as likely to report P30D OM as those who lived in single-parent households. Those who lived in two-parent households were 16% as likely to meet criteria for P30D OM as those in single-parent households. These relationships varied by age. CONCLUSION: Two-parent and grandparent-only households maybe associated with increased access to opioids compared to other family structures with fewer adults. The risk of increased access may be more harmful than the strain of a single-parent household. Disposal of prescription medication initiatives should target households with multiple adults and grandparents.