Sources of Nonmedical Prescription Drug Misuse Among US High School Seniors: Differences in Motives and Substance Use Behaviors
Sources of Nonmedical Prescription Drug Misuse Among US High School Seniors: Differences in Motives and Substance Use Behaviors
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DOI：
10.1016/j.jaac.2018.11.018
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发表时间：
2019-07-01
影响因子：
13.3
通讯作者：
Boyd, Carol J.
中科院分区：
文献类型：
--
作者：
McCabe, Sean Esteban;Veliz, Philip;Boyd, Carol J.
目的：检查是否来源的非医疗使用的处方药（NMUPD）涉及抗焦虑药，阿片类药物和兴奋剂与社会人口学特征，NMUPD特征（如，频率），和其他substance use.Method：美国高中毕业生（N = 18,549）的全国代表性样本进行了调查，通过自我管理的问卷（2009-2016）。基于设计的潜在类别分析和Rao-Scott chi（2）检验用于检验社会人口学特征、NMUPD特征、其他物质使用行为（例如，酗酒、吸烟、大麻使用）和NMUPD来源之间的关联。相当比例的非医疗使用者从多种来源获得处方药（44.2%）。潜在类别分析确定了NMUPD来源的5个亚组（朋友/亲戚来源，朋友/购买的来源，自己的剩余处方，多个来源和其他来源）。从朋友/购买来源获得处方药的非医疗用户更有可能是青春期男孩，而那些使用自己剩余处方的人更有可能是青春期女孩。从多个来源获得处方药的非医疗使用者更多地参与物质使用。相比之下，青少年非医疗用户谁使用自己的剩余处方较少参与substance use.Conclusion：越来越多的证据表明，不同的NMUPD来源与不同的物质使用行为。应劝阻所有NMUPD来源，因为它们将个人，家庭和社区置于危险之中。患者及其家属应接受教育，了解如何管理和妥善处置受管制药物，以避免药物流入社区。鼓励处方医生检查处方监测计划，并在处方受控药物时筛查青少年的物质使用/滥用。
Objective: To examine whether sources of nonmedical use of prescription drugs (NMUPD) involving anxiolytics, opioids, and stimulants were associated with sociodemographic characteristics, NMUPD characteristics (eg, frequency), and other substance use.Method: Nationally representative samples of US high school seniors (N = 18,549) were surveyed by self-administered questionnaires (2009-2016). Design-based latent class analysis and Rao-Scott chi(2) tests were used to test associations among sociodemographic characteristics, NMUPD characteristics, other substance use behaviors (eg, binge drinking, cigarette smoking, marijuana use), and NMUPD sources.Results: Approximately 11.0% of high school seniors reported past-year NMUPD (n = 1,917). A substantial proportion of nonmedical users obtained the prescription drugs from multiple sources (44.2%). Latent class analysis identified 5 subgroups of NMUPD sources (friend/relative sources, friend/purchased sources, own leftover prescription, multiple sources, and other sources). Nonmedical users who obtained prescription drugs from friend/purchased sources were more likely to be adolescent boys, whereas those who used their own leftover prescriptions were more likely to be adolescent girls. Nonmedical users who obtained prescription drugs from multiple sources were more involved in substance use. In contrast, adolescent nonmedical users who used their own leftover prescriptions were less involved in substance use.Conclusion: Growing evidence indicates that different NMUPD sources are associated with different substance use behaviors. All NMUPD sources should be discouraged, because they place individuals, families, and communities at risk. Patients and their families should receive education on how to manage and properly dispose of controlled medications to avoid diversion into the community. Prescribers are encouraged to check prescription monitoring programs and screen adolescents for substance use/misuse when prescribing controlled medications.