Maya Vijayaraghavan1, Daniel Freitas2, David R Bangsberg3, Christine Miaskowski4, Margot B Kushel5. 1. Moores UCSD Cancer Center, University of California, San Diego, 3855 Health Sciences Drive, San Diego, CA 92093, USA. Electronic address: mvijayaraghavan@ucsd.edu. 2. University of California, San Francisco, 521 Parnassus Avenue, San Francisco, CA 94117, USA. Electronic address: Daniel.Freitas@ucsf.edu. 3. Massachusetts General Hospital Center for Global Health, Ragon Institute of MGH, MIT and Harvard, Harvard Medical School, 100 Cambridge, 15th Floor, Boston, MA 02114, USA. Electronic address: dbangsberg@partners.org. 4. Department of Physiological Nursing/UCSF, 2 Koret Way - N631Y, San Francisco, CA 94143-0610, USA. Electronic address: chris.miaskowski@nursing.ucsf.edu. 5. University of California, San Francisco, 521 Parnassus Avenue, San Francisco, CA 94117, USA; Division of General Internal Medicine, San Francisco General Hospital, 1001 Potrero Avenue, SFGH 10, San Francisco, CA 94143, USA. Electronic address: mkushel@medsfgh.ucsf.edu.
Abstract
BACKGROUND: Non-opioid psychotherapeutic medications significantly increase the risk of opioid overdose-related deaths. We prospectively followed HIV-infected indigent adults sampled from the community to examine rates of and factors associated with non-medical use of benzodiazepines, muscle relaxants, and prescription stimulants. METHODS: We interviewed participants quarterly for 2 years about alcohol and illicit substance use; depression; use of prescribed opioid analgesics, benzodiazepines and muscle relaxants; opioid analgesic misuse; and non-medical use (i.e., use without a prescription) of benzodiazepines, muscle relaxants, and prescription stimulants. Using mixed-effects multivariate logistic regression, we determined factors associated with non-medical use of benzodiazepines, muscle relaxants, and prescription stimulants. RESULTS: Among the 296 participants at enrollment, 52.0% reported taking opioid analgesics that had been prescribed, 17.9% took benzodiazepines that had been prescribed, and 8.1% took muscle relaxants that had been prescribed. Over the 2-year study interval, 53.4% reported prescription opioid misuse, 25.3% reported non-medical use of benzodiazepines, 11.5% reported non-medical use of muscle relaxants, and 6.1% reported non-medical use of prescription stimulants. In multivariable analysis, opioid analgesic misuse in the past 90 days was associated with non-medical use of benzodiazepines, muscle relaxants, and prescription stimulants during the same time interval. Illicit substance use and depression were not associated with non-medical use of these medications. CONCLUSIONS: Prescription opioid analgesic misuse is associated with non-medical use of other psychotherapeutic medications. Health care providers should monitor for non-medical use of a broad array of psychoactive medications among high-risk populations to minimize harm.
BACKGROUND: Non-opioid psychotherapeutic medications significantly increase the risk of opioid overdose-related deaths. We prospectively followed HIV-infected indigent adults sampled from the community to examine rates of and factors associated with non-medical use of benzodiazepines, muscle relaxants, and prescription stimulants. METHODS: We interviewed participants quarterly for 2 years about alcohol and illicit substance use; depression; use of prescribed opioid analgesics, benzodiazepines and muscle relaxants; opioid analgesic misuse; and non-medical use (i.e., use without a prescription) of benzodiazepines, muscle relaxants, and prescription stimulants. Using mixed-effects multivariate logistic regression, we determined factors associated with non-medical use of benzodiazepines, muscle relaxants, and prescription stimulants. RESULTS: Among the 296 participants at enrollment, 52.0% reported taking opioid analgesics that had been prescribed, 17.9% took benzodiazepines that had been prescribed, and 8.1% took muscle relaxants that had been prescribed. Over the 2-year study interval, 53.4% reported prescription opioid misuse, 25.3% reported non-medical use of benzodiazepines, 11.5% reported non-medical use of muscle relaxants, and 6.1% reported non-medical use of prescription stimulants. In multivariable analysis, opioid analgesic misuse in the past 90 days was associated with non-medical use of benzodiazepines, muscle relaxants, and prescription stimulants during the same time interval. Illicit substance use and depression were not associated with non-medical use of these medications. CONCLUSIONS: Prescription opioid analgesic misuse is associated with non-medical use of other psychotherapeutic medications. Health care providers should monitor for non-medical use of a broad array of psychoactive medications among high-risk populations to minimize harm.
Authors: Marjorie J Robertson; Richard A Clark; Edwin D Charlebois; Jacqueline Tulsky; Heather L Long; David R Bangsberg; Andrew R Moss Journal: Am J Public Health Date: 2004-07 Impact factor: 9.308
Authors: Kate M Dunn; Kathleen W Saunders; Carolyn M Rutter; Caleb J Banta-Green; Joseph O Merrill; Mark D Sullivan; Constance M Weisner; Michael J Silverberg; Cynthia I Campbell; Bruce M Psaty; Michael Von Korff Journal: Ann Intern Med Date: 2010-01-19 Impact factor: 25.391
Authors: Aron J Hall; Joseph E Logan; Robin L Toblin; James A Kaplan; James C Kraner; Danae Bixler; Alex E Crosby; Leonard J Paulozzi Journal: JAMA Date: 2008-12-10 Impact factor: 56.272
Authors: Theresa W Kim; Alexander Y Walley; Timothy C Heeren; Gregory J Patts; Alicia S Ventura; Gabriel B Lerner; Nicholas Mauricio; Richard Saitz Journal: J Subst Abuse Treat Date: 2017-07-14
Authors: Abigail Norris Turner; Courtney Maierhofer; Nicholas T Funderburg; Brandon Snyder; Kristi Small; Jan Clark; Jose A Bazan; Nicole C Kwiek; Jesse J Kwiek Journal: AIDS Care Date: 2016-06-20
Authors: Theresa W Kim; Alexander Y Walley; Alicia S Ventura; Gregory J Patts; Timothy C Heeren; Gabriel B Lerner; Nicholas Mauricio; Richard Saitz Journal: AIDS Care Date: 2017-10-16
Authors: Anees Bahji; Yu Li; Rachel Vickers-Smith; Stephen Crystal; Robert D Kerns; Kirsha S Gordon; Alexandria Macmadu; Melissa Skanderson; Kaku So-Armah; Minhee L Sung; Fiona Bhondoekhan; Brandon D L Marshall; E Jennifer Edelman Journal: Int J Environ Res Public Health Date: 2022-05-06 Impact factor: 4.614
Authors: Maile Y Karris; Jeff Berko; Peter D Mazonson; Theoren M Loo; Frank Spinelli; Andrew Zolopa Journal: AIDS Res Hum Retroviruses Date: 2020-07-08 Impact factor: 2.205
Authors: Flavia Ismael; Beatriz Zaramella; Tatiane Battagin; João C S Bizario; Júlia Gallego; Victoria Villela; Lilian Bezerra de Queiroz; Fabio E Leal; Julio Torales; Antonio Ventriglio; Megan E Marziali; Priscila D Gonçalves; Silvia S Martins; João M Castaldelli-Maia Journal: Front Public Health Date: 2021-03-04
Authors: Yu Fu; Irene Lorrai; Barry Zorman; Daniele Mercatelli; Chase Shankula; Jorge Marquez Gaytan; Celine Lefebvre; Giordano de Guglielmo; Hyunjae Ryan Kim; Pavel Sumazin; Federico M Giorgi; Vez Repunte-Canonigo; Pietro Paolo Sanna Journal: Viruses Date: 2022-03-24 Impact factor: 5.818
Authors: E Jennifer Edelman; Yu Li; Declan Barry; Jennifer Brennan Braden; Stephen Crystal; Robert D Kerns; Julie R Gaither; Kirsha S Gordon; Ajay Manhapra; Jessica S Merlin; Brent A Moore; Benjamin J Oldfield; Lesley S Park; Christopher T Rentsch; Melissa Skanderson; Emily C Williams; Amy C Justice; Janet P Tate; William C Becker; Brandon D L Marshall Journal: J Acquir Immune Defic Syndr Date: 2020-05-01 Impact factor: 3.771