Ty S Schepis1, Jason A Ford2, Linda Wastila3,4, Sean Esteban McCabe5,6,7,8,9. 1. Department of Psychology, Texas State University, TX, USA. 2. Department of Sociology, University of Central Florida, Orlando, FL, USA. 3. Peter Lamy Center on Drug Therapy and Aging, University of Maryland, Baltimore, MD, USA. 4. Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, MD, USA. 5. Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA. 6. Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA. 7. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA. 8. Center for Human Growth and Development, Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA. 9. Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Abstract
OBJECTIVES: Although older adult prescription drug misuse (PDM) is associated with concerning consequences, stimulant PDM and poly- PDM involving multiple medication classes each remain understudied. Our objectives were to examine PDM and poly-PDM prevalence by medication class in US older adults and to identify the mental health, SUD, and health-related quality-of-life correlates of poly-PDM. METHOD: Data were from adults 50 and older completing the National Epidemiologic Survey on Alcohol and Related Conditions-III, (N = 14,667). Prevalence of PDM and poly-PDM by medication class was estimated. Logistic regression established odds of four SUD diagnoses, five psychopathology diagnoses and lifetime suicide attempts; linear regression evaluated health-related quality-of-life by PDM/poly-PDM status. RESULTS: Past-year PDM abstinence increased with age (50-54 years: 80.5%; 80 and older: 96.0%), while poly-PDM declined; past-year stimulant PDM was rare (≤0.6%), except when combined with opioid and tranquilizer/sedative PDM. Compared to no past-year PDM, both past-year opioid-only PDM and opioid-involved poly-PDM were associated with poorer health-related quality-of-life and greater odds of psychopathology and SUD, with the highest odds in poly-PDM. CONCLUSION: The presence of any opioid-involved PDM in older adults highlights screening for SUD, psychopathology, and other medical conditions, with the most significant intervention needs likely in those with opioid-involved poly-PDM.
OBJECTIVES: Although older adult prescription drug misuse (PDM) is associated with concerning consequences, stimulant PDM and poly- PDM involving multiple medication classes each remain understudied. Our objectives were to examine PDM and poly-PDM prevalence by medication class in US older adults and to identify the mental health, SUD, and health-related quality-of-life correlates of poly-PDM. METHOD: Data were from adults 50 and older completing the National Epidemiologic Survey on Alcohol and Related Conditions-III, (N = 14,667). Prevalence of PDM and poly-PDM by medication class was estimated. Logistic regression established odds of four SUD diagnoses, five psychopathology diagnoses and lifetime suicide attempts; linear regression evaluated health-related quality-of-life by PDM/poly-PDM status. RESULTS: Past-year PDM abstinence increased with age (50-54 years: 80.5%; 80 and older: 96.0%), while poly-PDM declined; past-year stimulant PDM was rare (≤0.6%), except when combined with opioid and tranquilizer/sedative PDM. Compared to no past-year PDM, both past-year opioid-only PDM and opioid-involved poly-PDM were associated with poorer health-related quality-of-life and greater odds of psychopathology and SUD, with the highest odds in poly-PDM. CONCLUSION: The presence of any opioid-involved PDM in older adults highlights screening for SUD, psychopathology, and other medical conditions, with the most significant intervention needs likely in those with opioid-involved poly-PDM.
Entities:
Keywords:
Prescription drug misuse; benzodiazepine; older adult; opioid; psychopathology; sedative; substance use
Authors: Beth D Darnall; David Juurlink; Robert D Kerns; Sean Mackey; Brent Van Dorsten; Keith Humphreys; Julio A Gonzalez-Sotomayor; Andrea Furlan; Adam J Gordon; Debra B Gordon; Diane E Hoffman; Joel Katz; Stefan G Kertesz; Sally Satel; Richard A Lawhern; Kate M Nicholson; Rosemary C Polomano; Owen D Williamson; Heath McAnally; Ming-Chih Kao; Stephan Schug; Robert Twillman; Terri A Lewis; Richard L Stieg; Kate Lorig; Theresa Mallick-Searle; Robert W West; Sarah Gray; Steven R Ariens; Jennifer Sharpe Potter; Penney Cowan; Chad D Kollas; Danial Laird; Barby Ingle; J Julian Grove; Marian Wilson; Kashelle Lockman; Fiona Hodson; Carol S Palackdharry; Roger B Fillingim; Jeffrey Fudin; Jennifer Barnhouse; Ajay Manhapra; Steven R Henson; Bruce Singer; Marie Ljosenvoor; Marlisa Griffith; Jason N Doctor; Kimeron Hardin; Cathleen London; Jon Mankowski; Andrea Anderson; Linda Ellsworth; Lisa Davis Budzinski; Becky Brandt; Greg Hartley; Debbie Nickels Heck; Mark J Zobrosky; Celeste Cheek; Megan Wilson; Cynthia E Laux; Geralyn Datz; Justin Dunaway; Eileen Schonfeld; Melissa Cady; Thérèse LeDantec-Boswell; Meredith Craigie; John Sturgeon; Pamela Flood; Melita Giummarra; Jessica Whelan; Beverly E Thorn; Richard L Martin; Michael E Schatman; Maurice D Gregory; Joshua Kirz; Patti Robinson; James G Marx; Jessica R Stewart; Phillip S Keck; Scott E Hadland; Jennifer L Murphy; Mark A Lumley; Kathleen S Brown; Michael S Leong; Mechele Fillman; James W Broatch; Aaron Perez; Kristine Watford; Kari Kruska; Dokyoung Sophia You; Stacy Ogbeide; Amy Kukucka; Susan Lawson; James B Ray; T Wade Martin; James B Lakehomer; Anne Burke; Robert I Cohen; Peter Grinspoon; Marc S Rubenstein; Stephani Sutherland; Kristie Walters; Travis Lovejoy Journal: Pain Med Date: 2019-03-01 Impact factor: 3.750
Authors: Bridget F Grant; Rise B Goldstein; Sharon M Smith; Jeesun Jung; Haitao Zhang; Sanchen P Chou; Roger P Pickering; Wenjun J Ruan; Boji Huang; Tulshi D Saha; Christina Aivadyan; Eliana Greenstein; Deborah S Hasin Journal: Drug Alcohol Depend Date: 2014-12-08 Impact factor: 4.492
Authors: Rachel D Maree; Zachary A Marcum; Ester Saghafi; Debra K Weiner; Jordan F Karp Journal: Am J Geriatr Psychiatry Date: 2016-06-07 Impact factor: 4.105