Taylor B Crouch1, Caitlin E Martin2, Kathryn Polak3, Wally Smith4, Pamela Dillon5, Steve Ondersma6, Dace Svikis7. 1. Department of Psychiatry, Virginia Commonwealth University School of Medicine, USA; Institute for Women's Health, Virginia Commonwealth University, USA. Electronic address: taylor.crouch@vcuhealth.org. 2. Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, USA; Virginia Commonwealth University Institute for Drug and Alcohol Studies, USA. 3. Virginia Commonwealth University Institute for Drug and Alcohol Studies, USA; Department of Psychology, Virginia Commonwealth University, USA. 4. Department of Internal Medicine, Virginia Commonwealth University School of Medicine, USA. 5. School of Pharmacy, Virginia Commonwealth University, USA. 6. Division of Public Health and Department of Obstetrics, Gynecology, & Reproductive Biology, Michigan State University, USA. 7. Institute for Women's Health, Virginia Commonwealth University, USA; Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, USA; Virginia Commonwealth University Institute for Drug and Alcohol Studies, USA.
Abstract
BACKGROUND: Nonmedical use of prescription medications (NUPM) is a growing problem but little is known about its gender-specific mechanisms despite NIDA's call for gender-stratified research over a decade ago. We explored gender differences in NUPM in a diverse sample of primary care patients. METHODS: N = 4458 participants participated in an anonymous health survey in urban primary care clinics. The primary outcome was past month NUPM. All analyses were stratified by gender. Bivariate relationships among NUPM and demographic, medical, psychological, and substance use-related variables were analyzed. Stepwise multivariate logistic regression models (LRMs) were estimated by gender. RESULTS: More men (9.5%) reported NUPM than women (7.4%). The final LRM among men included age (OR=0.98), race (OR=0.49), chronic pain diagnosis (OR=1.73), hepatitis (OR=1.78), depression diagnosis (OR=1.77), positive alcohol misuse screen (OR=1.58), and mood disturbance (OR=1.04). Among women, the model included mood disturbance (OR=1.04), illicit drug use (OR=2.22), family history of drug problems (OR=1.41), and heart disease diagnosis (OR=0.48). Effect sizes ranged from small to moderate. CONCLUSIONS: Among a sample of primary care patients, gender-stratified analyses indicated differential presentation of NUPM by gender. Demographic factors were more relevant correlates among men, with younger, White men at higher risk. Chronic pain and depression were more notable risk factors for men. Recent illicit drug use and family history of drug problems were uniquely associated among women, while recent distress was a strong correlate among both men and women. A better understanding of gender-specific correlates of NUPM can inform gender-tailored prevention and treatment efforts.
BACKGROUND: Nonmedical use of prescription medications (NUPM) is a growing problem but little is known about its gender-specific mechanisms despite NIDA's call for gender-stratified research over a decade ago. We explored gender differences in NUPM in a diverse sample of primary care patients. METHODS: N = 4458 participants participated in an anonymous health survey in urban primary care clinics. The primary outcome was past month NUPM. All analyses were stratified by gender. Bivariate relationships among NUPM and demographic, medical, psychological, and substance use-related variables were analyzed. Stepwise multivariate logistic regression models (LRMs) were estimated by gender. RESULTS: More men (9.5%) reported NUPM than women (7.4%). The final LRM among men included age (OR=0.98), race (OR=0.49), chronic pain diagnosis (OR=1.73), hepatitis (OR=1.78), depression diagnosis (OR=1.77), positive alcohol misuse screen (OR=1.58), and mood disturbance (OR=1.04). Among women, the model included mood disturbance (OR=1.04), illicit drug use (OR=2.22), family history of drug problems (OR=1.41), and heart disease diagnosis (OR=0.48). Effect sizes ranged from small to moderate. CONCLUSIONS: Among a sample of primary care patients, gender-stratified analyses indicated differential presentation of NUPM by gender. Demographic factors were more relevant correlates among men, with younger, White men at higher risk. Chronic pain and depression were more notable risk factors for men. Recent illicit drug use and family history of drug problems were uniquely associated among women, while recent distress was a strong correlate among both men and women. A better understanding of gender-specific correlates of NUPM can inform gender-tailored prevention and treatment efforts.
Authors: Jane M Liebschutz; Richard Saitz; Roger D Weiss; Tali Averbuch; Sonia Schwartz; Ellen C Meltzer; Elizabeth Claggett-Borne; Howard Cabral; Jeffrey H Samet Journal: J Pain Date: 2010-03-24 Impact factor: 5.820
Authors: Shelly F Greenfield; Carmen Rosa; Susan I Putnins; Carla A Green; Audrey J Brooks; Donald A Calsyn; Lisa R Cohen; Sarah Erickson; Susan M Gordon; Louise Haynes; Therese Killeen; Gloria Miele; Susan Tross; Theresa Winhusen Journal: Am J Drug Alcohol Abuse Date: 2011-09 Impact factor: 3.829