Patterns of Marijuana Use in a 6-Month Pain Management Sample in the United States.

This study is a 6-month retrospective analysis of urine drug testing (UDT) data from a pain management population among specimens with clinician-ordered marijuana testing (N = 194 809). Descriptive statistics about the specimen positivity of clinician-ordered marijuana UDT are provided as well as other drug positivity. Specimens from men and adults aged 18 to 34 years had the highest prevalence rates of marijuana positivity. The prevalence of past-month marijuana use among a comparative national population was lower than the prevalence of positive marijuana tests in the UDT specimens by all characteristics. Among the specimens tested for illicit drugs and marijuana, 4.0% were positive for amphetamine, 2.8% were positive for cocaine, and 0.9% were positive for heroin. The most common prescription drugs listed were opioids (64.7%), benzodiazepines (20.5%), and antidepressants (19.9%). In sum, the findings reflect previous research showing high rates of marijuana use, illicit drug use, and prescription drug use in a pain management population.

Opioid abuse and depression in adolescents: Results from the National Survey on Drug Use and Health.

OBJECTIVE: To investigate the association of major depressive episode (MDE) with nonmedical prescription opioid use (NMPOU) and opioid abuse/dependence among adolescents aged 12 to 17. METHODS: We analyzed 5 years of data from the National Survey on Drug Use and Health (NSDUH). We used logistic regressions to study the relationship between MDE and NMPOU among all adolescents, as well as the relationship of MDE with opioid abuse/dependence among adolescents with NMPOU. Other covariates included: sociodemographics, alcohol abuse/dependence, nonopioid drug abuse/dependence, delinquency, school performance, religious services attendance, and family support/supervision. RESULTS: In the sample of all adolescents, 6% reported past year NMPOU, and 8% reported past year MDE. When NMPOU and MDE were comorbid, MDE usually preceded the NMPOU. In the sample of adolescents with NMPOU, 15% reported past year opioid abuse/dependence, and 20% reported past year MDE. In adjusted logistic regression, MDE was associated with both NMPOU (OR=1.51, p<0.001) among all adolescents and opioid abuse/dependence (OR=2.18, p<0.001) among adolescents with NMPOU. CONCLUSION: MDE occurs commonly in adolescents and is associated with NMPOU and opioid abuse/dependence. In terms of population attributable risk, which is a function of both the prevalence and the strength of the association, MDE is an important risk factor for NMPOU among adolescents and opioid abuse/dependence among adolescents with NMPOU. Preventive and clinical programs to decrease NMPOU and opioid abuse/dependence among adolescents should consider the prominent role of depression.

Risk and protective factors for methamphetamine use and nonmedical use of prescription stimulants among young adults aged 18 to 25.

This article reports on correlates of past-year nonmedical use of prescription stimulants and methamphetamine among young adults aged 18 to 25. Data from the 2002 National Survey on Drug Use and Health (NSDUH) were used to conduct logistic regression analyses of the demographic, psychosocial, and behavioral correlates of nonmedical stimulant use. The sample size was 23,645. Multivariate analyses revealed that selling drugs and using marijuana and other illegal drugs were associated with increased odds of both methamphetamine and nonmedical prescription stimulant use. Females, individuals not enrolled in college, and those who had been arrested were more likely than their counterparts to have used methamphetamine, whereas black individuals and less religious individuals were less likely than their counterparts to have used methamphetamine. Psychological distress, sensation seeking, binge drinking, and college enrollment were associated with increased risks of nonmedical prescription stimulant use, whereas Hispanic and other ethnic identification were associated with decreased risks of nonmedical prescription stimulant use. Different intervention strategies are needed to prevent methamphetamine use versus nonmedical prescription stimulant use.

Risk and protective factors for nonmedical use of prescription stimulants and methamphetamine among adolescents.

PURPOSE: This article reports on correlates of past-year nonmedical use of prescription stimulants and methamphetamine among adolescents aged 12 to 17 years. METHODS: Data from the 2002 National Survey of Drug Use and Health (NSDUH) were used to conduct logistic regression analyses of the demographic, psychosocial, and behavioral correlates of illicit stimulant use. The sample size was 17,709. RESULTS: Analyses revealed that mental health treatment utilization and use of marijuana and other illegal drugs were correlated with nonmedical use of prescription stimulants and methamphetamine among adolescents. Females and adolescents who reported low religiosity, binge drinking, and selling drugs were more likely to use methamphetamine than were males or individuals who did not report these attitudes or behaviors. Additionally, black adolescents were less likely than white adolescents to use methamphetamine. Alternatively, adolescents who reported high family conflict and sensation-seeking were more likely than their counterparts to use prescription stimulants nonmedically, and Hispanic adolescents were less likely to use prescription stimulants nonmedically than white adolescents. CONCLUSIONS: Risk for illicit use of stimulants varies by demographic, psychosocial, and behavioral factors. Different intervention mechanisms, populations, and settings should be targeted to prevent nonmedical use of prescription stimulants versus methamphetamine among adolescents.

Nonmedical use of prescription stimulants in the United States.

OBJECTIVE: This study estimated prevalences and correlates of stimulant diversion in the United States and examined relationships between diversion and measures of abuse or dependence. METHODS: We conducted descriptive and multivariate analysis of data from the National Survey on Drug Use and Health. Key measures were nonmedical use (misuse) of any prescription stimulant, any stimulant other than methamphetamine, and stimulants indicated for attention-deficit/hyperactivity disorder (ADHD). RESULTS: Lifetime stimulant misuse included some misuse of longer-acting ADHD drugs. The majority of past-year misuse involved drugs other than methamphetamine, particularly for youth aged 12-17. Past year misuse was more prevalent among persons aged 12-25, compared with older adults, and among Whites, compared with other groups. Prevalences in large metropolitan areas were lower than or similar to those in less populated areas. About 13% of past-year stimulant misusers met the survey criteria for dependence or abuse, as did about 10% of persons aged 12-25 who misused only nonmethamphetamine stimulants. CONCLUSIONS: Most stimulant misuse in the United States (particularly among youth) involved prescription drugs other than methamphetamine. The problem is not limited to metropolitan areas.

Predictors of treatment receipt among adults with a drug use disorder.

This study used data from the 2000 and 2001 National Household Surveys on Drug Abuse to examine factors that contribute to the receipt of specialty substance abuse treatment, which is defined as treatment in rehabilitation facilities, hospitals, or mental health centers designed to help stop or reduce drug use. The population examined was a nationally representative sample of 3291 adults aged 18 or older with a drug use disorder in the past 12 months. Data were collected by computer-assisted interviews using a combination of computer-assisted personal interviews conducted by the interviewer and audio computer-assisted self-interviewing guided by the computer and respondent. Using descriptive analyses and multivariate logistic regression models, this study compared sociodemographic, substance abuse, and psychosocial characteristics of those receiving treatment with those not receiving treatment; it also examined the factors that influenced treatment receipt while controlling for potential confounders. Characteristics significantly contributing to treatment receipt among adults with a drug use disorder included the following: a woman without social support; a high school graduate with no college education; those receiving insurance through Medicaid or a state Children's Health Insurance Program; those on probation, parole, or supervised release in the past year; a daily smoker of cigarettes; those meeting at least three criteria for drug dependence; those having past year dependence on or abuse of alcohol; and those receiving any mental health treatment or counseling in the past year. Adults associated with the criminal justice system had a different pattern of treatment predictors from those who were not involved with the criminal justice system.