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Misuse of Prescription Pain Relievers, Stimulants, Tranquilizers, and Sedatives Among U.S. Older Adults Aged ≥50 Years

      Introduction

      Misuse of prescription medications has led to higher mortality and morbidity in the U.S. This study investigates medical and nonmedical use of prescription medications (prescription pain relievers, stimulants, prescription tranquilizers, and sedatives) among adults aged ≥50 years.

      Methods

      Data were from the 2015–2017 National Survey of Drug Use and Health. For each prescription medication, medical and nonmedical use were mutually exclusive (prescription pain relievers, stimulants, tranquilizers, and sedatives). Nonmedical use (misuse) was defined as the use of any prescription medications in greater amounts, frequency, or duration than prescribed or the use of medications without a prescription of the individual's own. Descriptive analysis was performed to assess prescription medication use and misuse among adults aged ≥50 years (pooled N=26,322). Correlates of misuse were assessed within multivariable logistic regression analyses at p<0.05. All analyses were conducted in 2019.

      Results

      In the past 12 months, 46.7% (51.7 million) of adults reported using any prescription medication, of which 7.7% (4.0 million) reported misuse. The proportion of past 12-month users reporting misuse was 5.4% for sedatives, 6.4% for prescription pain relievers, 6.5% for prescription tranquilizers, and 8.1% for stimulants. Overall, 16.2% (17.9 million) reported using 2 or more prescription medications within the past 12 months. Multiple prescription medication use was associated with female sex; White race; younger age; and use of nonprescription substances, including alcohol, tobacco, marijuana, and heroin.

      Conclusions

      It is important to monitor medication misuse behaviors among older adults who may be living with several chronic conditions requiring pain management. The strong associations with serious psychological distress underscore the need for increased access to mental health services among this key population.
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      REFERENCES

      1. Quickfacts United States. U.S. Census Bureau.http://www.census.gov/quickfacts/fact/table/US/PST045218. Accessed September 14, 2019.

        • Han B
        • Compton WM
        • Blanco C
        • Crane E
        • Lee J
        • Jones CM
        Prescription opioid use, misuse, and use disorders in U.S. adults: 2015 National Survey on drug use and health.
        Ann Intern Med. 2017; 167: 293-301
        • Masnoon N
        • Shakib S
        • Kalisch-Ellett L
        • Caughey GE
        What is polypharmacy? A systematic review of definitions.
        BMC Geriatr. 2017; 17: 230
      2. Opioid overdose crisis. NIH, National Institute on Drug Abuse, Advancing Addiction Science.http://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#two. Accessed July 31, 2019.

      3. What is the U.S. opioid epidemic?HHS.http://www.hhs.gov/opioids/about-the-epidemic/index.html. Accessed July 31, 2019.

        • Martins SS
        • Fenton MC
        • Keyes KM
        • Blanco C
        • Zhu H
        • Storr CL
        Mood and anxiety disorders and their association with non-medical prescription opioid use and prescription opioid-use disorder: longitudinal evidence from the National Epidemiologic Study on Alcohol and Related Conditions.
        Psychol Med. 2012; 42: 1261-1272
        • Meier A
        • Lambert-Harris C
        • McGovern MP
        • Xie H
        • An M
        • McLeman B
        Co-occurring prescription opioid use problems and posttraumatic stress disorder symptom severity.
        Am J Drug Alcohol Abuse. 2014; 40: 304-311
        • Ashrafioun L
        • Bishop TM
        • Conner KR
        • Pigeon WR
        Frequency of prescription opioid misuse and suicidal ideation, planning, and attempts.
        J Psychiatr Res. 2017; 92: 1-7
        • Substance Abuse and Mental Health Services Administration
        • Center for Behavioral Health Statistics and Quality
        Results from the 2017 National survey on drug use and health: detailed tables: prevalence estimates, standard errors, P values, and sample sizes.
        Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, Rockville, MD2018
        • Substance Abuse and Mental Health Services Administration
        • Center for Behavioral Health Statistics and Quality
        2017 National survey on drug use and health: public use file codebook.
        Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, Rockville, MD2018
        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders: DSM-IV.
        4th ed. American Psychiatric Association, Washington, DC1994
        • Kessler RC
        • Barker PR
        • Colpe LJ
        • et al.
        Screening for serious mental illness in the general population.
        Arch Gen Psychiatry. 2003; 60: 184-189
        • Korpi ER
        • den Hollander B
        • Farooq U
        • et al.
        Mechanisms of action and persistent neuroplasticity by drugs of abuse.
        Pharmacol Rev. 2015; 67: 872-1004
        • de Jong MR
        • Van der Elst M
        • Hartholt KA
        Drug-related falls in older patients: implicated drugs, consequences, and possible prevention strategies.
        Ther Adv Drug Saf. 2013; 4: 147-154
        • Steinhagen KA
        • Friedman MB
        Substance abuse and misuse in older adults.
        Aging Well. 2008; 3 (Accessed August 5, 2019): 20
        • Benyamin R
        • Trescot AM
        • Datta S
        • et al.
        Opioid complications and side effects.
        Pain Physician. 2008; 11 (Accessed Accessed August 5, 2019): S105-S120
        • White JM
        • Irvine RJ.
        Mechanisms of fatal opioid overdose.
        Addiction. 1999; 94: 961-972
        • Zhu W
        • Chernew ME
        • Sherry TB
        • Maestas N
        Initial opioid prescriptions among U.S. commercially insured patients, 2012-2017.
        N Engl J Med. 2019; 380: 1043-1052
        • Dowell D
        • Haegerich TM
        • Chou R
        CDC guideline for prescribing opioids for chronic pain–United States, 2016.
        JAMA. 2016; 315: 1624-1645