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K. Saleh, Shafaq. "Misuse of appetite- stimulant drugs in Babylon#." Iraqi Journal of Pharmaceutical Sciences ( P-ISSN 1683 - 3597 E-ISSN 2521 - 3512) 21, no. 2 (March 29, 2017): 31–34. http://dx.doi.org/10.31351/vol21iss2pp31-34.
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Drug misuse is defined as using of drugs for a non-therapeutic or non-medical purpose. In Iraq drug misuse is a major problem because almost any drug can be easily obtained from pharmacies. Appetite- stimulant drugs are example of drugs that are widely used without a prescription. The study included 230 patients who use these drugs in Babylon. A questionnaire included the following questions ; age, sex, marital state, the reason for use the drug , whether the drug is prescribed by physician or not , type of drug used , the frequency of daily dose and lastly the extent of side effects of the drugs used. The results showed that the age range of 35% of subjects were (17-21) years old and 70% of participants were females. The study also showed that 62% of them are unmarried and the reason for use, in 48% of subjects, was to increase the body weight. Furthermore, this study revealed that about 68% of those subjects utilized these drugs without prescription and the steroids are the most drug type used (33%). Additionally, 44% of subjects used these drugs twice daily and 80% of subjects who used steroids developed marked side effects. It can be concluded that there is a misuse of appetite- stimulant drugs in subjects participated in this study and most of these drugs are not used on therapeutic or scientific bases.
Key words : Misuse of drug , appetite-stimulant, dexamethasone.
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Moore, Thomas J., Phillip W. Wirtz, Stefan P. Kruszewski, and G. Caleb Alexander. "Changes in medical use of central nervous system stimulants among US adults, 2013 and 2018: a cross-sectional study." BMJ Open 11, no. 8 (August 2021): e048528. http://dx.doi.org/10.1136/bmjopen-2020-048528.
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ObjectiveTo assess the 5-year changes in the adult medical use of central nervous system (CNS) stimulants with higher risk of dependence and evaluate the population characteristics of users and their medical and/or neurological conditions.DesignCross-sectional study.SettingAnnual US Medical Expenditure Panel Survey, a stratified random sample of approximately 30 000 persons designed to produce national population estimates. It focuses on reported medical spending, medical services used, health status and prescription medications.ParticipantsAdults age 19 years and older who reported obtaining one or more prescriptions for amphetamine or methylphenidate products during two survey years, 2013 and 2018.Main outcomes measuresPrescriptions obtained, the specific stimulant product and annual treatment days of drug supplied.ResultsIn 2018, an estimated 4.1 million US adults (95% CI 3.4 million to 4.8 million) reported prescriptions for CNS stimulants, having filled a mean of 7.3 (95% CI 6.8 to 7.8) prescriptions with a mean of 226 (95% CI 210 to 242) days’ supply. Compared with 2013, the estimated number of adults reporting using CNS stimulants in 2018 increased by 1.8 million (95% CI 1.0 million to 2.7 million) or 79.8%. Most 2018 adult stimulant users reported taking psychoactive medication for one or more mental, behavioural or neurodevelopment disorders. Overall, 77.8% (95% CI 72.6% to 83.0%) reported some medication for adult attention deficit disorder, 26.8% (95% CI 22.2% to 31.5%) took medication for anxiety, 25.1% (95% CI 19.9% to 30.3%) for depression and 15.3% (95% CI 9.8% to 20.8%) indicated drug treatment for other mental or neurological disorders. Adult CNS stimulant use was higher in females, in younger age cohorts and among individuals of white race/ethnicity.ConclusionsAdult medical use of prescription stimulants increased markedly in 5 years and occurred in a population often reporting multiple mental or neurological disorders. Further action is needed to understand and manage this new resurgence in drugs with high risks of dependence.
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Lankenau, Stephen E., Sheree M. Schrager, Karol Silva, Alex Kecojevic, Jennifer Jackson Bloom, Carolyn Wong, and Ellen Iverson. "Misuse of prescription and illicit drugs among high-risk young adults in Los Angeles and New York." Journal of Public Health Research 1, no. 1 (February 14, 2012): 6. http://dx.doi.org/10.4081/jphr.2012.e6.
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<em>Background</em>. Prescription drug misuse among young adults is increasingly viewed as a public health concern, yet most research has focused on student populations and excluded high-risk groups. Furthermore, research on populations who report recent prescription drug misuse is limited. This study examined patterns of prescription drug misuse among high-risk young adults in Los Angeles (LA) and New York (NY), which represent different local markets for illicit and prescription drugs. <em>Design and Methods.</em> Between 2009 and 2011, 596 young adults (16 to 25 years old) who had misused prescription drugs within the past 90 days were interviewed in Los Angeles and New York. Sampling was stratified to enroll three groups of high-risk young adults: injection drug users (IDUs); homeless persons; and polydrug users. <em>Results</em>. In both sites, lifetime history of receiving a prescription for an opioid, tranquilizer, or stimulant was high and commonly preceded misuse. Moreover, initiation of opioids occurred before heroin and initiation of prescription stimulants happened prior to illicit stimulants. NY participants more frequently misused oxycodone, heroin, and cocaine, and LA participants more frequently misused codeine, marijuana, and methamphetamine. Combining prescription and illicit drugs during drug using events was commonly reported in both sites. Opioids and tranquilizers were used as substitutes for other drugs, e.g., heroin, when these drugs were not available. <em>Conclusion</em>. Patterns of drug use among high-risk young adults in Los Angeles and New York appear to be linked to differences in local markets in each city for illicit drugs and diverted prescription drugs.
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Lasopa, Sonam O., Catherine W. Striley, and Linda B. Cottler. "Diversion of prescription stimulant drugs among 10–18-year-olds." Current Opinion in Psychiatry 28, no. 4 (July 2015): 292–98. http://dx.doi.org/10.1097/yco.0000000000000172.
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Bidwal, Monica K., Eric J. Ip, Bijal M. Shah, and Melissa J. Serino. "Stress, Drugs, and Alcohol Use Among Health Care Professional Students." Journal of Pharmacy Practice 28, no. 6 (August 14, 2014): 535–42. http://dx.doi.org/10.1177/0897190014544824.
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Objective: To contrast the characteristics of pharmacy, medicine, and physician assistant (PA) students regarding the prevalence of drug, alcohol, and tobacco use and to identify risk factors associated with prescription stimulant use. Participants: Five hundred eighty nine students were recruited to complete a 50-item Web-based survey. Main Outcome Measures: Demographics, nonmedical prescription medication use, illicit drug and alcohol use, Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR) psychiatric diagnoses, and perceived stress scale (PSS) scores. Results: Medicine and PA students reported greater nonmedical prescription stimulant use than pharmacy students (10.4% vs 14.0% vs 6.1%; P < .05). Medicine and PA students were more likely to report a history of an anxiety disorder (12.1% vs 18.6% vs 5.9%; P < .05), major depressive disorder (9.4% vs 8.1% vs 3.3%; P < .05), and attention-deficit hyperactivity disorder (ADHD; 4.0% vs 9.3% vs 0.7%; P < .001) than pharmacy students. PSS scores for all 3 groups (21.9-22.3) were roughly twice as high as the general adult population. Conclusion: Illicit drug and prescription stimulant use, psychiatric disorders, and elevated stress levels are prevalent among health care professional students. Health care professional programs may wish to use this information to better understand their student population which may lead to a reassessment of student resources and awareness/prevention programs.
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Vaddadi, Sneha M., Nicholas J. Czelatka, Belsy D. Gutierrez, Bhumika C. Maddineni, Kenneth L. McCall, and Brian J. Piper. "Rise, and pronounced regional variation, in methylphenidate, amphetamine, and lisdexamfetamine distribution in the United States." PeerJ 9 (December 21, 2021): e12619. http://dx.doi.org/10.7717/peerj.12619.
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Background The prescription stimulants methylphenidate, amphetamine, and lisdexamfetamine are sympathomimetic drugs with therapeutic use. They are designated in the United States as Schedule II substances, defined by the 1970 Controlled Substances Act as having a “high potential for abuse”. Changing criteria for the diagnosis of Attention Deficit Hyperactivity Disorder in 2013 and the approval of lisdexamfetamine for binge eating disorder in 2015 may have impacted usage patterns. This report compared the pharmacoepidemiology of these stimulants in the United States from 2010–2017. Methods Distribution of amphetamine, methylphenidate, lisdexamfetamine were examined via weights extracted from the Drug Enforcement Administration’s (DEA) Automated Reports and Consolidated Ordering System (ARCOS). Median stimulant Daily Dosage per patient was determined for a regional analysis. The percent of cost and prescriptions attributable to each stimulant and atomoxetine in Medicaid from the “Drug Utilization 2018 - National Total” from the Centers for Medicare and Medicaid was determined. Results There was a rise in amphetamine (+67.5%) and lisdexamfetamine (+76.7%) from 2010–2017. The change in methylphenidate (−3.0%) was modest. Persons/day stimulant usage was lower in the West than in other US regions from 2014-2017. There was a negative correlation (r(48) = −0.43 to −0.65, p < .05) between the percent Hispanic population per state and the Daily Dosage/population per stimulant. Methylphenidate formulations accounted for over half (51.7%) of the $3.8 billion reimbursed by Medicaid and the plurality (45.4%) of the 22.0 million prescriptions. Amphetamine was responsible for less than one-fifth (18.4%) of cost but one-third of prescriptions (33.6%). Lisdexamfetamine’s cost (26.0%) exceeded prescriptions (16.3%). Conclusion The rising amphetamine and lisdexamfetamine distribution may correspond with a rise in adult ADHD diagnoses. Regional analysis indicates that stimulant distribution in the West may be distinct from that in other regions. The lower stimulant distribution in areas with greater Hispanic populations may warrant further study.
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Hupli, Aleksi. "Cognitive enhancement with licit and illicit stimulants in the Netherlands and Finland: what is the evidence?" Drugs and Alcohol Today 20, no. 1 (January 13, 2020): 62–73. http://dx.doi.org/10.1108/dat-07-2019-0028.
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Purpose European studies have shown lower prevalence rates of prescription stimulant use for cognitive enhancement, especially among student populations, compared to North America. This difference requires more cross-country research of the various factors involved. To find out whether other parts of the globe are witnessing similar increases in extra-medical stimulant use, and how this might relate to cognitive enhancement, requires empirical study of local contexts. This paper aims to argue that the academic and public discussion on cognitive enhancement should consider the specific country context of drug policy and research and rethink which drugs are included under the term cognitive enhancement drugs. Design/methodology/approach This paper offers a general review and a sociological country comparison between the Netherlands and Finland, focusing not only on prescription stimulants used to treat attention deficit hyperactivity disorder but also illicit amphetamines among young adults and methylphenidate use among Dutch and Finnish participants of the Global Drug Survey. This paper emphasises sociocultural perspectives and the importance of context in cognitive enhancement in general as the line between therapeutic and enhancement use can often be blurred. Data is drawn from global, European and national sources, including the International Narcotics Control Board, European Monitoring Centre for Drugs and Drug Addiction and Global Drug Survey. Findings There are hardly any national empirical studies done on cognitive enhancement drug use in Finland. On the other hand, there have been studies in the Netherlands showcasing that the use of prescription stimulants and other drugs for enhancement purposes is something that is happening among young people, albeit yet in a relatively small scale. Illicit and licit stimulant use and drug policy action in relation to cognitive enhancement drugs in the two countries varies, emphasising the importance of country context. Originality/value Given that cross-country research is scarce, this general review provides one of the first glimpses into cognitive enhancement drug use by comparing the country context and research in Finland, where the phenomenon has not been studied, with the Netherlands, where the topic has received more research and public attention. Further research areas are suggested.
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Pate, Margaret C., and Riane M. Bolin. "Examining the Relationship Between Strain and the Use of Nonmedical Prescription Drugs Among College Students." Journal of Drug Issues 49, no. 1 (November 18, 2018): 163–82. http://dx.doi.org/10.1177/0022042618812398.
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The study of nonmedical prescription drug use (NMPDU) on college campuses is of importance, as college students tend to engage in NMPDU more often than their same-age peers not attending college. Typical correlates of NMPDU include need for alertness, perception of peer use, desire to get high, and use of other drugs including alcohol and marijuana. Few studies have explored the relationship between strain, depression, and NMPDU among college students. Using general strain theory as the theoretical framework, the current study aims to add to the literature on NMPDU by exploring the role that strain and depression play in the prevalence of nonmedical prescription stimulant, tranquilizer/sedative, and pain reliever use at a midsized university. Results support the relationship proposed by strain theorists for both nonmedical use of prescription pain relievers and tranquilizers/sedatives, but not stimulants. Policy implications and future areas of research are discussed.
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Outhoff, Kim. "Cognitive enhancement: a brief overview." South African Family Practice 58, no. 1 (January 1, 2016): 3. http://dx.doi.org/10.4102/safp.v58i1.4436.
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Cognitive enhancement involves the non-medical use of illicit and/or prescription drugs, such as agents prescribed for attention deficit/hyperactive disorder (ADHD) and narcolepsy, usually in order to stay awake and to counteract fatigue and loss of concentration, generally in the context of high workload and stress. Growing interest in taking prescription stimulant drugs for non-licensed purposes to improve academic, work and sporting performance has raised medical, ethical and regulatory issues.
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Ain Mehfooz, Qurrat ul, Qasim Saleem, Khursheed Anwer, and Hamid Mahmood. "Comparison of non -Prescribed use of Tranquilizer with Stimulants Drugs among Medical Students." Pakistan Journal of Medical and Health Sciences 15, no. 12 (December 10, 2021): 3381–83. http://dx.doi.org/10.53350/pjmhs2115123381.
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Objective: The goal of this study to look at the patterns of drug use among medical students. Methodology: All medical students enrolled in the Bakhtawer Amin Medical & Dental College Multan, from first to fifth year were included in this study. The sample size was calculated using a single population proportion formula. The sample consisted of 200 students drawn from various batches and chosen using a stratified random selection procedure Results: The total study participants were 200 medical students of different years in which 139(70%) were males and 61(30%) were females. The participants having age range 18-25 years and maximum number of students were fall in age group 21-25 [117(58.5%)]. The results of the study showed that 76% used tranquilizer and 68% of the students used Stimulants without prescription as p-value 0.004 showing statistical significant difference in the use of both types of drugs. Student used tranquilizer and stimulants once a month as 32% vs 37% with significant p-value 0.034. Conclusion: The fourth-year students had the highest rate of drug usage. During the evaluation, the majority of students were drug users; there was no sign of physical dependency. The topic of non-prescribed drug usage among medical students is examined in this study. More research is needed to investigate national trends of drug addiction among medical students, as well as to find and reinforce protective variables. Supporting children with a non-prescription usage necessitates the development of strategies. Keywords:Nonmedical prescription drug use; Nonmedical prescription stimulant use; Nonmedical prescription tranquilizer use; Trends.
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Mineo, L., Y. Sarraf, S. Hanauer, D. Patel, C. Ingram, L. Montemagno, C. Concerto, and F. Battaglia. "Affective temperaments in medical students using prescription stimulants for neuroenhancement." European Psychiatry 41, S1 (April 2017): S392. http://dx.doi.org/10.1016/j.eurpsy.2017.02.444.
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IntroductionThe non-medical use of prescription stimulants (NMUPS) is a common habit among American college students; It refers to the use of stimulant medications by students who do not qualify for prescription or in higher quantities or manners other than prescribed in order to improve their academic performance. To the best of our knowledge, no studies have examined the role of specific affective, biologically determined and inherited traits that might predict misuse of stimulants for neuroenhancement in graduate education.AimTo examine the role for individual temperament traits on non-medical use of prescription stimulants (NMUPS) in medical college students.MethodsWe investigated 181 students using the short form of the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A). Furthermore, we assessed the association of demographic variables and health risk behaviors (drinking, smoking, use other illicit drugs) with NMUPS. Predictors were investigated using logistic regression.ResultsThe prevalence of NMUPS was 30.06% with 7.1% users being previously diagnosed with ADHD. NMUPS users had higher scores on the hyperthymic scale. The main reason for taking NMUPS was to “Increase ability to stay alert during studying” (80.1%) followed by “Allow studying for longer periods of time” (19.9%). The hyperthymic temperament score and being a user of other illicit drugs increased the odds of becoming NMUPS.ConclusionsOur results suggest that personality profiles can be used to identify students with an increased risk for NMUPS for early personalized counseling and behavioral intervention based on their temperament profile.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Advokat, Claire, Sean M. Lane, and Chunqiao Luo. "College Students With and Without ADHD." Journal of Attention Disorders 15, no. 8 (August 2, 2010): 656–66. http://dx.doi.org/10.1177/1087054710371168.
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Objective: To examine the relationship between ADHD medications, study habits, and academic achievement of ADHD-diagnosed undergraduates. Method: A total of 92 students with a self-reported ADHD diagnosis and a current prescription for ADHD medication were compared with 143 control students in a survey of academic performance. Results: Most ADHD students took stimulant medication and said the drugs helped them, yet believed they were worse than other students at planning and completing assignments and avoiding distractions. Although most study habits of ADHD students did not differ from controls, their high school and college GPA (grade point average), and ACT scores were significantly lower, and they withdrew from significantly more classes than did control students. Interestingly, preliminary data suggested that good study habits alone, even without stimulants, could overcome the achievement disparity of ADHD students. Conclusion: As previously shown for children and adolescents, stimulant medications alone did not eliminate the academic achievement deficit of ADHD undergraduates.
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Sud, N. "Is it Attention Deficit Hyperactivity Disorder (ADHD) or Stimulant use disorder ? How is ADHD diagnosed?" European Psychiatry 65, S1 (June 2022): S592. http://dx.doi.org/10.1192/j.eurpsy.2022.1516.
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Introduction From clinical experience, majority of patients in adult forensic services who have childhood diagnosis of ADHD self-report onset of substance misuse around the age of 12. Objectives Aim of the study was to explore if routine screening of childhood substance use is considered by ADHD diagnostic services. Methods PsycINFO and Embase databases were searched with the keywords: Attention Deficit Hyperactivity Disorder, ADHD, primary care/general practice, family physicians ,paediatrics, and children/adolescents, child and adolescent psychiatry, diagnostic assessments, substance / drug use, prescription drugs and drug screening. Results 24 articles were retrieved for age groups 12 to 17 years. Studies identified substance misuse as highly comorbid with ADHD but more so in conduct disorder. Studies identified diversion risk in adolescents. Conclusions Both ADHD and amphetamine misuse disorders are Axis 1 disorders (Baldwin 2009). Literature links substance misuse in ADHD to conduct disorder. There needs to be research into the diagnostic overlap between conduct disorder and ADHD and how this fits into the trauma model of adult offender treatment pathways. Treatment pathways for ADHD or conduct disorder and childhood onset substance misuse disorder are not clear both in primary or secondary care. Literature appears to put emphasis on early diagnosis and prescription stimulant treatment outside the social and psychological context and cites outcomes of the short term studies as reason for continued prescriptions in adolescence and beyond. There is need for studies exploring perspectives and trajectories of amphetamine use in adults who were diagnosed with ADHD in childhood, adolescence and as adults. Disclosure No significant relationships.
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Sharif, Safia, Amira Guirguis, Suzanne Fergus, and Fabrizio Schifano. "The Use and Impact of Cognitive Enhancers among University Students: A Systematic Review." Brain Sciences 11, no. 3 (March 10, 2021): 355. http://dx.doi.org/10.3390/brainsci11030355.
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Introduction: Cognitive enhancers (CEs), also known as “smart drugs”, “study aids” or “nootropics” are a cause of concern. Recent research studies investigated the use of CEs being taken as study aids by university students. This manuscript provides an overview of popular CEs, focusing on a range of drugs/substances (e.g., prescription CEs including amphetamine salt mixtures, methylphenidate, modafinil and piracetam; and non-prescription CEs including caffeine, cobalamin (vitamin B12), guarana, pyridoxine (vitamin B6) and vinpocetine) that have emerged as being misused. The diverted non-prescription use of these molecules and the related potential for dependence and/or addiction is being reported. It has been demonstrated that healthy students (i.e., those without any diagnosed mental disorders) are increasingly using drugs such as methylphenidate, a mixture of dextroamphetamine/amphetamine, and modafinil, for the purpose of increasing their alertness, concentration or memory. Aim: To investigate the level of knowledge, perception and impact of the use of a range of CEs within Higher Education Institutions. Methodology: A systematic review was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Whilst 1400 studies were identified within this study through a variety of electronic databases (e.g., 520 through PubMed, 490 through Science Direct and 390 through Scopus), 48 papers were deemed relevant and were included in this review. Results: The most popular molecules identified here included the stimulant CEs, e.g., methylphenidate, modafinil, amphetamine salt mixtures and caffeine-related compounds; stimulant CEs’ intake was more prevalent among males than females; drugs were largely obtained from friends and family, as well as via the Internet. It is therefore suggested that CEs are increasingly being used among healthy individuals, mainly students without any diagnosed cognitive disorders, to increase their alertness, concentration, or memory, in the belief that these CEs will improve their performance during examinations or when studying. The impact of stimulant CEs may include tolerance, dependence and/or somatic (e.g., cardiovascular; neurological) complications. Discussion: The availability of CEs for non-medical indications in different countries is influenced by a range of factors including legal, social and ethical factors. Considering the risk factors and motivations that encourage university students to use CE drugs, it is essential to raise awareness about CE-related harms, counteract myths regarding “safe” CE use and address cognitive enhancement in an early stage during education as a preventative public health measure.
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Ilieva, Irena P., Cayce J. Hook, and Martha J. Farah. "Prescription Stimulants' Effects on Healthy Inhibitory Control, Working Memory, and Episodic Memory: A Meta-analysis." Journal of Cognitive Neuroscience 27, no. 6 (June 2015): 1069–89. http://dx.doi.org/10.1162/jocn_a_00776.
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The use of prescription stimulants to enhance healthy cognition has significant social, ethical, and public health implications. The large number of enhancement users across various ages and occupations emphasizes the importance of examining these drugs' efficacy in a nonclinical sample. The present meta-analysis was conducted to estimate the magnitude of the effects of methylphenidate and amphetamine on cognitive functions central to academic and occupational functioning, including inhibitory control, working memory, short-term episodic memory, and delayed episodic memory. In addition, we examined the evidence for publication bias. Forty-eight studies (total of 1,409 participants) were included in the analyses. We found evidence for small but significant stimulant enhancement effects on inhibitory control and short-term episodic memory. Small effects on working memory reached significance, based on one of our two analytical approaches. Effects on delayed episodic memory were medium in size. However, because the effects on long-term and working memory were qualified by evidence for publication bias, we conclude that the effect of amphetamine and methylphenidate on the examined facets of healthy cognition is probably modest overall. In some situations, a small advantage may be valuable, although it is also possible that healthy users resort to stimulants to enhance their energy and motivation more than their cognition.
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Wang, Wanxin, Min Luo, Chuhao Xi, Yiling Lei, Siyuan Pan, Xue Gao, Yan Xu, et al. "Cross-sectional study on influence of the family environment on the lifetime non-medical use of prescription drugs among Chinese adolescents in Guangdong: an analysis of sex differences." BMJ Open 9, no. 7 (July 2019): e026758. http://dx.doi.org/10.1136/bmjopen-2018-026758.
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ObjectivesThis study aimed to assess if adolescents had used any prescription drugs non-medically, to explore the associations between the family environment and non-medical use of prescription drugs (NMUPD) and to investigate whether there are any sex differences in the aforementioned associations.DesignA population-based cross-sectional study.SettingA secondary analysis of the cross-sectional data collected from high school students in Guangdong who were sampled using a multistage, stratified-cluster, random-sampling method in the 2015 School-based Chinese Adolescents Health Survey.ParticipantsA total of 21 774 students aged 12–20 years.Data analysisMultilevel logistic regression models were used to explore the univariable and multivariable relationship between family environment and NMUPD among adolescents. Adjusted ORs and corresponding 95% CI were calculated.Outcome measuresQuestions regarding to adolescent’ NMUPD (including sedative, opioid and stimulant) were surveyed in the study.ResultsA total of 6.3% students reported lifetime NMUPD in this study. The most commonly used drugs were opioids (3.9%), followed by sedatives (3.2%) and stimulants (2.5%). Multilevel analyses indicated that living arrangements, family economic status, parental relationships, parental education levels, monthly pocket money, parental drinking and drug problems were significantly correlated to the NMUPD among all students. Among boys, living arrangements, family economic status, maternal education levels, monthly pocket money, parental drinking and drug problems were significantly related to different types of NMUPD. The same factors were related to girls’ NMUPD, except for maternal education levels. Parental relationships and paternal education levels were also associated with girls’ NMUPD.ConclusionThe family environment exerts an important influence on adolescents’ NMUPD. Interventions targeted at families are highly recommended considering the negative effects of NMUPD. In addition, the child’s sex might be taken into consideration when developing and implementing preventive strategies.
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Barrett, Sean P., Christine Darredeau, Lana E. Bordy, and Robert O. Pihl. "Characteristics of Methylphenidate Misuse in a University Student Sample." Canadian Journal of Psychiatry 50, no. 8 (July 2005): 457–61. http://dx.doi.org/10.1177/070674370505000805.
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Objective: Methylphenidate (MPH) is a prescription stimulant drug with known abuse potential; however, little is known about its patterns of misuse or the characteristics of its abusers. Methods: A sample of 50 university students reporting MPH misuse and 50 control subjects matched for age, sex, and ethnicity completed structured face-to-face interviews about their MPH and other drug use. For each substance ever used, they provided information regarding routes of administration and other substances ever coadministered, as well as details about the most recent administration. MPH users provided additional information about their reasons for use and, in 36 cases, about how they obtained the drug. Results: Relative to control subjects, those who misused MPH were more likely to have used various other prescription and nonprescription stimulant drugs over their lifetime, and most MPH users reported mixing the drug with other psychoactive substances. Of the MPH sample, 70% reported recreational use of the drug, while 30% reported that MPH was used exclusively for study purposes. Relative to those using it exclusively for study, recreational users were more likely to report using MPH intranasally, as well as coadministering MPH with other substances. Most of those who reported their source of MPH obtained it from an acquaintance with a prescription. Conclusions: Those who misuse MPH are more likely than their peers to misuse various other substances, and MPH misuse frequently occurs in the context of simultaneous polydrug use. Because the primary supply of inappropriately used MPH appears to be prescribed users, efforts should be directed toward preventing its diversion.
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Martinez-Raga, Jose, Amparo Ferreros, Carlos Knecht, Raquel de Alvaro, and Eloisa Carabal. "Attention-deficit hyperactivity disorder medication use: factors involved in prescribing, safety aspects and outcomes." Therapeutic Advances in Drug Safety 8, no. 3 (November 29, 2016): 87–99. http://dx.doi.org/10.1177/2042098616679636.
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While treatment of patients with attention-deficit hyperactivity disorder (ADHD) is based on a multimodal approach that combines medication with specific psychological interventions, pharmacotherapy alone is generally considered an essential and cost-effective element. This paper aims to comprehensively and critically review factors involved in prescribing and medication use in individuals diagnosed with ADHD, focusing on the difficulties facing patients with ADHD seeking treatment, as well as the safety and tolerability aspects of ADHD pharmacotherapies, with particular attention on the cardiovascular adverse events and the potential risk of misuse or diversion of ADHD medications. A comprehensive and systematic literature search of PubMed/MEDLINE database was conducted to identify studies published in peer-reviewed journals until 1 August 2016. Children, adolescents and adults often encounter significant difficulties in the process of accessing specialist assessment and treatment for ADHD as a consequence of disparities in service organization and available treatment provision. Despite the well-established efficacy and overall safety profile, ADHD medications are not exempt from adverse events. The cardiovascular safety of pharmacotherapies used for treating individuals with ADHD has raised particular concerns; however there is little evidence of serious cardiovascular adverse events, including no serious corrected QT (QTc) abnormalities associated with stimulants, atomoxetine or α2-adrenergic receptor agonists. Although the abuse of prescription stimulant drugs, particularly, short-acting stimulants is a prevalent and growing problem, nonmedical use of prescription stimulants within the clinical context is very limited. In addition, nonstimulant ADHD medications lack any reinforcing effects and consequently any abuse potential.
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Luty, Jason. "Controversial treatments in psychiatry." BJPsych Advances 23, no. 3 (May 2017): 169–78. http://dx.doi.org/10.1192/apt.bp.115.014803.
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SummaryPsychiatry uses some of the most controversial treatments in medicine. This may be partly because several are administered under coercion and opposed to the patient's expressed will, under the protection of the relevant mental health legislation. Electroconvulsive therapy (ECT) is perhaps the archetypal controversial treatment; although it is considered to be effective, the research supporting it is much less impressive than one would expect. The prescription of stimulant drugs for childhood attention-deficit hyperactivity disorder (ADHD) and substitution therapy (such as methadone maintenance) in addictions treatment remain topical and appear to be subject to political interference. ‘Treatment’ for homosexuality and psychosurgery were common in the past but are now rare. These issues are discussed to give insight into how once common controversial treatments can decline and become obsolete. However, seclusion and covert medication remain in practice and are highly scrutinised.Learning Objectives• Recognise that many controversial treatments, such as psychosurgery, have been superseded by psychotropic drugs used since the 1950s• Be aware of the limitations of evidence supporting controversial treatments, such as stimulants for childhood ADHD and ECT for depression in adults• Be aware that controversial treatments are highly emotive and may be viewed negatively by the public or politicians, despite evidence for their safety and effectiveness
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Mache, Stefanie, Monika Bernburg, David Groneberg, and Volker Harth. "Neuro-enhancement among German junior physicians: Prevalence, reasons and associations to mental health outcomes and quality of life." Work 67, no. 2 (November 9, 2020): 285–93. http://dx.doi.org/10.3233/wor-203279.
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BACKGROUND: Previous research studies have demonstrated that neuro-enhancement, the use of legal or illegal drugs by healthy individuals to improve their job performance, is practiced among employees. Researchers discussed possible reasons for employees to consider the use of substances for neuro-enhancement. OBJECTIVE: The aim of this study was to identify the prevalence of usage and motives for practicing neuro-enhancement among a sample of German junior physicians. The secondary objective was to determine associations between neuro-enhancement, mental health outcomes and quality of life. METHODS: This cross-sectional study included an online survey to analyze junior physicians’ neuro-enhancement stimulant use and their motives for usage (n = 873). Second, mental health outcomes and quality of life were assessed. Descriptive and analytic (Kruskal Wallis test, logistic regression) statistics were obtained. RESULTS: Of the 873 junior physicians, 18% reported having used stimulants for neuro- enhancement. 8% of the physicians have taken prescription stimulants (e.g. modafinil) or illicit drugs (e.g. cannabis) at least once in their lifetime. The most common reasons for taking stimulants were to enhance concentration, to relax and to increase alertness. Neuro-enhancement was associated with emotional exhaustion (p < 0.01), lower quality of life (p < 0.05) and work-related stress (p < 0.01). CONCLUSIONS: Our study results give an overview on the actual situation regarding frequency and motives for taking performance-enhancing substances. The prevalence rate was low in comparison to current public debates. Decreasing the prevalence of neuro-enhancement among physicians requires the implementation of strategies targeting stress reduction and workload management.
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Hisham, Idura, and Shazia Shabbir. "A question of information mismatch in the SPC and PIL on the effect of ADHD stimulant medications on tourette's syndrome." BJPsych Open 7, S1 (June 2021): S326. http://dx.doi.org/10.1192/bjo.2021.857.
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AimsTo assess the quality of information provided by pharmaceutical companies to patients and doctors regarding the impact of stimulant medications indicated for the treatment of Attention Deficit Hyperactive Disorder (ADHD) on Tourette's syndrome(TS) and tics in children and its implication on treatment.BackgroundIt is estimated that between 35% to 90% of TS patients also have ADHD. However, there remains a pervasive belief that the use of stimulants to treat ADHD symptoms in children with comorbid tic disorders is contraindicated because of concerns about possible tic exacerbation. Recent studies has disproved this, which is reflected in United Kingdom(UK) and European ADHD and TS guidelines. Pharmaceutical companies are legally required to provide a Summary of Product Characteristic (SPC) and Patient Information Leaflet (PIL) for each medicine as it is an integral part of the marketing authorisation approval. The SPC contains vital information for the usage and prescription of a drug for use by healthcare professionals. The PIL included in the medication packaging is a patient-friendly version of the SPC.MethodThe available stimulant medications licenced for use in paediatric patients with ADHD in the UK were identified through the Medicines & Healthcare products regulatory Agency (MHRA) website. The SPC and PIL were then accessed from the Electronic Medicines Compendium (EMC) website. Those not on the site were obtained directly from the marketing authorisation holder. Any direct mention of tics or Tourette's in the contraindication, warning and caution, or side effect section were documented. The information was then tabulated and compared.ResultOf the three stimulant drug types, 17 variations are currently available for use in the UK. There were inconsistencies found between the SPC and PIC in reference to the impact of these drugs on tics and TS in all 17 licensed medication. Most discrepancy was found in regard to TS as a side effect (16/17) and also tics (15/17). TS is also listed as a contraindication in the SPC and PIL for all available variety of Dexamphetamine class drugs. This is inconsistent with current clinical evidence and guidelines.ConclusionThe disparities in information regarding the impact of stimulant medications on tics and TS can have wide ranging effects. Outcomes could include poor patient adherence, or prevention of initiation of potentially beneficial treatment. It would benefit to standardize the information between these two documents to minimize inconsistencies in understanding between doctor and patient.
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Schifano, Fabrizio, Stefania Chiappini, John Corkery, and Amira Guirguis. "Abuse of Prescription Drugs in the Context of Novel Psychoactive Substances (NPS): A Systematic Review." Brain Sciences 8, no. 4 (April 22, 2018): 73. http://dx.doi.org/10.3390/brainsci8040073.
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Recently, a range of prescription and over-the-counter drugs have been reportedly used as Novel Psychoactive Substances (NPS), due to their potential for abuse resulting from their high dosage/idiosyncratic methods of self-administration. This paper provides a systematic review of the topic, focusing on a range of medications which have emerged as being used recreationally, either on their own or in combination with NPS. Among gabapentinoids, pregabalin may present with higher addictive liability levels than gabapentin, with pregabalin being mostly identified in the context of opioid, polydrug intake. For antidepressants, their dopaminergic, stimulant-like, bupropion activities may explain their recreational value and diversion from the therapeutic intended use. In some vulnerable clients, a high dosage of venlafaxine (‘baby ecstasy’) is ingested for recreational purposes, whilst the occurrence of a clinically-relevant withdrawal syndrome may be a significant issue for all venlafaxine-treated patients. Considering second generation antipsychotics, olanzapine appears to be ingested at very large dosages as an ‘ideal trip terminator’, whilst the immediate-release quetiapine formulation may possess proper abuse liability levels. Within the image- and performance- enhancing drugs (IPEDs) group, the beta-2 agonist clenbuterol (‘size zero pill’) is reported to be self-administered for aggressive slimming purposes. Finally, high/very high dosage ingestion of the antidiarrhoeal loperamide has shown recent increasing levels of popularity due to its central recreational, anti-withdrawal, opiatergic effects. The emerging abuse of prescription drugs within the context of a rapidly modifying drug scenario represents a challenge for psychiatry, public health and drug-control policies.
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Panther, Shannon G., Alice M. Knotts, Tamara Odom-Maryon, Kenneth Daratha, Teri Woo, and Tracy A. Klein. "Off-label Prescribing Trends for ADHD Medications in Very Young Children." Journal of Pediatric Pharmacology and Therapeutics 22, no. 6 (December 1, 2017): 423–29. http://dx.doi.org/10.5863/1551-6776-22.6.423.
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OBJECTIVE This study examines off-label medication prescribing use and trends in children on Medicaid with ADHD with particular focus on the very young (under age 6 years). METHODS This was an observational cohort study and retrospective analysis of ADHD medication prescriptions from Oregon Medicaid records (N = 83,190) in 2012. Manufacturer prescribing information was used to determine off-label designation. Children ages 3 to 18 years at the time of prescription who had continuous Medicaid enrollment of at least 10 months during the index year of 2012 were included in the sample frame. RESULTS Children with ADHD were prescribed off-label medications primarily at the ages of 5 years and younger. Among children ages 3 to 5 years, 91.4% of prescriptions were off-label. After the age of 5 years, the percentage of off-label prescriptions dropped notably to 21%, reflecting the increase in availability of approved medications for the treatment of ADHD starting at age 6 years. In the 3- to 5-year-old age group, specific off-label and concerning medication-related observations included a high frequency of alpha agonist (e.g., guanfacine, clonidine) prescribing; the prescribing of untested formulations such as clonidine patches; prescribing of atomoxetine; and prescribing of large doses of stimulant medications. CONCLUSIONS Most ADHD drugs prescribed for very young children are off-label, which is concerning owing to lack of safety and efficacy data in this vulnerable population.
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Sattler, Sebastian, Guido Mehlkop, Vanessa Bahr, and Cornelia Betsch. "Why Parents Misuse Prescription Drugs to Enhance the Cognitive Performance of Healthy Children: The Influence of Peers and Social Media." Journal of Drug Issues 51, no. 3 (February 25, 2021): 461–82. http://dx.doi.org/10.1177/0022042621994547.
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The mechanisms affecting parents’ misuse of prescription stimulant drugs to boost healthy children’s school performance are hardly unknown. Using four web-based factorial vignette surveys (2×2 between-subjects design experiment), we investigated the willingness of U.S. parents with school-aged children to medicate a fictitious 13-year-old child whose grades had declined. We examined mechanisms of informational and normative social influence on their decision-making: others’ behavior ( NExperiment 1 = 359), others’ definitions ( NExperiment 2 = 326), social control ( NExperiment 3 = 325), and others’ experience ( NExperiment 4 = 313). In addition, we explored the moderating role of influential sources (close friends vs. social media). Parents were more willing to engage in said behavior when others reported engagement in this behavior or positive drug experiences, especially if both influences were transmitted via social media. Others’ definitions and social control had no effect. Thus, social media might be a channel for the prevention of pharmacological cognitive enhancement.
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Schoedel, Kerri A., Carine Kolly, Anne Gardin, Srikanth Neelakantham, and Kasra Shakeri-Nejad. "Abuse and dependence potential of sphingosine-1-phosphate (S1P) receptor modulators used in the treatment of multiple sclerosis: a review of literature and public data." Psychopharmacology 239, no. 1 (November 13, 2021): 1–13. http://dx.doi.org/10.1007/s00213-021-06011-6.
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AbstractAbuse and misuse of prescription drugs remains an ongoing concern in the USA and worldwide; thus, all centrally active new drugs must be assessed for abuse and dependence potential. Sphingosine-1-phosphate (S1P) receptor modulators are used primarily in the treatment of multiple sclerosis. Among the new S1P receptor modulators, siponimod, ozanimod, and ponesimod have recently been approved in the USA, European Union (EU), and other countries. This review of literature and other public data has been undertaken to assess the potential for abuse of S1P receptor modulators, including ozanimod, siponimod, ponesimod, and fingolimod, as well as several similar compounds in development. The S1P receptor modulators have not shown chemical or pharmacological similarity to known drugs of abuse; have not shown abuse or dependence potential in animal models for subjective effects, reinforcement, or physical dependence; and do not have adverse event profiles demonstrating effects of interest to individuals who abuse drugs (such as sedative, stimulant, mood-elevating, or hallucinogenic effects). In addition, no reports of actual abuse, misuse, or dependence were identified in the scientific literature for fingolimod, which has been on the market since 2010 (USA) and 2011 (EU). Overall, the data suggest that S1P receptor modulators are not associated with significant potential for abuse or dependence, consistent with their unscheduled status in the USA and internationally.
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Berro, L. F., and J. K. Rowlett. "0151 The Dual Orexin Receptor Antagonist Almorexant Blocks the Sleep-Disrupting Effects of Methamphetamine in Male Rhesus Monkeys." Sleep 43, Supplement_1 (April 2020): A59—A60. http://dx.doi.org/10.1093/sleep/zsaa056.149.
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Abstract Introduction Individuals with stimulant use disorder show a high prevalence of sleep problems. In the laboratory, stimulant drugs have been shown to affect sleep parameters in human and nonhuman primates, even when administered many hours before bedtime. Although the mechanisms underlying the relationship between stimulant use/abuse and sleep impairment remain unclear, recent research has implicated the orexin (also called “hypocretin”) system as a critical regulator of sleep-wake states. The aim of the present study was to investigate the effects of the dual orexin receptor antagonist (DORA) almorexant on the sleep-disrupting effects of methamphetamine in rhesus monkeys. Methods Male adult rhesus monkeys (Macaca mulatta, n=4) were fitted with primate collars to which Actiwatch monitors were attached. Actigraphy recording was conducted during baseline conditions and on the night after acute morning (9h) administration of vehicle or methamphetamine (0.03, 0.1 or 0.3 mg/kg, i.m.). During a second set of treatments, vehicle or almorexant (1, 3 or 10 mg/kg, i.m.) were administered in the evening (16:30h, 1.5h before “lights off”) following morning (9h) administration of methamphetamine (0.3 mg/kg, i.m.). Results Morning methamphetamine administration dose-dependently impaired sleep in rhesus monkeys, with the dose of 0.3 mg/kg significantly increasing sleep latency and decreasing sleep efficiency. Evening administration of almorexant improved both actigraphy-based sleep measures after morning administration of methamphetamine in a dose dependent manner. Conclusion Our findings indicate that orexin receptor systems are involved in methamphetamine-induced sleep disruption. The exact role of the two orexin receptors in this effect, alone or together, remains to be determined. This study suggests that DORAs can be effective in treating sleep impairment in individuals with methamphetamine use disorder or under stimulant prescription for other sleep and psychiatric disorders. Support Supported by UMMC Research Enhancement Funds.
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Bobadilla, Vanessa, Fabian-Xosé Fernandez, Andrew Tubbs, Subhajit Chakravorty, Michael Perlis, Lauren Hale, Charles Branas, William Killgore, Chloe Wills, and Michael Grandner. "0689 Sedative and Stimulant Misuse and Suicide Ideation in a Community Sample." Sleep 45, Supplement_1 (May 25, 2022): A301—A302. http://dx.doi.org/10.1093/sleep/zsac079.685.
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Abstract Introduction Previous studies have shown that prescription sleep medications are associated with suicide ideation. In this study we seek to identify the risk of off-label or illicit use of sedatives/hypnotics to predict suicidal ideation. Methods Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) Study, including N=1,003 working-age adults. For the present study, the data on off-label or illicit stimulants and sedatives were examined. Suicide ideation was assessed by whether participant reported any ideation in the past 2 weeks (PHQ, Item #9). Covariates included age, sex, education, race/ethnicity, and smoking. Additional models included adjustment for insomnia severity (ISI), daytime sleepiness (ESS), sleep duration (NHANES), psychiatric health (PHQ4), and general stress (PSS). Results In adjusted models examining sedatives/hypnotic use, higher likelihood of suicidal ideation was associated with any use (OR=1.77, 95%CI[1.26,2.47]), recent use (OR=2.71, 95%CI[1.77,4.15]), desire to use (OR=2.14, 95%CI[2.74,6.26]),problematic use (OR=7.39, 95%CI[3.32,16.47]), role limitations (OR=7.94, 95%CI[3.39,18.59]), others expressing concern (OR=4.38, 95%CI([2.29,8.41]), and inability to control use (OR=7.15, 95%CI[3.60,14.20]). Similarly, models examining stimulant use showed that higher likelihood of suicide ideation was associated with history of use (OR=1.81, 95%CI[2.01,3.93]), recent use (OR=4.44, 95%CI[2.63,7.49]), desire to use (4.82, 95%CI[2.78,8.34]), problematic use (OR=17.04, 95%CI[5.67,51.24]), role limitations (OR=9.07, 95%CI[3.47,23.68]), others expressing concern (OR=17.26, 95%CI([7.48,39.84]), and inability to control use (OR=6.44, 95%CI[3.26,12.71]). When sleep and mental health variables were added to the model, results were attenuated but remained significant at the p<.05 level. Conclusion Illicit use of substances that both promote sleep or arousal are associated with suicidal ideation, over and above contributions of sleep disturbance and mood/stress. It is possible that these behaviors represent self-medication attempts or an adverse effect of these drugs. Further research on these problematic associations is recommended. Support (If Any)
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Meyer, Daniel, Pranavi Athota, Austin Gowen, Nghi M. Nguyen, Victoria L. Schaal, Sowmya V. Yelamanchili, and Gurudutt Pendyala. "Effect of Combined Methamphetamine and Oxycodone Use on the Synaptic Proteome in an In Vitro Model of Polysubstance Use." Genes 13, no. 10 (October 8, 2022): 1816. http://dx.doi.org/10.3390/genes13101816.
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Polysubstance use (PSU) generally involves the simultaneous use of an opioid along with a stimulant. In recent years, this problem has escalated into a nationwide epidemic. Understanding the mechanisms and effects underlying the interaction between these drugs is essential for the development of treatments for those suffering from addiction. Currently, the effect of PSU on synapses—critical points of contact between neurons—remains poorly understood. Using an in vitro model of primary neurons, we examined the combined effects of the psychostimulant methamphetamine (METH) and the prescription opioid oxycodone (oxy) on the synaptic proteome using quantitative mass-spectrometry-based proteomics. A further ClueGO analysis and Ingenuity Pathway Analysis (IPA) indicated the dysregulation of several molecular functions, biological processes, and pathways associated with neural plasticity and structural development. We identified one key synaptic protein, Striatin-1, which plays a vital role in many of these processes and functions, to be downregulated following METH+oxy treatment. This downregulation of Striatin-1 was further validated by Western blot. Overall, the present study indicates several damaging effects of the combined use of METH and oxy on neural function and warrants further detailed investigation into mechanisms contributing to synaptic dysfunction.
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Quintana-Mathé, P., M. Grifell-Guàrdia, Á. Palma, I. Fornís-Espinosa, C. Gil-Lladanosa, F. Caudevilla-Galligo, L. Galindo-Guarin, M. Farré-Albaladejo, M. Torrens-Melich, and M. Ventura-Vilamala. "Is methylphenidate a prescription drug being sold in the illegal market? Analysis of samples submitted to a drug checking facility." European Psychiatry 33, S1 (March 2016): S313. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1069.
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IntroductionMethylphenidate is a CNS stimulant approved for treatment of ADHD. It is generally considered well tolerated and exhibiting low dependence potential, although diversion for recreational use has been described. Provided that its effects are comparable to those of more popular drugs of abuse, such as cocaine and amphetamines, we hypothesized that it could be sold as such.ObjectiveThe aim of this study was:– to describe the presence of methylphenidate from the samples handled to, and analyzed by, Spanish harm-reduction service energy control between August 2009 and August 2015;– to determine whether it is being sold as other drugs.Materials and methodsAll samples presented to energy control (EC) were analyzed. EC is a Spanish harm-reduction non-governmental organization that offers to users the possibility of analyzing the substances they intend to consume.Samples in which methylphenidate was detected using Gas Chromatography–Mass Spectrometry were selected for this study.ResultsFrom a total of 20062 samples, 17 contained methylphenidate (0,09%), with no clear variations among the years studied. The samples were mostly sold as amphetamine (29%), methylphenidate (23%) and ethylphenidate (18%).ConclusionPresence of Methylphenidate in the Spanish illegal drug market seems anecdotic and stable over the studied timeframe. Moreover, it was sold as substances with similar dosages, lowering potential for life-threatening intoxications. Therefore, our results suggest that diversion of methylphenidate into the drug market as adulterant is not a concerning phenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Santacroce, R., C. Ruiz Bennasar, J. R. Sancho Jaraiz, C. Montemitro, G. Baroni, M. Corbo, A. Pasquini, et al. "Party Hard: Drug-related Fatalities in Ibiza from 2010 to 2016." European Psychiatry 41, S1 (April 2017): S79—S80. http://dx.doi.org/10.1016/j.eurpsy.2017.01.252.
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IntroductionIllicit drug use is well known as an important contributor to the global burden of diseases, but the physical and psychopathological risks of recreational drugs misuse are often underestimated and drug-related fatalities in specific settings are under-investigated.Objectives and methodsIn the framework of the EU-funded project “EU-Madness”, we collected and analysed all the reports of drug-related fatalities in Ibiza from January 2010 to September 2016, with the aim of characterising the sample, and identifying the involved substances and the nature of deaths associated with their consumption.ResultsOverall, 58 drug-related fatalities were registered from 2010 to September 2016 (87.9% males, 12.1% females, mean age 33.16; females were significantly younger than males). Most of the deceased were Britons (36.2%), followed by Spanish (22.4%), Italians (6.9%) and Germans (5.2%). In half the cases, the substance identified in post-mortem analyses was a stimulant; in 24.1% of the sample it was a depressor a prescription drug or more than two substances in 22.4%. Most of the fatalities were due to cardiovascular accidents (62%); 22.4% were deaths by drowning, 12% by fall from heights and 3.4% were due to mechanical asphyxia.ConclusionsAccording to the results from our sample, stimulants (mainly MDMA and cocaine) are the substances of abuse involved in most drug-caused fatalities. The number of fatalities per year has been steadily increasing, but the growing diffusion of novel psychoactive substances (NPS) does not seem to be a direct cause (although better methods of their analysis in post-mortem samples should be designed).Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Clement, Jeffrey, Maura Jacobi, and Brad N. Greenwood. "Patient access to chronic medications during the Covid-19 pandemic: Evidence from a comprehensive dataset of US insurance claims." PLOS ONE 16, no. 4 (April 1, 2021): e0249453. http://dx.doi.org/10.1371/journal.pone.0249453.
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Patient access and adherence to chronic medications is critical. In this work, we evaluate whether disruptions related to Covid-19 have affected new and existing patients’ access to pharmacological therapies without interruption. We do so by performing a retrospective analysis on a dataset of 9.4 billion US prescription drug claims from 252 million patients from May, 2019 through August, 2020 (about 93% of prescriptions dispensed within those months). Using fixed effect (conditional likelihood) linear models, we evaluate continuity of care, how many days of supply patients received, and the likelihood of discontinuing therapy for drugs from classes with significant population health impacts. Findings indicate that more prescriptions were filled in March 2020 than in any prior month, followed by a significant drop in monthly dispensing. Compared to the pre-Covid era, a patient’s likelihood of discontinuing some medications increased after the spread of Covid: norgestrel-ethinyl estradiol (hormonal contraceptive) discontinuation increased 0.62% (95% CI: 0.59% to 0.65%, p<0.001); dexmethylphenidate HCL (ADHD stimulant treatment) discontinuation increased 2.84% (95% CI: 2.79% to 2.89%, p<0.001); escitalopram oxalate (SSRI antidepressant) discontinuation increased 0.57% (95% CI: 0.561% to 0.578%, p<0.001); and haloperidol (antipsychotic) discontinuation increased 1.49% (95% CI: 1.41% to 1.57%, p<0.001). In contrast, the likelihood of discontinuing tacrolimus (immunosuppressant) decreased 0.15% (95% CI: 0.12% to 0.19%, p<0.001). The likelihood of discontinuing buprenorphine/naloxone (opioid addiction therapy) decreased 0.59% (95% CI: 0.55% to 0.62% decrease, p<0.001). We also observe a notable decline in new patients accessing these latter two therapies. Most US patients were able to access chronic medications during the early months of Covid-19, but still were more likely to discontinue their therapies than in previous months. Further, fewer than normal new patients started taking medications that may be vital to their care. Providers would do well to inquire about adherence and provide prompt, nonjudgmental, re-initiation of medications. From a policy perspective, opioid management programs seem to demonstrate a robust ability to manage existing patients in spite of disruption.
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Ilyas, Stephen, and Joanna Moncrieff. "Trends in prescriptions and costs of drugs for mental disorders in England, 1998–2010." British Journal of Psychiatry 200, no. 5 (May 2012): 393–98. http://dx.doi.org/10.1192/bjp.bp.111.104257.
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BackgroundIncreasing rates of prescriptions for antidepressants, antipsychotics and stimulants have been reported from various countries.AimsTo examine trends in prescriptions and the costs of all classes of psychiatric medication in England.MethodData from the Prescription Cost Analysis 1998–2010 was examined, using linear regression analysis to examine trends.ResultsPrescriptions of drugs used for mental disorders increased by 6.8% (95% CI 6.3–7.4) per year on average, in line with other drugs, but made up an increasing proportion of all prescription drug costs (P = 0.001). There were rising trends in prescriptions of all classes of psychiatric drugs, except anxiolytics and hypnotics (which did not change). Antidepressant prescriptions increased by 10% (95% CI 9.0–11) per year on average, and antipsychotics by 5.1% (95% CI 4.3–5.9). Antipsychotics overtook antidepressants as the most costly class of psychiatric medication, with costs rising 22% (95% CI 17–27) per year.ConclusionsRising prescriptions may be partly explained by longer-term treatment and increasing population. Nevertheless, it appears that psychiatric drugs make an increasing contribution to total prescription drug costs, with antipsychotics becoming the most costly. Low-dose prescribing of some antipsychotics is consistent with other evidence that their use may not be restricted to those with severe mental illness.
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McNeil, Ryan, Taylor Fleming, Samara Mayer, Allison Barker, Manal Mansoor, Alex Betsos, Tamar Austin, Sylvia Parusel, Andrew Ivsins, and Jade Boyd. "Implementation of Safe Supply Alternatives During Intersecting COVID-19 and Overdose Health Emergencies in British Columbia, Canada, 2021." American Journal of Public Health 112, S2 (April 2022): S151—S158. http://dx.doi.org/10.2105/ajph.2021.306692.
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Objectives. To explore the implementation and effectiveness of the British Columbia, Canada, risk mitigation guidelines among people who use drugs, focusing on how experiences with the illicit drug supply shaped motivations to seek prescription alternatives and the subsequent impacts on overdose vulnerability. Methods. From February to July 2021, we conducted qualitative interviews with 40 people who use drugs in British Columbia, Canada, and who accessed prescription opioids or stimulants under the risk mitigation guidelines. Results. COVID-19 disrupted British Columbia’s illicit drug market. Concerns about overdose because of drug supply changes, and deepening socioeconomic marginalization, motivated participants to access no-cost prescription alternatives. Reliable access to prescription alternatives addressed overdose vulnerability by reducing engagement with the illicit drug market while allowing greater agency over drug use. Because prescriptions were primarily intended to manage withdrawal, participants supplemented with illicit drugs to experience enjoyment and manage pain. Conclusions. Providing prescription alternatives to illicit drugs is a critical harm reduction approach that reduces exposure to an increasingly toxic drug supply, yet further optimizations are needed. (Am J Public Health. 2022;112(S2):S151–S158. https://doi.org/10.2105/AJPH.2021.306692 )
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Wilczek-Rużyczka, Ewa, Celestyna Grzywniak, Maciej Korab, and Ksenia Cielebąk. "ERPS AS AN INDEX OF IMPAIRED WORKING MEMORY IN AN ISCHEMIC BRAIN STROKE APHASIC PATIENT AWAKENED FROM A LONG-TERM COMA FOLLOWING AN AMPHETAMINE OVERDOSE." Acta Neuropsychologica 19, no. 2 (March 14, 2021): 137–45. http://dx.doi.org/10.5604/01.3001.0014.8032.
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Nowadays, amphetamines constitute the prescription drugs most commonly abused by adolescents and young adults (Berman, O’Neill, Fears et al. 2008). The prevalence of problematic (mainly illegal) use of amphetamines as a stimulant by college students, and here especially before serious examinations, has also been rising. This fact represents a serious public health concern. The patient, aged 19, was awakened from from a long-term coma that had lasted 21 days following an amphetamine overdose and manifested tetraparesis, cortical blindness and deficits in cognitive and emotional processes. After a year of rehabilitation the majority of symptoms had disappeared, but cortical blindness andworking memory deficits remained. In addition, frontal lobe syndrome symptoms appeared. After two years of therapy as a result of immense tiredness caused by all an night wedding reception she started to manifest Charles-Bonnet syndrome. She experienced strange visual sensations such as visual hallucinations and saw various non-existing shapes (coloured blots, patterns and fireworks of vivid colours). She also saw objects (often terrifying) as well as animals (mainly African) and people with deformed faces and long teeth, and persons in African dress with feathers and coral beads in their hair. Her real identity was not remembered by the patient for longer than 2 hours and even then she insisted on being referred to as Shakira. She was given a qEEG examination (in open and closed eyes conditions) and ERPs with the use of auditory stimuli at the period when the hallucinations (to a small degree) still occurred. Studies conducted into the functional neuroimaging of the brain work in milliseconds in the examined patient can explain her symptoms. A comparison of the subject’s ERPs with the grand average of ERPs in healthy controls shows that the N170 and N 250 components are impaired in the subject: the occipital-temporal area of the subject brain shows a strong positivity instead of negativities. This positivity might reflect an enhanced reactivity of neurons in the corresponding area induced by the removal of lateral inhibition from the neurons as a result of local damage. ------------------------------------------------------------------------------------------------------------------------------------
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Maier, Larissa J., and Michael P. Schaub. "The Use of Prescription Drugs and Drugs of Abuse for Neuroenhancement in Europe." European Psychologist 20, no. 3 (July 2015): 155–66. http://dx.doi.org/10.1027/1016-9040/a000228.
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Abstract. Pharmacological neuroenhancement, defined as the misuse of prescription drugs, illicit drugs, or alcohol for the purpose of enhancing cognition, mood, or prosocial behavior, is not widespread in Europe – nevertheless, it does occur. Thus far, no drug has been proven as safe and effective for cognitive enhancement in otherwise healthy individuals. European studies have investigated the misuse of prescription and illicit stimulants to increase cognitive performance as well as the use of tranquilizers, alcohol, and cannabis to cope with stress related to work or education. Young people in educational settings report pharmacological neuroenhancement more frequently than those in other settings. Although the regular use of drugs for neuroenhancement is not common in Europe, the irregular and low-dose usage of neuroenhancers might cause adverse reactions. Previous studies have revealed that obtaining adequate amounts of sleep and using successful learning techniques effectively improve mental performance, whereas pharmacological neuroenhancement is associated with ambiguous effects. Therefore, non-substance-related alternatives should be promoted to cope with stressful situations. This paper reviews the recent research on pharmacological neuroenhancement in Europe, develops a clear definition of the substances used, and formulates recommendations for practitioners regarding how to react to requests for neuroenhancement drug prescriptions. We conclude that monitoring the future development of pharmacological neuroenhancement in Europe is important to provide effective preventive measures when required. Furthermore, substance use to cope with stress related to work or education should be studied in depth because it is likely more prevalent and dangerous than direct neuroenhancement.
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Manchikanti, Laxmaiah. "National Drug Control Policy and Prescription Drug Abuse: Facts and Fallacies." Pain Physician 3;10, no. 5;3 (May 14, 2007): 399–424. http://dx.doi.org/10.36076/ppj.2007/10/399.
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In a recent press release Joseph A. Califano, Jr., Chairman and President of the National Center on Addiction and Substance Abuse at Columbia University called for a major shift in American attitudes about substance abuse and addiction and a top to bottom overhaul in the nation’s healthcare, criminal justice, social service, and eduction systems to curtail the rise in illegal drug use and other substance abuse. Califano, in 2005, also noted that while America has been congratulating itself on curbing increases in alcohol and illicit drug use and in the decline in teen smoking, abuse and addition of controlled prescription drugs-opioids, central nervous system depressants and stimulants-have been stealthily, but sharply rising. All the statistics continue to show that prescription drug abuse is escalating with increasing emergency department visits and unintentional deaths due to prescription controlled substances. While the problem of drug prescriptions for controlled substances continues to soar, so are the arguments of undertreatment of pain. The present state of affairs show that there were 6.4 million or 2.6% Americans using prescription-type psychotherapeutic drugs nonmedically in the past month. Of these, 4.7 million used pain relievers. Current nonmedical use of prescription-type drugs among young adults aged 18-25 increased from 5.4% in 2002 to 6.3% in 2005. The past year, nonmedical use of psychotherapeutic drugs has increased to 6.2% in the population of 12 years or older with 15.172 million persons, second only to marijuana use and three times the use of cocaine. Parallel to opioid supply and nonmedical prescription drug use, the epidemic of medical drug use is also escalating with Americans using 80% of world’s supply of all opioids and 99% of hydrocodone. Opioids are used extensively despite a lack of evidence of their effectiveness in improving pain or functional status with potential side effects of hyperalgesia, negative hormonal and immune effects, addiction and abuse. The multiple reasons for continued escalation of prescription drug abuse and overuse are lack of education among all segments including physicians, pharmacists, and the public; ineffective and incoherent prescription monitoring programs with lack of funding for a national prescription monitoring program NASPER; and a reactive approach on behalf of numerous agencies. This review focuses on the problem of prescription drug abuse with a discussion of facts and fallacies, along with proposed solutions. Key words: Prescription drug abuse, opioid abuse, opioid misuse, National Drug Control Policy, NASPER, prescription drug monitoring programs.
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Dahlman, Disa, Tove Abrahamsson, Alex H. Kral, and Anders Hakansson. "Nonmedical Use of Antihistaminergic Anxiolytics and Other Prescription Drugs among Persons with Opioid Dependence." Journal of Addiction 2016 (2016): 1–11. http://dx.doi.org/10.1155/2016/9298571.
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Background. Nonmedical prescription drug use (NMPDU) is an increasing problem, insufficiently studied among people in opioid maintenance treatment (OMT). This study investigates the prevalence of and factors associated with NMPDU for drug classes insufficiently described in opioid-dependent populations, including antihistaminergic anxiolytics and central stimulants.Methods. Study participants were recruited at two OMT clinics in Malmo, Sweden, between October 2014 and December 2015 (N=73) and interviewed about their use, motivations for use, and acquisition and administration of prescription drugs.Results. The majority of the sample reported lifetime NMPDU: 60% for benzodiazepine-like hypnotics (z-drugs), 21% for pregabalin, 19% for stimulants, and 12%–15% for antihistaminergic anxiolytics. Lower age was associated with nonmedical benzodiazepine use (Adjusted Odds Ratio = 0.89; 95% Confidence Interval = 0.82–0.97). Illicit acquisition was reported by 61% of people using z-drugs, 46% of people using pregabalin, and 38% of people using prescription stimulants, but only by 6–10% of people using antihistaminergic anxiolytics.Conclusions. The substantial nonmedical use of pregabalin, z-drugs, and prescription stimulants found in this study suggests that clinicians should prescribe these drugs with great caution. Nonmedical use of antihistaminergic anxiolytics does not seem to be a clinical issue among people in OMT in a Swedish setting, but we propose future studies to monitor their use.
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Serdarevic, Mirsada, Vicki Osborne, Amy Elliott, Catherine W. Striley, and Linda B. Cottler. "If kids ruled the world, how would they stop the non-medical use of prescription drugs?" Journal of Health Research 34, no. 4 (February 13, 2020): 283–94. http://dx.doi.org/10.1108/jhr-02-2019-0031.
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PurposeThis study examined how youth would mitigate non-medical use of prescription medication among their peers.Design/methodology/approachThe National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) was conducted as an interview comprising 11,048 youth of 10–18 years of age between 2008 and 2011 from entertainment venues of 10 US urban, suburban, and rural areas. Using a mixed-methods approach, participants completed a survey culminating in open-ended questions asking: (1) How should kids your age be informed about prescription drugs and their effects? (2) If you ran the world, how would you stop kids from taking other people’s prescription medicines? (3) Why do people use prescription stimulants without a prescription? Responses from a random sample of 900 children were analyzed using qualitative thematic analyses.FindingsThe random sample of 900 youth (52 percent female, 40 percent white, with a mean age of 15.1 years) believed they should be educated about prescription drugs and their negative effects at schools, at home by parents, through the media, and health professionals. Youth would stop kids from using other people’s prescription drugs through more stringent laws that restricted use, and providing education about negative consequences of use. Peer pressure was the most common reason the youth gave for using other’s pills, though some reported taking them out of curiosity.Originality/valueThe importance of considering youth’s opinions on non-medical use of prescription medications is often overlooked. This evidence, from a peer perspective, could end the illicit use of prescription drugs among today’s youth.
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Worley, Julie, and Joanne M. Hall. "Doctor Shopping: A Concept Analysis." Research and Theory for Nursing Practice 26, no. 4 (2012): 262–78. http://dx.doi.org/10.1891/1541-6577.26.4.262.
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Prescription drug abuse is a significant problem in the United States that poses a serious health risk to Americans and is therefore significant to the field of nursing. The prescription drugs that are designated in the United States as having abuse potential are called controlled or scheduled drugs. The most common types of abused prescription drugs are benzodiazepines prescribed for anxiety, opioids prescribed for pain, and stimulants prescribed for attention deficit disorder. These prescription drugs are abused by taking larger doses than prescribed for nonmedical use to achieve a high or euphoric feeling, or are sold illicitly for profit. In 2009, there were 2.4 million nonmedical users of prescription opioids in the United States. These prescription drugs are often obtained by seeing multiple prescribers, often under false pretenses or with complicity from the prescribers that leads to abuse and illicit sales. The term doctor shopping has been used not only to refer to this phenomenon but has also had other meanings throughout the past decades. Thus, concept analysis is the focus of this article for clarification using the Walker and Avant method. Health implications and suggestions for minimizing doctor shopping are included.
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Kaloyanides, Kristy B., Sean E. McCabe, James A. Cranford, and Christian J. Teter. "Prevalence of Illicit Use and Abuse of Prescription Stimulants, Alcohol, and Other Drugs Among College Students: Relationship with Age at Initiation of Prescription Stimulants." Pharmacotherapy 27, no. 5 (May 2007): 666–74. http://dx.doi.org/10.1592/phco.27.5.666.
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Frances, Richard J. "Prevalence of Illicit Use and Abuse of Prescription Stimulants, Alcohol, and Other Drugs Among College Students: Relationship with Age at Initiation of Prescription Stimulants." Yearbook of Psychiatry and Applied Mental Health 2008 (January 2008): 87–88. http://dx.doi.org/10.1016/s0084-3970(08)70679-0.
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Volqvartz, Tabia, Anna Louise Vestergaard, Sissel K. Aagaard, Mette F. Andreasen, Iana Lesnikova, Niels Uldbjerg, Agnete Larsen, and Pinar Bor. "Use of stimulants, over‐the‐counter and prescription drugs among Danish pregnant women." Basic & Clinical Pharmacology & Toxicology 127, no. 3 (March 10, 2020): 205–10. http://dx.doi.org/10.1111/bcpt.13396.
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Baggio, Stéphanie, Joseph Studer, Meichun Mohler-Kuo, Jean-Bernard Daeppen, and Gerhard Gmel. "Non-medical prescription drug and illicit street drug use among young Swiss men and associated mental health issues." International Journal of Adolescent Medicine and Health 26, no. 4 (November 1, 2014): 525–30. http://dx.doi.org/10.1515/ijamh-2013-0330.
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Abstract Non-medical use of prescription drugs (NMUPD) is increasing among the general population, particularly among teenagers and young adults. Although prescription drugs are considered safer than illicit street drugs, NMUPD can lead to detrimental consequences. The aim of the present study was to investigate the relationship between drug use (NMUPD on the one side, illicit street drugs on the other side) with mental health issues and then compare these associations. A representative sample of 5719 young Swiss men aged around 20 years filled in a questionnaire as part of the ongoing baseline Cohort Study on Substance Use Risk Factors (C-SURF). Drug use (16 illicit street drugs and 5 NMUPDs, including sleeping pills, sedatives, pain killers, antidepressants, stimulants) and mental health issues (depression, SF12) were assessed. Simple and multiple linear regressions were employed. In simple regressions, all illicit and prescription drugs were associated with poorer mental health. In multiple regressions, most of the NMUPDs, except for stimulants, were significantly associated with poorer mental health and with depression. On the contrary, the only associations that remained significant between illicit street drugs and mental health involved cannabis. NMUPD is of growing concern not only because of its increasing occurrence, but also because of its association with depression and mental health problems, which is stronger than the association observed between these problems and illicit street drug use, excepted for cannabis. Therefore, NMUPD must be considered in screening for substance use prevention purposes.
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Ghodse, Hamid. "‘Uppers’ keep going up." British Journal of Psychiatry 191, no. 4 (October 2007): 279–81. http://dx.doi.org/10.1192/bjp.bp.107.035212.
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SummaryAmphetamine-type stimulants are the second most widely used drugs in the world. Over prescription results in diversion for recreational use and the development of dependence. The internet plays a significant role in global misuse of amphetamine-type stimulants, permitting uncontrolled dispensing by online pharmacies and providing information on techniques for illicit manufacture.
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Hoyer, Dennis, and Christopher J. Correia. "Teaching About Nonmedical Use of Prescription Drugs Among College Students." Teaching of Psychology 46, no. 4 (August 30, 2019): 340–49. http://dx.doi.org/10.1177/0098628319872613.
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The misuse of prescription medications has emerged as a national public health concern. Epidemiological studies suggest that college students are at an elevated risk to engage in nonmedical use of several medications, including stimulants and central nervous system depressants. Teachers can easily integrate material related to the nonmedical use of prescription drugs (NMUPD) into undergraduate psychology and statistics courses. Presenting this information provides an opportunity for teachers to address fundamental topics in ways that students tend to find interesting and personally relevant. We use this article to introduce a definition of NMUPD, present statistics on prevalence and a wide range of physical and psychological correlates among college students, and discuss risk and protective factors and motives for use. We also present a number of concrete examples of how teachers can use the material to illustrate basic concepts often included in statistics, research methods, and other psychology courses.
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Xie, Weidong, Yunan Zhao, and Yaou Zhang. "Traditional Chinese Medicines in Treatment of Patients with Type 2 Diabetes Mellitus." Evidence-Based Complementary and Alternative Medicine 2011 (2011): 1–13. http://dx.doi.org/10.1155/2011/726723.
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Type 2 diabetes mellitus (T2DM) occurs in 95% of the diabetic populations. Management of T2DM is a challenge. Traditional Chinese medicines (TCM) are usually served as adjuvants used to improve diabetic syndromes in combination of routine antidiabetic drugs. For single-herb prescriptions, Ginseng, Bitter melon, Golden Thread, Fenugreek, Garlic, and Cinnamon might have antidiabetic effects in T2DM patients. Among 30 antidiabetic formulas approved by the State Food and Drugs Administrator of China, top 10 of the most frequently prescribed herbs are Membranous Milkvetch Root, Rehmannia Root, Mongolian Snakegourd Root, Ginseng, Chinese Magnoliavine Fruit, Kudzuvine Root, Dwarf Lilyturf Tuber, Common Anemarrhena Rhizome, Barbary Wolfberry Fruit, and India Bread, which mainly guided by the theory of TCM. Their action mechanisms are related to improve insulin sensitivity, stimulate insulin secretion, protect pancreatic islets, and even inhibit intake of intestinal carbohydrates. However, it is very difficult to determine antihyperglycemic components of TCM. Nevertheless, TCM are becoming popular complementary and alternative medicine in treatment of syndromes of T2DM. In the future, it requires further validation of phytochemical, pharmacological, and clinical natures of TCM in T2DM in the future studies, especially for those herbs with a high prescription frequency.
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Arria, Amelia M., Kevin E. O'Grady, Kimberly M. Caldeira, Kathryn B. Vincent, and Eric D. Wish. "Nonmedical Use of Prescription Stimulants and Analgesics: Associations with Social and Academic Behaviors among College Students." Journal of Drug Issues 38, no. 4 (October 2008): 1045–60. http://dx.doi.org/10.1177/002204260803800406.
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Nonmedical use of prescription stimulants and analgesics was assessed from personal interviews with a stratified random sample of 1,253 first-year college students ages 17 to 20 attending a large public university (86% response rate). Lifetime and past-year prevalence of nonmedical use of stimulants, analgesics, or both was 19.6%wt and 15.6%wt, respectively. Nonmedical users had significantly lower grade point averages (GPAs) in high school as compared with nonusers; in college they skipped classes more often, spent more time socializing, and spent less time studying. For example, nonmedical users of both stimulants and analgesics skipped 21 % of their college classes whereas nonusers skipped 9%. Controlling for high school GPA and other factors, past-year nonmedical use independently predicted lower college GPA by the end of the first year of college; this effect was partially mediated by skipping more classes. Nonmedical users of prescription drugs comprise a high-risk group for academic problems in college.
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Abd-Elsayed, Alaa. "Prescription Drugs and the US Workforce: Results from a National Safety Council Survey." Pain Physician 1;23, no. 1;1 (January 14, 2020): 1–16. http://dx.doi.org/10.36076/ppj.2020/23/1.
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Background: The cost of chronic pain in the United States is extremely high. Opioids are one of the most common medications prescribed for the treatment of chronic pain, and their misuse and addiction have been of concern. It has been found that opioids are frequently abused and negatively impact the American workforce. Objectives: The objective of this study was to obtain data on US employers’ concerns and priorities, perceptions of prescription drug abuse, perceived impact of prescription drug use on the workplace, identification of and response to drug abuse, perceived ability to handle prescription drug abuse in the workplace, and workplace initiatives, employee assistance programs, employee drug testing, workplace prescription drug training, insurance coverage of alternative treatment, and overall preparedness to deal with the issue. Study Design: This research used an employer proprietary questionnaire created by members of the National Safety Council in cooperation with market research experts at B2B International. Setting: Employers surveyed via an online survey represent diverse industries and geographical areas. Methods: The research was conducted using a proprietary questionnaire. Participants were recruited from a sample of verified panelists through Research Now, and fieldwork was conducted online by B2B International. This report is on 501 interviews that each represent a US employer with 50 or more employees. The employers sampled are extremely diverse in not only size and industry, but also geography and centralization. Results: Our results showed that 67% of employers reported concerns related to prescription drug misuse, which was comparable to workplace violence and more concerning than the use of illegal drugs. Sixty-one percent reported concerns related to prescription opioids, which was a higher concern than using anti-anxiety medications, stimulants, and even heroin. Limitations: Survey study with descriptive analysis with limited sample. Conclusions: Prescription drug misuse and abuse concern American employers. Their side effects are clear, but employers are less likely to acknowledge their detrimental business effect. Employers report being unprepared for dealing with issues related to this; however, the firms with programs in place feel more prepared to deal with misuse and abuse. Key words: Prescription drugs, US workforce, chronic pain
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Watkins, Katherine E., Phyllis L. Ellickson, Mary E. Vaiana, and Scott Hiromoto. "An Update on Adolescent Drug Use: What School Counselors Need to Know." Professional School Counseling 10, no. 2 (December 2006): 2156759X0601000. http://dx.doi.org/10.1177/2156759x0601000214.
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School counselors need to have accurate and age-appropriate prevention education information in order to counsel teens on drug use. This article presents developmentally specific prevention materials for the most important emerging substances of abuse: Ecstasy, methamphetamine, cough and cold medication, prescription opiates and stimulants, and the “date rape” drugs. Because developing appropriate materials requires understanding how adolescents develop, an expert panel approach was used, supplemented with a literature review and teen focus groups.
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McCabe, Sean Esteban, Brady T. West, Ty S. Schepis, and Christian J. Teter. "Simultaneous co-ingestion of prescription stimulants, alcohol and other drugs: a multi-cohort national study of US adolescents." Human Psychopharmacology: Clinical and Experimental 30, no. 1 (November 5, 2014): 42–51. http://dx.doi.org/10.1002/hup.2449.
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