Department of Psychology, Texas State University, San Marcos, Texas (TSS); Peter Lamy Center on Drug Therapy and Aging, and Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland (LW); Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing; Institute for Research on Women and Gender; Institute for Healthcare Policy and Innovation; Center for Human Growth and Development; Institute for Social Research, University of Michigan, Ann Arbor, Michigan (SE).
J Addict Med. 2021;15(3):191-200. doi: 10.1097/ADM.0000000000000736.
Roughly 6.5 million US residents engaged in prescription tranquilizer/sedative (eg, benzodiazepines, Z-drugs) misuse in 2018, but tranquilizer/sedative misuse motives are understudied, with a need for nationally representative data and examinations of motives by age group. Our aims were to establish tranquilizer/sedative misuse motives and correlates of motives by age cohort, and whether motive-age cohort interactions existed by correlate.
Data were from the 2015 to 2018 US National Survey on Drug Use and Health, with 223,520 total respondents (51.5% female); 6580 noted past-year prescription tranquilizer/sedative misuse motives (2.4% overall, 50.3% female). Correlates included substance use (eg, opioid misuse), mental (eg, suicidal ideation) and physical health variables (e.g., inpatient hospitalization). Design-based, weighted cross-tabulations and logistic regression analyses were used, including analyses of age cohort-motive interactions for each correlate.
Prescription tranquilizer/sedative misuse motives varied by age group, with the highest rates of self-treatment only motives (ie, sleep and/or relax) in those 65 and older (82.7%), and the highest rates of any recreational motives in adolescents (12-17 years; 67.5%). Any tranquilizer/sedative misuse was associated with elevated odds of substance use, mental health, and physical health correlates, but recreational misuse was associated with the highest odds. Age-based interactions suggested stronger relationships between tranquilizer/sedative misuse and mental health in adults 50 and older.
Any tranquilizer/sedative misuse signals a need for substance use and mental health screening, with intervention needs most acute in those with any recreational motives. Older adult tranquilizer/sedative misuse may be more driven by undertreated insomnia and anxiety/psychopathology than in younger groups.
2018 年，约有 650 万美国居民滥用处方镇静剂/安定药（如苯二氮卓类药物、Z 类药物），但镇静剂/安定药滥用的动机研究不足，需要有全国代表性的数据，并按年龄组检查这些动机。我们的目的是确定按年龄组划分的镇静剂/安定药滥用动机和相关动机，以及是否存在由相关因素引起的动机与年龄组的相互作用。
数据来自 2015 年至 2018 年美国国家药物使用与健康调查，共有 223520 名总受访者（51.5%为女性）；6580 人提到过去一年有处方镇静剂/安定药滥用的动机（总体占 2.4%，女性占 50.3%）。相关因素包括物质使用（如阿片类药物滥用）、心理健康（如自杀意念）和身体健康变量（如住院治疗）。采用基于设计的加权交叉表和逻辑回归分析，包括对每个相关因素的年龄组-动机相互作用的分析。
处方镇静剂/安定药滥用动机因年龄组而异，在 65 岁及以上人群中，仅自我治疗动机（即睡眠和/或放松）的比例最高（82.7%），而在青少年（12-17 岁）中，任何娱乐性动机的比例最高（67.5%）。任何镇静剂/安定药滥用都与物质使用、心理健康和身体健康相关因素的几率增加有关，但娱乐性滥用与几率增加的关系最高。基于年龄的相互作用表明，在 50 岁及以上的成年人中，镇静剂/安定药滥用与心理健康之间的关系更强。
任何镇静剂/安定药滥用都表明需要进行物质使用和心理健康筛查，在有任何娱乐性动机的人群中，干预需求最为迫切。与年轻群体相比，老年镇静剂/安定药滥用可能更多地是由未经治疗的失眠和焦虑/精神病理学引起的。
