Department of Sociology, University of Central Florida, Orlando, FL United States.
Department of Psychology, Texas State University, San Marcos, TX United States.
Int J Drug Policy. 2021 Feb;88:103017. doi: 10.1016/j.drugpo.2020.103017. Epub 2020 Nov 20.
Most research on prescription drug misuse (PDM) focuses on the misuse of specific classes of psychoactive prescription drugs among adolescents or young adults. The current research addressed important gaps in the literature by assessing poly-prescription drug misuse (poly-PDM), the misuse of more than one class of psychoactive prescription drug, across different adult age cohorts.
We used the 2015-2018 National Survey on Drug Use and Health to examine the prevalence of past-year poly-PDM and specific combinations of PDM. Multinomial logistic regression was used to identify demographic, health-related factors, and substance use behaviors that were significantly associated with poly-PDM.
The prevalence of poly-PDM decreases with age and is common among individuals who engage in PDM. Slightly more than one in four respondents in age cohorts 18-25 (31.66%, 95% CI = 30.35, 33.00) and 26-34 (29.92%, 95% CI = 25.82, 30.12) who engage in PDM, misused more than one class of prescription drug. Additionally, poly-PDM was identified as a high-risk type of PDM as roughly 60% of adults younger than 65 who endorse poly-PDM reported having a substance use disorder (SUD). While certain characteristics (i.e., race/ethnicity, marital status, depression, suicidal ideation, illegal drug use, and SUD) were consistently associated with poly-PDM across age cohorts, other characteristics (i.e., sexual identity, income, and justice involvement) varied across age cohorts. Finally, a comparison of poly-PDM to single PDM showed, in all age cohorts, that having an SUD was associated with an increased likelihood of poly-PDM, while Black adults were less likely than whites to report poly-PDM.
By identifying prevalence and correlates of poly-PDM across adult age cohorts, the current research has significant implications. Understanding stability and heterogeneity in the characteristics associated with poly-PDM should inform interventions, identify at-risk groups, and shape public health approaches to dealing with high-risk substance use behavior.
大多数关于处方药物滥用（PDM）的研究都集中在青少年或年轻成年人中特定类别的精神活性处方药物的滥用上。本研究通过评估不同成年年龄组中多种精神活性处方药物（poly-PDM）的滥用情况，即超过一种类别的精神活性处方药物的滥用，填补了文献中的重要空白。
我们使用了 2015-2018 年全国药物使用和健康调查，以评估过去一年中 poly-PDM 以及特定的 PDM 组合的流行率。使用多项逻辑回归来确定与 poly-PDM 显著相关的人口统计学、健康相关因素和物质使用行为。
poly-PDM 的流行率随着年龄的增长而降低，并且在从事 PDM 的个体中很常见。在从事 PDM 的 18-25 岁（31.66%，95%置信区间[CI] = 30.35，33.00）和 26-34 岁（29.92%，95% CI = 25.82，30.12）年龄组中，略多于四分之一的受访者同时滥用了不止一类处方药物。此外，poly-PDM 被确定为一种高风险类型的 PDM，因为大约 60%的 65 岁以下报告 poly-PDM 的成年人患有物质使用障碍（SUD）。虽然某些特征（即种族/族裔、婚姻状况、抑郁、自杀意念、非法药物使用和 SUD）在所有年龄组中都与 poly-PDM 始终相关，但其他特征（即性取向、收入和司法参与）则因年龄组而异。最后，将 poly-PDM 与单一 PDM 进行比较，结果表明，在所有年龄组中，患有 SUD 与 poly-PDM 的可能性增加相关，而黑人成年人报告 poly-PDM 的可能性低于白人。
通过确定不同成年年龄组中 poly-PDM 的流行率和相关因素，本研究具有重要意义。了解与 poly-PDM 相关特征的稳定性和异质性，应该为干预措施提供信息，确定高危群体，并为处理高风险物质使用行为的公共卫生方法提供依据。
