Bushnell Greta, Lloyd Kristen, Olfson Mark, Gerhard Tobias, Keyes Katherine, Cerdá Magdalena, Hasin Deborah
Center for Pharmacoepidemiology and Treatment Science, Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA.
Department of Biostatistics and Epidemiology, Rutgers University School of Public Health, Piscataway, NJ, USA.
Addiction. 2025 May;120(5):951-961. doi: 10.1111/add.16749. Epub 2025 Jan 22.
Sedative, hypnotic or anxiolytic use disorders (SHA-UD) are defined by significant impairment or distress caused by recurrent sedative, hypnotic or anxiolytic use. This study aimed to measure trends in the prevalence of SHA-UD diagnoses in adolescent and young adult US Medicaid enrollees from 2001 to 2019.
Annual, cross-sectional study, 2001-2019.
Medicaid Analytic eXtracts (MAX) and Transformed Medicaid Analytic Files (TAF) from 42 US states with complete data.
PARTICIPANTS/CASES: Adolescents (13-17 years) and young adults (18-29 years) with ≥10 months Medicaid enrollment in the calendar year; analytic sample contained 5.7 (2001) to 13.2 (2019) million persons per year.
Annual prevalence of SHA-UD in adolescent and young adult Medicaid enrollees [defined as an inpatient or outpatient ICD code (304.1x, 305.4x, F13.1x, F13.2x) in the calendar year] was stratified by sex, race/ethnicity, receipt of a benzodiazepine, z-hypnotic or barbiturate prescription, and selected mental health diagnoses. Absolute and relative percent-changes from 2001 vs. 2019 were summarized. Secondary analyses were restricted to states with more consistent data capture.
The prevalence of SHA-UD diagnoses statistically significantly increased for adolescents (0.01% to 0.04%) and young adults (0.05% to 0.24%) from 2001 to 2019. Increasing trends were observed in sex and race/ethnicity subgroups, with greatest relative increases among Non-Hispanic Black (624%) and Hispanic (529%) young adults. The trend increased among those with and without a benzodiazepine, z-hypnotic or barbiturate prescription; i.e. young adults with (2001 = 0.39% to 2019 = 1.77%) and without (2001 = 0.03% to 2019 = 0.18%) a prescription. Most adolescents (76%) and young adults (91%) with a SHA-UD diagnosis in 2019 had a comorbid substance use disorder.
Sedative, hypnotic or anxiolytic use disorders (SHA-UD) diagnoses increased 3- to 5-fold between 2001 and 2019 for adolescent and young adult US Medicaid enrollees, with prevalence remaining low in adolescents. The increase over two decades may be attributed to changes in the availability, use and misuse of sedative, hypnotic and anxiolytic medications and to increased detection, awareness and diagnosing of SHA-UD.
镇静、催眠或抗焦虑药物使用障碍（SHA-UD）的定义是反复使用镇静、催眠或抗焦虑药物导致显著的功能损害或痛苦。本研究旨在衡量2001年至2019年美国青少年及青年医疗补助计划参保者中SHA-UD诊断患病率的趋势。
2001年至2019年的年度横断面研究。
来自美国42个州的医疗补助分析提取物（MAX）和转换后的医疗补助分析文件（TAF），数据完整。
参与者/病例：在日历年中医疗补助参保时间≥10个月的青少年（13 - 17岁）和青年（18 - 29岁）；分析样本每年包含570万（2001年）至1320万人（2019年）。
青少年及青年医疗补助参保者中SHA-UD的年度患病率[定义为日历年中的住院或门诊国际疾病分类代码（304.1x、305.4x、F13.1x、F13.2x）]按性别、种族/族裔、是否接受苯二氮䓬类、Z类催眠药或巴比妥类药物处方以及选定的心理健康诊断进行分层。总结了2001年与2019年的绝对和相对百分比变化。二次分析仅限于数据记录更一致的州。
2001年至2019年，青少年（从0.01%增至0.04%）和青年（从0.05%增至0.24%）中SHA-UD诊断的患病率在统计学上显著增加。在性别和种族/族裔亚组中观察到上升趋势，非西班牙裔黑人青年（624%）和西班牙裔青年（529%）的相对增幅最大。在有和没有苯二氮䓬类、Z类催眠药或巴比妥类药物处方的人群中该趋势均上升；即有处方的青年（2001年 = 0.39%至2019年 = 1.77%）和无处方的青年（2001年 = 0.03%至2019年 = 0.18%）。2019年，大多数被诊断为SHA-UD的青少年（76%）和青年（91%）患有共病物质使用障碍。
2001年至2019年期间，美国青少年及青年医疗补助参保者中镇静、催眠或抗焦虑药物使用障碍（SHA-UD）的诊断增加了3至5倍，青少年中的患病率仍然较低。二十年来的增加可能归因于镇静、催眠和抗焦虑药物的可及性、使用和滥用情况的变化，以及对SHA-UD的检测、认识和诊断的增加。
