No abstract

Although there is extensive research on gender differences in the use of alcohol and illicit substances, few studies have examined gender differences in nonmedical prescription drug use, Using data from the 1991 National Household Survey on Drug Abuse (NHSDA), based on a sample of 3185 persons, logistic regression analysis is employed to determine how gender and other factors affect the likelihood of past-year nonmedical prescription drug use. Analysis revealed that women are significantly more likely than men to use any prescription drug, and that this gender difference is primarily driven by women's increased risk for narcotic analgesic and minor tranquilizer nonmedical use. Other factors, such as race, age, health status, and other substance use, also are significant predictors of nonmedical use. Findings from this study will enable researchers, policy makers, and providers to have a greater understanding of nonmedical drug use patterns and support greater gender sensitivity in the prevention, education, and treatment of nonmedical prescription drug use.

This study examines the association between adherence to during-treatment process measures of quality (defined as initiation and engagement in treatment as developed by the Washington Circle) and outcome measures (defined as arrests and incarcerations) in the following year. The data come from the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) administrative data system linked to data from state agencies involved in criminal justice. Clients who initiated a new episode of outpatient treatment and who engaged in treatment were significantly less likely to be arrested or incarcerated during the following year. Initiation of substance abuse treatment alone, without engagement in treatment, was not significantly associated with arrests or incarcerations. These findings validate the clinical importance of the Washington Circle performance measures of initiation and engagement. These "process of care" measures can make a difference when used as a target for quality improvement at treatment facilities.

Background/Objectives: The effects of illness extend beyond the individual to caregivers and family members. This study identified evidence of spillover of illness onto household members’ health-related quality of life. Methods: Medical Expenditures Panel Survey (MEPS) data from 2000–2003 were analyzed using multivariable regression to identify spillover of household members’ chronic conditions onto individuals’ health-related quality of life as measured by the EuroQol-5D (EQ-5D) score (N = 24,188). Spillover was assessed by disease category, timing of occurrence (preexisting or new conditions), and age of the household member (adult or child). Results: Controlling for an individual’s own health conditions and other known predictors of EQ-5D scores, the authors found that the odds of an individual reporting full health (an EQ-5D score of 1.0, relative to <1.0) were lower with the presence of existing mental (odds ratio 0.71; 95% confidence interval, 0.64–0.79), respiratory (0.85; 0.75–0.97), and musculoskeletal (0.83; 0.75–0.93) conditions among adults and with mental (0.72; 0.62–0.82) and respiratory (0.80; 0.81–0.96) conditions among children in the household. The odds of an individual reporting full health were also lower for newly occurring chronic conditions in the household, including adults’ mental (0.79; 0.65–0.97), nervous/sensory system (0.76; 0.61–0.96), and musculoskeletal (0.78; 0.65–0.95) conditions and children’s mental conditions (0.64; 0.48–0.86). EQ-5D dimensions may be unsuited to fully capture spillover utility among household members, and MEPS lacks condition severity and caregiver status among household members. Conclusions: Evidence from a US sample suggests that individuals who live with chronically ill household members have lower EQ-5D scores than those who live either alone or with healthy household members. Averting spillover effects may confer substantial additional benefit at the population level for interventions that prevent or alleviate conditions that incur such effects.