Prescription opioid misuse and mental health among young injection drug users

Abstract

Background Prescription opioid (PO) misuse is a significant concern in the United States. Objectives This study describes the prevalence and timing of PO misuse, diagnoses of opiate abuse and dependence, and their associations with psychiatric disorders in a sample of young people who inject drugs (PWID). Methods Participants were 570 young (18–25 years) PWID, primarily heroin users, recruited through outreach and respondent-driven sampling. Trained interviewers administered a semi-structured psychiatric interview. Diagnoses of substance use and mental disorders were based on DSM-IV diagnostic criteria. Results Estimated rates of lifetime PO abuse and dependence were 19% and 17% respectively. Past year PO misuse was significantly associated with anti-social personality disorder (ASPD, OR = 2.15, 95% CI 1.43–3.24), past year substance-induced major depression (SIMD, OR = 1.81, 95% CI 1.16–2.83), and prior post-traumatic stress disorder (PTSD, OR = 2.45, 95% CI 1.31–4.60). Among male PO users, PTSD was a significant predictor of PO abuse (prior, OR = 7.62, 95% CI 2.16–26.88; past year, OR = 21.67 95% CI 2.46–190.75), and dependence (prior, OR = 4.82, 95% CI 1.48–15.67; past year, OR = 9.65, 95% CI 1.75–53.32). Conclusion Among young PWID, PTSD is a significant risk factor for PO misuse for both men and women, and men with PTSD are in addition at increased risk for PO abuse and dependence. These findings have implications for harm reduction and substance abuse prevention efforts.

Prescription opioid medication misuse among university students

“…Differences between groups also existed prominently when examining the mental health of respondents. Previous studies have identified a number of relationships between mental health disorders and prescription opioid use including bipolar disorder, post‐traumatic stress disorder (PTSD), panic and depressive symptoms . In addition to supporting these existing data, this study provides a more nuanced look at this relationship: current prescription opioid medication misusers were more likely than past misusers, who were more likely than non‐misusers, to report more depressive symptoms (as measured by the PHQ‐9), to screen positive for PTSD, to endorse more symptoms of anxiety, to screen positive for ADHD, and to be either currently taking prescribed mental health medications or to have been treated for psychological/emotional problems in the past.…”

Exploring trends of nonmedical use of prescription drugs and polydrug abuse in the Twittersphere using unsupervised machine learning

“…Primarily, in this study, the central theme that emerged was that polydrug abuse is predominantly associated with Twitter prescription drug abuse discussions and could be indicative of larger behavioral trends of users abusing multiple prescription drugs and also combining use with other illicit substances. These results could form the basis for future indepth studies examining the unique health and substance abuse consequences associated highly prevalent polydrug uses (including potentially linkages to mental health issues and behavior among young adults and adolescents already identified in the literature) (Fink et al, 2015;Kelly, Wells, Pawson, LeClair, & Parsons, 2014;Mackesy-Amiti, Donenberg, Ouellet, 2015).…”

Alternate Routes of Administration among Prescription Opioid Misusers and Associations with Sexual HIV Transmission Risk Behaviors

“…This link is unsurprising given the literature documenting multiple mental health problems associated with prescription opioid misuse, including among young adult injection drug users (Mackesy-Amiti, Donenberg, and Ouellet 2015). However, mental health problems are also associated with HIV transmission risk among substance users (German and Latkin 2012).…”

“…The misuse of prescription opioids among young people is associated with several health and social problems, including mental distress, victimization, and homelessness (Schrager et al 2014, Mackesy-Amiti, Donenberg, and Ouellet 2015, Jessell et al 2015). The use of alternate routes of administration of prescription opioids, including snorting, smoking, or injecting, may result in increased vulnerability, as the effects of the drug are intensified and the risk of addiction is elevated (Compton and Volkow 2006).…”