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Drug Alcohol Depend. 2014 Oct 1;143:263-7. doi: 10.1016/j.drugalcdep.2014.06.044. Epub 2014 Jul 27.

Non-medical use of non-opioid psychotherapeutic medications in a community-based cohort of HIV-infected indigent adults.

Author information

1
Moores UCSD Cancer Center, University of California, San Diego, 3855 Health Sciences Drive, San Diego, CA 92093, USA. Electronic address: mvijayaraghavan@ucsd.edu.
2
University of California, San Francisco, 521 Parnassus Avenue, San Francisco, CA 94117, USA. Electronic address: Daniel.Freitas@ucsf.edu.
3
Massachusetts General Hospital Center for Global Health, Ragon Institute of MGH, MIT and Harvard, Harvard Medical School, 100 Cambridge, 15th Floor, Boston, MA 02114, USA. Electronic address: dbangsberg@partners.org.
4
Department of Physiological Nursing/UCSF, 2 Koret Way - N631Y, San Francisco, CA 94143-0610, USA. Electronic address: chris.miaskowski@nursing.ucsf.edu.
5
University of California, San Francisco, 521 Parnassus Avenue, San Francisco, CA 94117, USA; Division of General Internal Medicine, San Francisco General Hospital, 1001 Potrero Avenue, SFGH 10, San Francisco, CA 94143, USA. Electronic address: mkushel@medsfgh.ucsf.edu.

Abstract

BACKGROUND:

Non-opioid psychotherapeutic medications significantly increase the risk of opioid overdose-related deaths. We prospectively followed HIV-infected indigent adults sampled from the community to examine rates of and factors associated with non-medical use of benzodiazepines, muscle relaxants, and prescription stimulants.

METHODS:

We interviewed participants quarterly for 2 years about alcohol and illicit substance use; depression; use of prescribed opioid analgesics, benzodiazepines and muscle relaxants; opioid analgesic misuse; and non-medical use (i.e., use without a prescription) of benzodiazepines, muscle relaxants, and prescription stimulants. Using mixed-effects multivariate logistic regression, we determined factors associated with non-medical use of benzodiazepines, muscle relaxants, and prescription stimulants.

RESULTS:

Among the 296 participants at enrollment, 52.0% reported taking opioid analgesics that had been prescribed, 17.9% took benzodiazepines that had been prescribed, and 8.1% took muscle relaxants that had been prescribed. Over the 2-year study interval, 53.4% reported prescription opioid misuse, 25.3% reported non-medical use of benzodiazepines, 11.5% reported non-medical use of muscle relaxants, and 6.1% reported non-medical use of prescription stimulants. In multivariable analysis, opioid analgesic misuse in the past 90 days was associated with non-medical use of benzodiazepines, muscle relaxants, and prescription stimulants during the same time interval. Illicit substance use and depression were not associated with non-medical use of these medications.

CONCLUSIONS:

Prescription opioid analgesic misuse is associated with non-medical use of other psychotherapeutic medications. Health care providers should monitor for non-medical use of a broad array of psychoactive medications among high-risk populations to minimize harm.

KEYWORDS:

Benzodiazepines; Muscle relaxants; Non-medical use; Prescription stimulants

PMID:
25107312
PMCID:
PMC4161633
DOI:
10.1016/j.drugalcdep.2014.06.044
[Indexed for MEDLINE]
Free PMC Article

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