Opioids and benzodiazepines are two of the most commonly prescribed psychoactive medications in older adults (Simoni-Wastila et al., 2005). Although they can be used safely and effectively to treat conditions that commonly affect this population (e.g. chronic pain, anxiety), they are also among the prescription medications most commonly misused by older adults (Blazer and Wu, 2009; Schepis and McCabe, 2016; Wu and Blazer, 2011). Studies show that older adults who take opioids are at increased risk for sedation, impaired cognition and physical function, falls, injuries, and fractures (Buckeridge et al., 2010; Maree et al., 2016; Rolita et al., 2013; Simoni-Wastila and Yang, 2006; Spector et al., 2007). Compared to younger individuals, older adults who misuse opioids are also at increased risk for serious medical outcomes including death (West et al., 2015; West and Dart, 2016). Benzodiazepines can have similar harms in older adults as well as other side effects such as paradoxical reactions, suicidality, and respiratory distress (Airagnes et al., 2016; Maree et al., 2016). Finally, opioids and benzodiazepines in combination are particularly dangerous and frequently implicated in overdose deaths (Airagnes et al., 2016).

Estimates of substance use for youth based on NSDUH are not directly comparable with estimates based on the Monitoring the Future Study. Rates are not directly comparable across these surveys because of differences in populations covered, sample design, questionnaires, and interview setting. NSDUH collects data in residences, whereas MTF collects data in school classrooms. Furthermore, NSDUH estimates are tabulated by age, whereas MTF estimates are tabulated by grade, representing different ages as well as different populations. Section E describes other sources of data on substance use and mental health issues, including data sources for populations outside the NSDUH target population. TheRisk and Protective Factors and Estimates of Substance Use Initiation reportpresents data regarding the perceived harmfulness of using cigarettes, alcohol, and specific illicit drugs and the perceived availability of substances.

NSDUH also reports on substance use disorders, substance use treatment, mental health problems, and mental health care. Our interpretation of these results is that all four of the adverse mental health outcomes mapped geotemporospatially by SAMHSA are linked upon formal geospatial analysis with the use of all four of the addictive drugs for which data was available. On testing of single domains of variables against serious mental illness only the drug group was significant, whilst median household income and racial profiling were not. Inverse probability weighting was employed to transform data from a purely ecological observational data series to a formal pseudo-randomized design.

SAMHSA’s National Survey of Drug Use and Health is the most comprehensive survey of SUD prevalence and treatment in the United States. It is an annual sample survey of the civilian, noninstitutionalized population of the United States ages 12 or older. Based on NSDUH, Figure 1 shows the number of persons who were treated for a SUD at a specialty facility or by a nonspecialty treatment provider in the past year for each year from 2015 to 2018. The NSDUH series, formerly titled National Household Survey on Drug Abuse , is a primary source of statistical and trend information on substance use and mental illness among the U.S. population of noninstitutionalized civilians aged 12 or older. Jones CM,Paulozzi LJ,Mack KA.Sources of prescription opioid pain relievers by frequency of past-year nonmedical use United States, 2008–2011.

To address our research goals, we used the most recent data from a source that is used to derive national estimates of OUD treatment needs. We also unpacked the distinct phenomenon of treatment gap and perceived treatment need.9 By quantifying and comparing both NSDUH-defined and https://sober-house.org/ patient-defined assessments of treatment need, we were able to illuminate the chasm between the two. Notably, 12.5% of individuals with a treatment gap reported a treatment need, and more than half (53.4%) of the adults with a treatment need reported trying to obtain treatment.

Benzodiazepine misuse in the elderly: risk factors, consequences, and management

Information on survey content and survey continuity (e.g., disparity between the survey measures across years) is an important output of major federal surveys because it affects the availability of data and the analytic possibilities. This report presents a summary of the impact of a partial redesign in 2015 of the National Survey on Drug Use and Health questionnaire and data collection procedures. Section D includes a glossary that covers key definitions used the NSDUH reports and tables.

Significant differences are highlighted between estimates in 2015 and those prior. Trends for substance use treatment and other estimates are not available because of methodological changes in 2015. TheReceipt of Services for Substance Use and Mental Health Issues Among Adults reportpresents data from the 2015 NSDUH for substance use treatment and mental health service use among adults ages 18 or older in the United States. Figure1 shows the rates of mental illness for the four NSDUH-defined mental health disorders included in the SAMHSA substate shapefiles of any mental illness, major depressive episode, serious mental illness and suicidal thinking. However, it should be noted that overall SUD treatment use rates remain extremely low. In 2018, only 4.6% and 9.2% of those with an alcohol use disorder or other drug use disorder in the past year, respectively, received any treatment at a specialty facility .

Risk factors associated with opioid medication misuse in community-dwelling older adults with chronic pain

Among adults with misuse, 59.9% reported using opioids without a prescription, and 40.8% obtained prescription opioids for free from friends or relatives for their most recent episode of misuse. The 2015 NSDUH report contains a collection of detailed tables that present data on substance use and mental health. Thetables(also available in PDF | 14.2 MB) present national estimates of rates of substance use, numbers of users, and other measures related to illicit drugs, alcohol, and tobacco products. The focus is on trends between 2014 and 2015 and from 2002 to 2015, as well as differences across population subgroups in 2015. However, there were questionnaire changes for 2015 that no longer allow comparability between 2015 data and previous years’ data. Please refer to Section C of theMethodological Summary and Definitions reportfor more information.

• In this study, we identified newly incident extra-medical users of prescription pain relievers , all observed with onsets before the 22nd birthday.
• We considered that it was important to use modern geospatiotemporal regression and the tools of formal causal inference in investigating these questions and associations, and in particular in assessing the potentially causal nature of the relationship.
• Prescription drug misuse among older adults is an underappreciated (Center for Substance Abuse Treatment, 1998; Maree et al., 2016) but increasingly important public health concern .
• In order to calculate a model standard deviation the weights were also utilized in mixed effects regression using the R package nlme again with substate region as the grouping variable.

National level NSDUH data make it clear that there are considerable differences between various ethnicities in drug use and especially daily / near daily cannabis use. These can be averaged out by ethnicity to derive a cannabis use frequency index at the national level. It is likely that regional data also impacts cannabis use by ethnic populations so an index of this was derived by multiplying the local monthly cannabis use by the national ethnic near daily cannabis use to derive a local cannabis ethnic daily index at state level. Since the THC concentration of cannabis has also been increasing the LCEDI can in turn be multiplied by the THC content to produce a local cannabis ethnic daily potency index of local ethnic exposure to cannabinoids. This LCEDPI index may also be referred to as an “Ethnic score” and it has been used as an important instrumental variable controlling for environmental cannabinoid exposure arising from the sociocultural environment rather than any intrinsic ethnic risk propensity .

Both the prescription OUD only and OUD with heroin use groups had a similar pattern of reported barriers. Table 3 further shows barriers among those with an OUD treatment need with and without a NSDUH-defined treatment gap, with similar most commonly reported barriers. Fewer than 30% of adults with OUD receive treatment, and only 1 in 10 report a need for treatment, reflecting persistent structural barriers to care and differences in perceived care needs between patients with OUD and the NSDUH-defined treatment gap measure. Military Personnel reportcompares data related to substance use and mental health for military family members with the general population. The numbers of military family members included in the 2015 NSDUH were relatively small. As a consequence, the report focuses on wives aged 18 to 49 and children aged 12 to 17.

Furthermore, despite efforts to improve uptake of MOUD treatment, racism, lack of affordability, and stigma all continue to play a role in limiting treatment access. Public health programs and policies for eliminating barriers such as the “X-waiver” and investing in interventions above and beyond MOUD prescribing such as harm reduction should be proactively undertaken. Simultaneously, active disinvestment from carceral and punitive approaches to persons with OUD and persons using opioids should be prioritized to enable fulfillment of their self-described care needs. First, NSDUH is based on self-reporting and, thus, is subject to recall bias and underreporting of substance use. Third, NSDUH definitions of treatment are specifically centered around MOUD and behavioral therapy. This definition of treatment is restrictive and ignores the totality of the care needs of patients with OUD that may extend to harm reduction and other critical social supports.

Disability status and prescription drug misuse among U.S. adults

Methamphetamine use disorder continues to be inadequately treated, but improvements are being made in the field of immunotherapeutics, including vaccines, which could provide new options for treatment. Cocaine and nicotine vaccines have been tested clinically, but have yet to elicit the necessary antibody concentrations required to be effective. Methamphetamine vaccines have been tested in multiple nonclinical models and appear promising.

Annual estimates were calculated by multiplying the mean monthly number of days absent by 12. Sociodemographic and administrative characteristics of interest in our sample were age, sex, highest education level, insurance, and annual income level. We used the variable COUTYP4 to characterize geographic place of residence as “nonmetro” or “metro.”15 In addition, we included survey year in the regression analysis. No funding organization played any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The rates of mental illness can be aggregated into state areas to compare mental illness rates by the legal status of cannabis.

Publications

Two specific variables cited in previous studies as potential confounders were a tendency toward rule-breaking and a recent history of severe psychological distress. Given that we were able to adequately control for these issues, we are confident that neither explains the increased work absenteeism observed among those with AUD. The primary outcome of interest was workplace absenteeism among full-time workers. This outcome was assessed using 2 separate questions, “During the past 30 days … ” and, “During the past 30 days … how many whole days of work did you miss because you just didn’t want to be there?

Access for public-use of de-identified data is available to download in a variety of formats from the National Survey on Drug Use and Health website, by year. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links. The results support continued development of IXT-v100 for the treatment of methamphetamine use disorder. As expected based on prior studies with anti-methamphetamine monoclonal antibodies, the antibodies resulting from vaccination with IXT-v100 altered methamphetamine pharmacokinetics by increasing serum concentrations and extending the half-life.

Grucza RA,Abbacchi AM,Przybeck TR,Gfroerer JC.Discrepancies in estimates of prevalence and correlates of substance use and disorders between two national surveys. To estimate the prevalence of prescription opioid use, misuse, and use disorders and motivations eco sober house ma for misuse among U.S. adults. Additionally, because of the comprehensive nature of the NSDUH questionnaire, this study was able to control for multiple other factors that could potentially affect the association between AUD and workplace absenteeism.

The estimate of 14.4 percent of adults in 2016 who received mental health services in the past year was similar to the estimates in years from 2012 to 2015, but it was higher than the estimates in most years between 2002 and 2011. Among the 44.7 million adults with any mental illness in the past year, about 19.2 million (43.1 percent) received mental health services in the past year. The percentage of adults with AMI who received mental health care in 2016 was similar to the percentages in most years from 2008 to 2015. Included in the 44.7 million adults with past year AMI were 10.4 million adults with serious mental illness .

Data Catalog

Notably, we ran a multivariable logistic regression model to assess the association between population characteristics and perceived OUD treatment need. However, because of low frequencies in certain predictor variable categories, we were unable to report the results of that analysis. We analyzed publicly available NSDUH data from 2015 to 2019 to provide the most current estimates. NSDUH is a cross-sectional household survey of annual self-reported estimates on alcohol, tobacco, and prescription and nonprescription drug use and other health-related domains. The survey is administered online or in person to noninstitutionalized civilians aged 12 years or older living in the United States.11 Because of survey redesign beginning in 2015, NSDUH does not recommend pooling data after 2015 with earlier survey years.

This 3-week double-blind randomized controlled study tested 36 male abstinent AUD patients receiving CBM or placebo-training, who were also compared to 18 male healthy controls. The approach avoidance task was used to test the AUD patients before and after training. CBM training took place over 6 sessions, using a joystick-based approach-avoidance task. Blood samples were collected after the pre- and post-AAT test sessions for the AUD groups, and during an outpatient appointment with the controls.

Inciardi JA,Surratt HL,Lugo Y,Cicero TJ.The diversion of prescription opioid analgesics. Jordan BK,Karg RS,Batts KR,Epstein JF,Wiesen C.A clinical validation of the National Survey on Drug Use and Health assessment of substance use disorders. Mild, moderate, and severe AUD diagnoses were generated using questions in NSDUH that mirror Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Notably, a decision was made to use DSM-5 instead of DSM-IV criteria due to its clinical relevance and better characterization of functional impairment (definition of AUD in eAppendix and eTable 1, concordance between DSM-5 AUD and DSM-IV alcohol abuse or dependence in eTable 2 in the Supplement). This was an analysis of publicly available data and was thus exempt from institutional review board review by the University of Maryland, Baltimore. EColumns do not add up to 100% because of missing values reported for self-reported health status.