Added: Tiron Strawbridge - Date: 26.09.2021 12:42 - Views: 31452 - Clicks: 2254
Try out PMC Labs and tell us what you think. Learn More. Alternative consumption practices of prescription drug misuse have been less well monitored than general prevalence. We describe prescription drug smoking among socially active youth and highlight correlates of this practice. We also examine its association with drug problems, drug dependence, and mental health.
We surveyed young adults recruited from nightlife venues in New York via time-space sampling. We use linear and logistic regression models to examine the probability of smoking prescription drugs and its association with drug problems, dependence, and mental health. Qualitative findings supplement the survey data.
Prescription drug smokers do not report greater mental health problems. Qualitative interview data support these survey findings. Prescription drug smoking is a ificant drug trend among socially active youth. It is associated with drug problems and symptoms of dependence net of frequency of misuse. Prevention and intervention efforts for youth who misuse prescription drugs should address the issue of prescription drug smoking, and this may be an area for clinicians to address with their adolescent patients.
Epidemiological systems have monitored the 21 st century trend of prescription drug misuse. The prevalence of prescription drug misuse is especially high among youth. Yet, the emergence of alternative prescription drug misuse practices beyond oral consumption has been poorly monitored. Prescription drug smoking includes the inhalation of prescription pills through smoking or vaporization.
The transition to smoking prescription pills is a ificant act for young people in that it represents an escalation of drug use. The normative manner of drug consumption for pills is oral consumption, an act reinforced by the standard pattern of use as pharmaceuticals. As such, pill smoking represents a more extreme form of prescription drug misuse, one that decreases the time to onset of drug effects and increases the intensity of the high. The escalation of route of administration is noteworthy in that it has been tied to drug dependence and social problems for users of cocaine and heroin 10 , 11 as well as infectious disease risk.
In this paper, we present an overview of prescription drug smoking among youth. We have three primary goals. First, using survey data, we describe this trend among young prescription drug misusers and highlight correlates of this practice. Second, we examine the association of prescription drug smoking with drug problems, drug dependence, and mental health. Finally, we utilize qualitative data to describe this practice from the point of view of young prescription drug misusers. Collectively, these analyses provide a descriptive epidemiological profile of pill smoking among young prescription drug misusers.
To generate our sample, we utilized time-space sampling in nightlife venues in New York City NYC , supplemented briefly by targeted online recruitment. Time-space sampling was first developed to capture hard-to-reach populations, 20 — 22 but is also useful to generate samples of venue-based populations. A venue was viable if a preponderance of youth patron traffic existed on that day of the week.
We generated lists of venues for each day of the week across several key nightlife scenes — e. For each day of the week, socially viable venues were listed and ased a . Using a random digit generator, a random was drawn corresponding to a particular venue on a particular day, yielding our schedule for recruitment.
Once at the venue, research staff attempted to survey as many individuals as possible, aiming to achieve saturation at the venue. The of staff depended upon the size of the venue. For those who provided consent, the surveys were initially administered by trained staff consent, age, and NYC residency and respondents self-reported more sensitive information race, sexual identity, gender, and substance use.
Staff were trained not to administer surveys to individuals who were impaired by intoxication to ensure the capacity to consent. Screening survey response rates Survey software determined whether the screened individual was eligible for the study 9. A majority of those deemed eligible Near the end of the project, venue recruitment was supplemented by targeted recruitment via online groups associated with nightlife scenes of interest.
We first identified web-based groups relevant to the youth cultures of interest using a form of web-based social mapping. Regardless of recruitment method, staff contacted participants by phone and e-mail to provide more information about the study, confirm eligibility, and schedule the initial assessment. Eligibility criteria were as follows: 1 Aged 18—29; 2 Reported the misuse of prescription drugs at least three times in the past six months; and 3 Reported the misuse of prescription drugs at least once in the past three months.
The conformation of age and identity via ID diminished the possibility of duplicate assessments. During their initial assessment, participants completed the informed consent process and the survey. Half of the participants also completed a qualitative interview. All procedures were reviewed and approved by university Institutional Review Boards. Respondents reported their frequency of misuse of three prescription drug types pain killers, sedatives, and stimulants during the three months, with examples provided for each type.
Respondents also self-reported whether they had misused prescription drugs through smoking. For this article, we use a dichotomous variable indicating whether the respondent had ever smoked prescription drugs. Research demonstrates that the BSI is a strong measure of mental health symptoms among drug users. We also include the involvement in particular nightlife scenes associated with various youth cultures. These are not mutually exclusive. When examining the probability of smoking prescription drugs, we use logistic regression models, with nested regressions that subsequently add demographics, prescription drug use, and nightlife participation.
For the drug problems, dependence, and mental health scales, we use linear regression to examine the effect of prescription drug smoking while controlling for demographics and frequency of prescription drug misuse. The linear models use the log of each of these five scales, as indicated as necessary by regression diagnostics.
We qualitatively interviewed the first of participants, which ensured a sufficient yet manageable of interviews. The qualitative data for this paper come from interviews with 41 participants who reported smoking or vaporizing prescription drugs. All interviews were conducted in private rooms to ensure confidentiality.
Interviewers probed around the techniques used to smoke prescription drugs, the motivations behind this route of administration, and what participants liked and did not like about smoking prescription drugs. All interviews were recorded and transcribed. A goal of thematic analysis is to identify general sentiments across the sample while leaving outlying individual assertions aside. The thematic analyses were performed utilizing a codebook constructed in NVIVO data analysis software. Subsequent waves of coding and analysis were conducted to facilitate more nuanced understandings of prescription drug smoking.
We use these qualitative data to describe the practices and contexts of prescription drug smoking as well as to explicate our findings from the survey data. Sample characteristics are presented in Table 1. The respondents had an average age of The sample had slightly more males than females and two-thirds were White. Many were either currently enrolled in college or had completed a college degree.
The smoking of prescription drugs was common among the youth in our study. Almost one out of five Table 2 presents models, in which we consider three nested logistic regressions to understand the association of smoking prescription drugs with demographics, frequency of recent prescription drug misuse, and subcultural nightlife scenes, respectively. In Model 1, the effect for males on smoking is statistically ificant, and maintains ificance with the additional controls for recent misuse and nightlife scenes in Models 2 and 3, respectively.
From Model 3, with the full complement of controls, males have 3. The effect of identifying as heterosexual relative to sexual minority identity is also ificant in Model 1, with the former having 2. This effect, however, is reduced to non-ificance when controlling for the nightlife scenes in Model 3, most likely due to its strong association with participation in gay and lesbian nightlife scenes. In Model 3, we also observe a ificant association between frequency of recent pain killer misuse and smoking.
Each increase of one day of pain killer misuse raises the odds of smoking prescription drugs by 1. Finally, those who participated in the EDM scene had 2. By contrast, those participating in college bar scenes had Next, we consider smoking prescription drugs as an independent variable in linear regressions of measures of drug problems and mental health net of other covariates, as shown in Table 3.
Those who have smoked prescription drugs scored The independent variables explained Similarly, those who have smoked scored By contrast, we did not observe ificant effects of smoking on mental health, though recent misuse of stimulants and pain killers was consistently ificant in those models.
The independent variables explain a much smaller proportion of the variance in mental health, ranging from 8. As indicated by the survey data, almost one out of five young prescription drug misusers reported smoking prescription pills. The interviews indicated that misusers typically progressed from oral consumption to smoking, rather than the reverse. Some youth view smoking pills as commonplace. And the thing to do if you were gonna do it back home when I was in high school, was smoke it.
Thus, some youth recognize that smoking indicates an escalation of drug use, often becoming an option as they increase the frequency of their prescription drug misuse. Peer networks are the common context in which this occurs. I was like I was at a house party.
I was going to use the bathroom and two people I casually knew were in the bathroom. They were like—they put stuff away really quickly. And I thought they were doing coke. Can you share any of it? This young man eventually transitioned to using heroin. Some youth report smoking prescription drugs to mitigate the effects of other drug use. Prescription drug smoking may therefore be incorporated into wider polydrug use routines among youth. Our survey findings also indicated associations of prescription drug smoking with symptoms of dependence and drug problems.
This concern even resonated among some prescription drug misusers. Thus, even for youth who smoke prescription drugs, there are concerns about what this practice says about their habit. In this article, we considered escalations in mode of administration for prescription drug misuse, specifically from orally ingesting pills to smoking pills.
While studies have examined the escalation in mode of administration for illicit drugs, researchers have provided few focused assessments of escalation for prescription drugs. We examined factors associated with this escalation and consequences of such escalation for dependence and mental health, while contextualizing these survey findings with excerpts from our interviewees.
Importantly, our paper identifies that the transition to non-normative routes of administration represents an escalation — indicated by problems and dependence — even after ing for frequency of use. In terms of escalation to smoking prescription drugs, our demonstrate that this mode of administration was more likely among males. Although studies have suggested that the lifetime prevalence of illicit drug use is converging between males and females, 30 studies have shown that males often use a wider range of drugs 31 and have heavier patterns of substance use.
Recent pain killer misusers also reported higher odds of smoking prescription pills. In terms of subcultural participation, those involved in Electronic Dance Music scenes were much more likely to report smoking pills. By contrast, those involved in the college bar scene were less likely to have smoked prescription drugs. This is somewhat surprising given that studies have regularly highlighted the high prevalence of prescription drug misuse among college students, 4 yet college students may misuse prescription drugs primarily for functional reasons and thus may be less inclined to smoke pills.
Regarding consequences, we found no effect for smoking prescription drugs on mental health outcomes, but strong effects for the CIDI and SIP-AD measures of problem drug use. Thus, our findings provide further support to research identifying that transitions to non-oral modes of consumption mostly sniffing increase prescription drug abuse related problems.
Thus, smoking is associated with higher dependence and problems above and beyond greater recent misuse.Dangers of smoking pills
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The Pill and Smoking: Understanding the Risks