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

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...

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Bibliographic Details
Published in:Drug and alcohol dependence 2014-10, Vol.143, p.263-267
Main Authors: Vijayaraghavan, Maya, Freitas, Daniel, Bangsberg, David R, Miaskowski, Christine, Kushel, Margot B
Format: Article
Language:English
Subjects:
Adult
Alcoholism - epidemiology
Analgesics, Opioid
Benzodiazepines
Central Nervous System Stimulants
Cohort Studies
Cross-Sectional Studies
Female
HIV Infections - epidemiology
Homeless Persons - statistics & numerical data
Humans
Longitudinal Studies
Male
Middle Aged
Muscle relaxants
Muscle Relaxants, Central
Non-medical use
Poverty - statistics & numerical data
Prescription Drug Misuse - statistics & numerical data
Prescription stimulants
Prospective Studies
Psychiatry
Psychotropic Drugs
San Francisco
Statistics as Topic
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Summary: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.
ISSN:0376-8716
1879-0046
DOI:10.1016/j.drugalcdep.2014.06.044