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Prescription opioid misuse among youth in primary care: A comparison of risk factors
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Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
being significant (p = 0.015). Patients reporting substance use were also less likely to be consistent condom users. Conclusions: This study suggests that adolescents self-referring to an adolescent health clinic are likely to engage in multiple risk behaviors and involvement in sexual risky behavior is related to substance use. Therefore, there is a significant need for medical providers to screen adolescents for both sexual risk behaviors and substance use, which provides an opportunity for comprehensive care. Financial support: NIDA R34DA031806. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.404 Cannabis self-administration in the laboratory and use in the natural environment during outpatient tiagabine maintenance Joshua Lile, Thomas Kelly, William Stoops, Jessica Fogel, Arit Harvanko, Richard Charnigo, Lon Hays University of Kentucky, Lexington, KY, United States Aims: The GABA reuptake inhibitor tiagabine produces behavioral and therapeutic effects that overlap with 9-THC, and therefore might be useful as a medication for cannabis-use disorders. The purpose of this study is to determine the ability of outpatient maintenance on tiagabine to reduce cannabis self-administration in the laboratory and use in the natural environment. Methods: Non-treatment-seeking daily cannabis users are maintained on tiagabine (0 and 12 mg/day) on an outpatient basis for two weeks. Subjects receive financial incentives for abstinence, verified by semi-quantitative urinalysis. Medication compliance is managed via Wisepill® technology, which permits real-time monitoring. On the final four days of each maintenance condition, subjects participate in two 2-session blocks (one sampling and one self-administration session) to assess the reinforcing, subjective, performance and physiological effects of smoked cannabis (0 and 5.7% 9-THC). Results: Seven subjects have completed the protocol; additional subjects will be enrolled until the target number have completed. Review of the data collected to date suggests that tiagabine alone and in combination with cannabis has been well tolerated. Subjects have been abstinent 31% of study days, which did not differ by maintenance condition. Cannabis has functioned as a reinforcer, increased positive subjective effects ratings, impaired psychomotor performance and elevated heart rate. Tiagabine has had minimal effect on the response to cannabis, although heart rate and a small number of subjective effects questionnaire items appear attenuated during tiagabine maintenance. Conclusions: The limited impact of tiagabine could be a function of dose, which is lower than the therapeutic range. Future studies will incorporate higher tiagabine doses and larger financial incentives to better model the motivation to quit. Overall, these results demonstrate the feasibility of using outpatient maintenance procedures to screen potential medications for cannabis-use disorders. Financial support: Supported by K02 DA031766, R01 DA025605 and UL1TR000117. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.405
Prescription opioid misuse among youth in primary care: A comparison of risk factors Lewei A. Lin, M.A. Walton, F.C. Blow Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States Aims: The rise in prescription opioid misuse (POM) is an emerging public health problem that often begins in adolescent years. Because these substances can originate from prescribers, it is vital to examine this issue in the primary care setting. Among a sample of youth who presented to primary care clinics, we assessed past 3 month misuse of prescription opioids as well as other substance use and obtained an assessment of psychosocial risk factors. Methods: Data are from a sample of primarily African-American (62.6%) youths ages 12–18, presenting to primary care community health clinics (Federally Qualified Health Centers) in two urban settings in the United States (n = 1076) that were enrolled in a prevention and early intervention study. We grouped participants into those reporting baseline opioid misuse (n = 79), those who used other substances (n = 330) including alcohol, marijuana, and misuse of other prescription drugs, and non-users (n = 667). Results: In comparison to participants who used other substances, those with POM began using marijuana and alcohol at younger ages, had higher likelihood of other prescription drug misuse, and higher likelihood of binge drinking (45.6% vs 24.2%). Compared to those who used other substances, those who misused opioids also had higher frequency of delinquency, higher levels of psychiatric symptoms with a particularly high percent reporting suicidal thoughts or behaviors (30.4% vs 10.6%). Multinomial regression revealed that among a range of risk factors, youth with POM were significantly less likely to be African-American (OR: 0.36, 95% CI: 0.21–0.63), more likely to have non-violent delinquency (OR: 1.06, 95% CI: 1.01–1.12), and more likely to have suicidal thoughts or attempts (OR: 2.33, 95% CI: 1.18–4.59) compared to those who used other substances. Conclusions: Adolescents with POM have higher rates of other substance use and other psychosocial risk factors compared to those who use other substances. Future studies are needed to better understand what contributes to these differences. Financial support: NIDA DA020075; 2013-2014 NIDA-AACAP Resident Research Award in Substance Abuse and Addiction. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.406 Sustained-release methylphenidate for the treatment of methamphetamine dependence Walter Ling, Maureen P. Hillhouse, J. Jenkins, J. Hernandez, M. Olaer, S. Reed, Larissa Mooney, M. Torrington, D. Dickerson Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA, United States Aims: Recent research indicates that methylphenidate (MPH; Concerta® ) may be effective in reducing amphetamine/methamphetamine (MA) use in drug-dependent individuals. The aim of this study was to investigate sustainedrelease methylphenidate (MPH) for reducing MA use in MA-dependent adults.
Abstracts / Drug and Alcohol Dependence 146 (2015) e118–e201
being significant (p = 0.015). Patients reporting substance use were also less likely to be consistent condom users. Conclusions: This study suggests that adolescents self-referring to an adolescent health clinic are likely to engage in multiple risk behaviors and involvement in sexual risky behavior is related to substance use. Therefore, there is a significant need for medical providers to screen adolescents for both sexual risk behaviors and substance use, which provides an opportunity for comprehensive care. Financial support: NIDA R34DA031806. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.404 Cannabis self-administration in the laboratory and use in the natural environment during outpatient tiagabine maintenance Joshua Lile, Thomas Kelly, William Stoops, Jessica Fogel, Arit Harvanko, Richard Charnigo, Lon Hays University of Kentucky, Lexington, KY, United States Aims: The GABA reuptake inhibitor tiagabine produces behavioral and therapeutic effects that overlap with 9-THC, and therefore might be useful as a medication for cannabis-use disorders. The purpose of this study is to determine the ability of outpatient maintenance on tiagabine to reduce cannabis self-administration in the laboratory and use in the natural environment. Methods: Non-treatment-seeking daily cannabis users are maintained on tiagabine (0 and 12 mg/day) on an outpatient basis for two weeks. Subjects receive financial incentives for abstinence, verified by semi-quantitative urinalysis. Medication compliance is managed via Wisepill® technology, which permits real-time monitoring. On the final four days of each maintenance condition, subjects participate in two 2-session blocks (one sampling and one self-administration session) to assess the reinforcing, subjective, performance and physiological effects of smoked cannabis (0 and 5.7% 9-THC). Results: Seven subjects have completed the protocol; additional subjects will be enrolled until the target number have completed. Review of the data collected to date suggests that tiagabine alone and in combination with cannabis has been well tolerated. Subjects have been abstinent 31% of study days, which did not differ by maintenance condition. Cannabis has functioned as a reinforcer, increased positive subjective effects ratings, impaired psychomotor performance and elevated heart rate. Tiagabine has had minimal effect on the response to cannabis, although heart rate and a small number of subjective effects questionnaire items appear attenuated during tiagabine maintenance. Conclusions: The limited impact of tiagabine could be a function of dose, which is lower than the therapeutic range. Future studies will incorporate higher tiagabine doses and larger financial incentives to better model the motivation to quit. Overall, these results demonstrate the feasibility of using outpatient maintenance procedures to screen potential medications for cannabis-use disorders. Financial support: Supported by K02 DA031766, R01 DA025605 and UL1TR000117. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.405
Prescription opioid misuse among youth in primary care: A comparison of risk factors Lewei A. Lin, M.A. Walton, F.C. Blow Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States Aims: The rise in prescription opioid misuse (POM) is an emerging public health problem that often begins in adolescent years. Because these substances can originate from prescribers, it is vital to examine this issue in the primary care setting. Among a sample of youth who presented to primary care clinics, we assessed past 3 month misuse of prescription opioids as well as other substance use and obtained an assessment of psychosocial risk factors. Methods: Data are from a sample of primarily African-American (62.6%) youths ages 12–18, presenting to primary care community health clinics (Federally Qualified Health Centers) in two urban settings in the United States (n = 1076) that were enrolled in a prevention and early intervention study. We grouped participants into those reporting baseline opioid misuse (n = 79), those who used other substances (n = 330) including alcohol, marijuana, and misuse of other prescription drugs, and non-users (n = 667). Results: In comparison to participants who used other substances, those with POM began using marijuana and alcohol at younger ages, had higher likelihood of other prescription drug misuse, and higher likelihood of binge drinking (45.6% vs 24.2%). Compared to those who used other substances, those who misused opioids also had higher frequency of delinquency, higher levels of psychiatric symptoms with a particularly high percent reporting suicidal thoughts or behaviors (30.4% vs 10.6%). Multinomial regression revealed that among a range of risk factors, youth with POM were significantly less likely to be African-American (OR: 0.36, 95% CI: 0.21–0.63), more likely to have non-violent delinquency (OR: 1.06, 95% CI: 1.01–1.12), and more likely to have suicidal thoughts or attempts (OR: 2.33, 95% CI: 1.18–4.59) compared to those who used other substances. Conclusions: Adolescents with POM have higher rates of other substance use and other psychosocial risk factors compared to those who use other substances. Future studies are needed to better understand what contributes to these differences. Financial support: NIDA DA020075; 2013-2014 NIDA-AACAP Resident Research Award in Substance Abuse and Addiction. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.406 Sustained-release methylphenidate for the treatment of methamphetamine dependence Walter Ling, Maureen P. Hillhouse, J. Jenkins, J. Hernandez, M. Olaer, S. Reed, Larissa Mooney, M. Torrington, D. Dickerson Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA, United States Aims: Recent research indicates that methylphenidate (MPH; Concerta® ) may be effective in reducing amphetamine/methamphetamine (MA) use in drug-dependent individuals. The aim of this study was to investigate sustainedrelease methylphenidate (MPH) for reducing MA use in MA-dependent adults.