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- W2900859897 abstract "See Related Article on p. 709 See Related Article on p. 709 In this issue of the Journal of Adolescent Health, a study by Carrasco-Garrido et al. assessed trends in misuse of prescription tranquilizers, sedatives, and sleeping pills over time in a school-based sample of adolescents in Spain [[1]Carrasco-Garrido P Jimenez-Trujillo I Hernandez-Barrera V et al.Trends in the misuse of tranquilizers, sedatives, and sleeping pills by adolescents in Spain, 2004-2014.J Adolesc Health. 2018; 63: 709-716Scopus (14) Google Scholar]. Their results showed that the prevalence of misuse increased significantly from 2004–2014, that girls had a higher prevalence of misuse than boys, and that the use of alcohol and other drugs was a strong correlate of misuse. This research is important in that it shines a light on a class of prescription drugs that have been overlooked. We know that people perceive prescription drugs differently than “street” drugs. Prescription drugs are viewed as being safer, use is more socially acceptable, and they are easier to access [2Cicero TJ Inciardi JA Munoz A Trends in abuse of OxyContin and other opioid analgesics in the United States: 2002-2004.J Pain. 2005; 6: 667-672Abstract Full Text Full Text PDF Scopus (378) Google Scholar, 3McCabe SE Misperceptions of nonmedical prescription drug use: a web survey of college students.Addict Behav. 2008; 33: 713-724Crossref PubMed Scopus (109) Google Scholar, 4Quintero G Peterson J Young B An exploratory study of socio-cultural factors contributing to prescription drug misuse among college students.J Drug Issues. 2006; 36: 903-931Crossref Scopus (76) Google Scholar, 5Weyandt LL Janusis G Wilson KG et al.Nonmedical prescription stimulant use among a sample of college students.J Atten Disord. 2009; 13: 284-296Crossref PubMed Scopus (132) Google Scholar]. While the dramatic increase in overdose deaths associated with prescription opioids [[6]Overdose death rates. Available at: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. Accessed August 13, 2018.Google Scholar] challenges these perceptions for one class of prescription drugs, it is important to understand the risks associated with other classes of prescription drugs as well. Central nervous system depressants are often categorized as tranquilizers (e.g., Xanax, Ativan, and Valium) and sedatives (e.g., Ambien, Lunesta, and Restoril) in survey research and are widely prescribed to and often misused by adolescents. The most commonly used/misused class of tranquilizers/sedatives are benzodiazepines, which are commonly prescribed to treat anxiety, seizures, and insomnia. While benzodiazepines have shown to be effective, there is also a serious concern about their abuse potential. A number of statistics suggest tranquilizers/sedatives may be playing a key role in the current prescription drug crisis. The number of people with prescriptions for benzodiazepines increased 67% between 1996–2013 [[7]Bachhuber MA Hennessy S Cunningham CO Starrels JL Increasing benzodiazepine prescriptions and overdose mortality in the United States, 1996-2013.Am J Public Health. 2016; 106: 686-888Crossref PubMed Scopus (247) Google Scholar]. Public health surveillance data shows that roughly 1.5 million adolescents reported past year tranquilizer/sedative use or misuse in 2016 and the prevalence of misuse has remained stable in recent years [8Center for Behavioral Health Statistics and Quality2014 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD2015Google Scholar, 9Miech RA Johnston LD O'Malley PM et al.Monitoring the future national survey results on drug use, 1975–2017: volume I, secondary school students. Institute for Social Research, The University of Michigan, Ann Arbor2018http://monitoringthefuture.org/pubs.html#monographsGoogle Scholar]. In addition, benzodiazepine use/misuse is associated with negative health-related outcomes, as the number of benzodiazepine related emergency department visits increased 160% from 2004–2011 [[10]Drug Abuse Warning Network. Available at: https://www.samhsa.gov/data/data-we-collect/dawn-drug-abuse-warning-network. Accessed August 13, 2018.Google Scholar] and overdose deaths increased by 137% between 2007–2016 [[6]Overdose death rates. Available at: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. Accessed August 13, 2018.Google Scholar]. These statistics are troubling, given that rates of opioid misuse are on the decline among adolescents [[9]Miech RA Johnston LD O'Malley PM et al.Monitoring the future national survey results on drug use, 1975–2017: volume I, secondary school students. Institute for Social Research, The University of Michigan, Ann Arbor2018http://monitoringthefuture.org/pubs.html#monographsGoogle Scholar] and overdose deaths associated with prescription opioids have increased at a much slower rate [[6]Overdose death rates. Available at: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. Accessed August 13, 2018.Google Scholar]. While an abundance of research has focused on prescription opioids, these statistics clearly indicate that tranquilizers/sedatives are playing an important role in the current prescription drug crisis. To date we know a good deal about tranquilizer/sedative misuse among adolescents, but further research is needed to provide a more comprehensive understanding of the associated risks. First, the primary source of tranquilizers/sedatives are friends/family and adolescents misuse for both self-treatment (e.g., relax or relieve tension; help with feelings or emotions) and recreational (e.g., feel good or get high; to experiment) motives [[8]Center for Behavioral Health Statistics and Quality2014 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD2015Google Scholar]. Research on these characteristics of misuse is important because it helps to identify adolescents at increased risk for negative outcomes. Research shows that obtaining prescription drugs from dealers/strangers (compared to friends/relatives) and use for recreational motives (compared to self-treatment) increases the risk of more frequent prescription drug misuse, other illicit drug use, and substance use disorder symptoms [11Ford JA Lacerenza C The relationship between source of diversion and prescription drug misuse, abuse, and dependence.Subst Use Misuse. 2011; 46: 819-827Crossref PubMed Scopus (34) Google Scholar, 12Schepis TS Krishnan-Sarin S Sources of prescriptions for misuse by adolescents: differences in sex, ethnicity, and severity of misuse in a population-based study.J Am Acad Adolesc Psychiatry. 2009; 48: 828-836Abstract Full Text Full Text PDF PubMed Scopus (53) Google Scholar, 13McCabe SE Cranford JA Boyd CJ Teter CJ Motives, diversion and routes of administration associated with nonmedical use of prescription opioids.Addict Behav. 2007; 32: 562-575Crossref PubMed Scopus (282) Google Scholar, 14Drazdowski TK A systematic review of the motivations for the non-medical use of prescription drugs in young adults.Drug Alcohol Depend. 2016; 162: 3-25Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar]. Second, the extant research has identified a number of correlates of tranquilizer/sedative misuse, as the risk of misuse is increased among older adolescents, females, whites, those not in school, with peers who approve of drug use, weak social bonds, exposure to stress/strain, lower levels of religiosity, depression, and other drug use [15Rigg KK Ford JA The misuse of benzodiazepines among adolescents: psychosocial risk factors in a national sample.Drug Alcohol Depend. 2014; 137: 137-142Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar, 16Ford JA McCutcheon J The misuse of Ambien among adolescents: prevalence and correlates in a national sample.Addict Behav. 2012; 37: 1389-1394Crossref PubMed Scopus (28) Google Scholar, 17Schepis TS Teter CJ Simoni-Wastilla L McCabe SE Prescription tranquilizer/sedative misuse prevalence and correlates across age cohorts in the US.Addict Behav. 2018; 87: 24-32Crossref Scopus (42) Google Scholar]. Third, research shows that coingestion is common and those who coingest initiate misuse at an earlier age and are more likely to misuse for recreational motives [[18]Schepis TS West BT Teter CJ McCabe SE Prevalence and correlates of co-ingestion of prescription tranquilizers and other psychoactive substances by US high school seniors: results from a national survey.Addict Behav. 2016; 52: 8-12Crossref PubMed Scopus (25) Google Scholar]. Coingestion is risky, as 86% of benzodiazepine deaths also involve the use of opioids [[6]Overdose death rates. Available at: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. Accessed August 13, 2018.Google Scholar]. The risks associated with coingestion are particularly troubling as the rates of people being prescribed both opioids and benzodiazepines doubled between 2001–2013 [[19]Sun EC Dixit A Humphreys K et al.Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis.BMJ. 2017; 356: j760Crossref PubMed Scopus (305) Google Scholar]. Finally, research shows that tranquilizer/sedative misuse during adolescence increases the risk for substance use disorder symptoms in adulthood [[20]McCabe SE Veliz P Boyd CJ Schulemberg JE Medical and nonmedical use of prescription sedatives and anxiolytics: adolescents’ use and substance use disorder symptoms in adulthood.Addict Behav. 2017; 65: 296-301Crossref PubMed Scopus (29) Google Scholar]. Given the serious risks associated with the misuse of prescription tranquilizers/sedatives further rigorous scientific research is necessary. While a number of studies have identified risk factors for misuse, research is needed to identify the causal mechanisms that place certain groups (e.g., females) at increased risk for misuse. Additionally, it is imperative that the field moves beyond a simple dichotomous measure of misuse and focuses on patterns of misuse that increase the risk of negative outcomes. For example research should pay closer attention to frequent PDM, substance use disorders associated with prescription drugs, and coingestion of prescription drugs with other substances. Finally, we need a better understanding of the factors related to stability and change in prescription drug misuse over the life course. Identifying factors that likely reduce (e.g., social bonds/capital) or increase (e.g., peer influence, stress/strain) misuse during the transition from adolescence to adulthood is essential. The misuse of prescription tranquilizers/sedatives is a serious health risk for adolescents and focusing solely on opioids may be leading to the misuse of other drugs being overlooked. In particular, benzodiazepines are clearly worthy of attention from the scientific community. It is important to understand that not all misuse is equal. For example, an adolescents who misuses two or three times a year to manage their emotions and obtains pills from their parents is different than an adolescent who misuses weekly to get high and buys pills from a dealer. It is essential that we identify risk and protective factors related to patterns of misuse that are more likely to produce negative outcomes. In addition, medical professionals, parents, and adolescents must become aware of the risks associated with tranquilizer/sedative misuse. Doctors must carefully prescribe these drugs and understand that adolescents may misuse these drugs and develop addiction. Parents must closely monitor their children who have been prescribed these drugs, making sure they are safely stored and not diverted. To develop effective prevention and intervention strategies a more comprehensive understanding of the factors that increase the risk of negative outcomes associated with the misuse of tranquilizers/sedatives is required. Trends in the Misuse of Tranquilizers, Sedatives, and Sleeping Pills by Adolescents in Spain, 2004–2014Journal of Adolescent HealthVol. 63Issue 6PreviewMisuse of prescription medication has increased during the last 20 years among adolescents and young adults. We aimed to report the prevalence and factors associated with misuse of tranquilizers, sedatives, and sleeping pills (TSSp) in high-school students in Spain. We also analyzed misuse of these drugs during the decade 2004–2014. Full-Text PDF" @default.
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- W2900859897 title "The Prescription Drug Problem We Are Missing: Risks Associated with the Misuse of Tranquilizers and Sedatives" @default.
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