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Simon KE, Buttram ME, Samuel KD, Doyle NA, Davis RE. Stigma Related to the Non-Medical Use and Diversion of Prescription Stimulant Drugs: Should We Care. Subst Use Misuse 2024; 59:1200-1209. [PMID: 38565901 DOI: 10.1080/10826084.2024.2330903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Non-medical use (NMU) and diversion of prescription stimulants are prevalent on college campuses. Diversion represents a primary source of acquisition for NMU among young adults. This study examined relationships between stigmatizing beliefs related to NMU and diversion of stimulant medications and engagement in these behaviors, as well as how such perceptions are associated with indicators of psychological distress among those who engage in these behaviors. METHODS Young adults (N = 384) were recruited from a large US university to participate in this cross-sectional electronic survey-based study. Relationships between stigma variables and NMU and diversion were assessed. Among those who engage in NMU and diversion, we tested relationships between stigma variables and indicators of psychological distress, using validated instruments. RESULTS Perceived social and personal stigmatic beliefs did not significantly predict NMU. However, perceived social and personal stigma of diversion significantly reduced diversion likelihood. For NMU, associations were found between stigma variables and indicators of psychological distress. Markedly, we found that as stigmatic perceptions of NMU increased, so did depressive, anxiolytic, and suicidal symptomatology among those who engage in NMU. CONCLUSIONS Stigmatization does not deter NMU; however, stigmatization is positively associated with psychological harm among those who engage in NMU. Interventions should be developed to reduce stigmatization in order to improve psychological health among those who engage in NMU. Stigmatic perceptions of diversion were not predictive of psychological harm, though they are negatively associated with diversion behavior.
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Affiliation(s)
- Kayla E Simon
- Department of Health, Human Performance, and Recreation, Substance Use and Mental Health Laboratory, University of Arkansas, Fayetteville, Arkansas, USA
| | - Mance E Buttram
- Department of Health, Human Performance, and Recreation, Center for Public Health and Technology, University of Arkansas, Fayetteville, Arkansas, USA
| | - Krishen D Samuel
- Department of Health, Human Performance, and Recreation, Substance Use and Mental Health Laboratory, University of Arkansas, Fayetteville, Arkansas, USA
| | - Nicole A Doyle
- College of Global Population Health, University of Health Sciences and Pharmacy, St. Louis, Missouri, USA
| | - Robert E Davis
- Department of Health, Human Performance, and Recreation, Substance Use and Mental Health Laboratory, University of Arkansas, Fayetteville, Arkansas, USA
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Shelton RC, Goodwin K, McNeil M, Bernitz M, Alexander SP, Parish C, Brotzman L, Lee M, Li WB, Makam S, Ganek N, Foskett D, Warren C, Metsch LR. Application of The Consolidated Framework for Implementation Research to inform understanding of barriers and facilitators to the implementation of opioid and naloxone training on college campuses. Implement Sci Commun 2023; 4:56. [PMID: 37221618 PMCID: PMC10204023 DOI: 10.1186/s43058-023-00438-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/09/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The opioid epidemic in the US continues to worsen. Opioid-only and polysubstance-involved opioid overdose deaths are increasing among adolescents and young adults, who have limited knowledge of opioid overdose prevention, including recognition and response. College campuses have infrastructure to support national-level implementation of evidence-based public health strategies for providing opioid overdose prevention and naloxone training programs among this priority population. However, college campuses are an underutilized, understudied setting for this programming. To address this gap, we conducted research assessing barriers and facilitators to planning and implementing this programming on college campuses. METHODS We held 9 focus groups among purposively selected campus stakeholders whose perceptions were important to understand in planning for the dissemination and implementation of opioid overdose prevention and naloxone training. Focus group scripts were informed by The Consolidated Framework for Implementation Research (CFIR) to query about perceptions of opioid and other substance use, opioid and other substance use-related resources, and naloxone administration training. We used a deductive-inductive, iterative approach to thematic analysis. RESULTS Themes about implementation barriers included (1) the perception that problematic use of other (non-opioid) substances was more prevalent than opioid use on campus and focus on those substances would be a greater priority on college campuses; (2) student schedules were overwhelmed with academic commitments and extracurricular activities, making delivery of additional training challenging; (3) barriers related to the perceived complexity and decentralization of communication on campus, preventing students from knowing how to access substance use-related resources. Themes about implementation facilitators included (1) framing naloxone training as important in becoming a responsible leader on campus and in the broader community and (2) leveraging existing infrastructure, champions within existing campus groups, and tailored messaging to facilitate participation in naloxone training. CONCLUSIONS This is the first study to provide in-depth insights into potential barriers and facilitators to widespread, routine implementation of naloxone/opioid education on undergraduate college campuses. The study captured diverse stakeholder perspectives and was theoretically grounded in CFIR, contributing to the growing literature on the application and refinement of CFIR across diverse community and school contexts.
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Affiliation(s)
- Rachel C Shelton
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA.
| | - Kathleen Goodwin
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Michael McNeil
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
- Columbia Health, Columbia University, New York, NY, USA
| | - Melanie Bernitz
- Columbia Health, Columbia University, New York, NY, USA
- Center for Family and Community Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Savannah P Alexander
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Carrigan Parish
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Laura Brotzman
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Matthew Lee
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | | | | | | | | | - Chloe Warren
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, Columbia University, 722 W 168th St, Room 941, New York, NY, 10032, USA
- School of General Studies, Columbia University, New York, NY, USA
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Zhong XL, Sheng DL, Cheng TZ, Zhang ZW. Effect of exercise prescription teaching on exercise quality and mental health status of college students. World J Psychiatry 2023; 13:191-202. [PMID: 37303933 PMCID: PMC10251364 DOI: 10.5498/wjp.v13.i5.191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/21/2023] [Accepted: 04/19/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND The teaching mode of fitness exercise prescriptions for college students in physical education conforms to the scientific principles and rules of fitness, which can adapt to the characteristics of students' individual physiological functions and stimulate their interest in learning.
AIM To analyze the effect of prescribed exercise teaching on the sports quality and mental health of college students.
METHODS The participants of the study were 240 students in our class of 2021, of which 142 were men and 98 were women. The 240 students were randomly divided into an experimental group using the exercise prescription teaching model and a control group using the conventional teaching model. The experimental and control groups were divided into four classes of 30 students each. The teaching activities of the two teaching mode groups were strictly controlled, and the same tests were used before and after the experiment to test the subjects' exercise quality (in-cluding standing long jump, 50 m race, 800 m race, sit-ups, sit-and-reach), physical form (including height, weight, Ketorolai index), cardiopulmonary function (including heart rate, blood pressure, spirometry, 12-min running distance, maximum oxygen intake) and mental health (SCL-90, including somatization, obsessive-compulsive, interpersonal, depression, anxiety, hostility, phobia, paranoia, psychotic symptoms) to understand the effects of the exercise prescription teaching mode on students' physical and mental health status.
RESULTS There were differences in the exercise scores of standing long jump, 50 m, 800 m/1000 m running, sit-ups, and sit-and-reach in the experimental group after the experiment compared with those before the experiment, and the above indices of the experimental group were different from those of the control group after the experiment (P < 0.05). There were differences in body weight and Ketorolai index in the experimental group after the experiment compared to those before the experiment, and the indices of the experimental group were also different from those of the control group after the experiment (P < 0.05). After the experiment, there were differences in spirometry, 12-min running distance, and maximum oxygen intake in the experimental group compared to those before the experiment, and the indices of the experimental group were also different from those of the control group after the experiment (P < 0.05). After the experiment, the indicators of somatization, interpersonal sensitivity, depression, anxiety, and hostility in the experimental group were different from those in the pre-experimental group, and the indexes of the experimental group were also different from those of the control group after the experiment (P < 0.05).
CONCLUSION Exercise prescription teaching can mobilize college students' consciousness, enthusiasm, and initiative; expand personalities; enhance physical fitness and improve their mental health more than the conventional fitness exercise prescription teaching method.
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Affiliation(s)
- Xing-Long Zhong
- Police Command and Tactics Department, Zhejiang Police College, Hangzhou 310053, Zhejiang Province, China
| | - Da-Li Sheng
- Police Command and Tactics Department, Zhejiang Police College, Hangzhou 310053, Zhejiang Province, China
| | - Tong-Zhou Cheng
- Police Command and Tactics Department, Zhejiang Police College, Hangzhou 310053, Zhejiang Province, China
| | - Zhe-Wei Zhang
- Police Command and Tactics Department, Zhejiang Police College, Hangzhou 310053, Zhejiang Province, China
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Fuss C, Romm KF, Crawford ND, Harrington KRV, Wang Y, Ma Y, Taggart T, Ruiz MS, Berg CJ. Psychosocial Correlates of Opioid Use Profiles among Young Adults in a Longitudinal Study across 6 US Metropolitan Areas. Subst Use Misuse 2023; 58:981-988. [PMID: 37082785 PMCID: PMC10645480 DOI: 10.1080/10826084.2023.2201839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Background: Examining opioid use profiles over time and related factors among young adults is crucial to informing prevention efforts. Objectives: This study analyzed baseline data (Fall 2018) and one-year follow-up data from a cohort of 2,975 US young adults (Mage=24.55, 42.1% male; 71.7% White; 11.4% Hispanic). Multinomial logistic regression was used to examine: 1) psychosocial correlates (i.e. adverse childhood experiences [ACEs], depressive symptoms, parental substance use) of lifetime opioid use (i.e. prescription use vs. nonuse, nonmedical prescription [NMPO] use, and heroin use, respectively); and 2) psychosocial correlates and baseline lifetime use in relation to past 6-month use at one-year follow-up (i.e. prescription use vs. nonuse and NMPO/heroin use, respectively). Results: At baseline, lifetime use prevalence was: 30.2% prescription, 9.7% NMPO, and 3.1% heroin; past 6-month use prevalence was: 7.6% prescription, 2.5% NMPO, and 0.9% heroin. Compared to prescription users, nonusers reported fewer ACEs and having parents more likely to use tobacco, but less likely alcohol; NMPO users did not differ; and heroin users reported more ACEs and having parents more likely to use cannabis but less likely alcohol. At one-year follow-up, past 6-month use prevalence was: 4.3% prescription, 1.3% NMPO, and 1.4% heroin; relative to prescription users, nonusers were less likely to report baseline lifetime opioid use and reported fewer ACEs, and NMPO/heroin users were less likely to report baseline prescription opioid use but more likely heroin use. Conclusions: Psychosocial factors differentially correlate with young adult opioid use profiles, and thus may inform targeted interventions addressing different use patterns and psychosocial risk factors.
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Affiliation(s)
- Caroline Fuss
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Department of Pediatrics, College of Medicine,University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Natalie D Crawford
- Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kristin R V Harrington
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yan Ma
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tamara Taggart
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Monica S Ruiz
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
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Weyandt LL, Gudmundsdottir BG, Holding EZ, Marraccini ME, Keith M, May SE, Shepard E, Francis A, Wilson ED, Channell I, Sweeney C. Prescription opioid misuse among university students: A systematic review. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1119-1137. [PMID: 32780647 DOI: 10.1080/07448481.2020.1786095] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 05/08/2020] [Accepted: 06/12/2020] [Indexed: 06/11/2023]
Abstract
Misuse of prescription opioids has substantially increased in the past decade among the general population, including among university students. Relative to the literature concerning opioid misuse among the general population, little information is available regarding the college student population. Objective: The purpose of the present study was to conduct a systematic review of the literature concerning the prevalence of prescription opioid misuse among the university student population. Results: The lifetime estimate for prescription opioid misuse among general populations of students ranged from 4% to 19.7%, with higher estimates for special student populations. Students most at risk for misuse of prescription opioids are those who report higher rates of psychological distress, depression, and suicidal thoughts and behaviors, and white, male students who use alcohol and illicit drugs. Conclusions: Findings from this study underscore the need for opioid prevention and intervention programs on university campuses.
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Affiliation(s)
- Lisa L Weyandt
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | | | - Emily Z Holding
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marisa E Marraccini
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Megan Keith
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Shannon E May
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, Connecticut, USA
| | - Emily Shepard
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Alyssa Francis
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Elizabeth D Wilson
- School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Isabella Channell
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Caroline Sweeney
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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Nonmedical Prescription Opioid Use among a Sample of College Students: Prevalence and Predictors. PHARMACY 2021; 9:pharmacy9020106. [PMID: 34071670 PMCID: PMC8167772 DOI: 10.3390/pharmacy9020106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022] Open
Abstract
Nonmedical use of prescription opioid medication (NMPO) in the United States is a public health crisis, resulting in high rates of emergency room visits, morbidity, and mortality. The purpose of this study was to explore prevalence estimates and correlates of NMPO among a convenience sample of college students in the northeast and southeast regions of the US to help generate directions for future research. Motivations for misuse, age of onset, access, concomitant substance use, and individual factors were investigated among a sample of undergraduate students from two universities. Participants (N = 847) completed a battery of various self-report measures. Findings revealed that 7.7% (Southeastern University) and 12.8% of students (Northeastern University) reported lifetime NMPO, whereas past-month NMPO was reported by 0.8% and 0.9% of participants, respectively. Lifetime history of regularly using alcohol, nonmedical use of benzodiazepine medication, nonmedical use of prescription stimulants, symptoms of depression and anxiety, and executive functioning (i.e., metacognition and behavioral regulation) were significantly related to lifetime history of NMPO in this college sample. These findings offer several potential subsequent lines of investigation regarding the associations between various demographic and psychological factors and NMPO. Future research is needed to help identify college students who are at risk of NMPO.
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7
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Qeadan F, Madden EF, Bern R, Parsinejad N, Porucznik CA, Venner KL, English K. Associations between opioid misuse and social relationship factors among American Indian, Alaska Native, and Native Hawaiian college students in the U.S. Drug Alcohol Depend 2021; 222:108667. [PMID: 33771399 DOI: 10.1016/j.drugalcdep.2021.108667] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/23/2021] [Accepted: 01/31/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite declining overall rates of opioid misuse among college students, racial and ethnic differences in percentage and correlates of opioid misuse among student populations remains unclear. This study seeks to estimate percentages of opioid misuse among American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) college students and determine whether problems in social bonds affect AI/AN/NH opioid misuse. METHODS Guided by social relationship factors associated with substance use in the Social Development Model, we used 2015-2019 data from the American College Health Association-National College Health Assessment survey in multivariable logistic regression models to examine the role of social bonds with peers and family in opioid misuse (prescription and non-prescription) among AI/AN/NH college students across the U.S. RESULTS The percentage of opioid misuse was highest among AI/AN/NH college students (7.12 %) relative to other race/ethnicity groups. AI/AN/NH college students who reported experiencing loneliness (aOR: 1.68; 95 % CI 1.33-2.12; P < .0001), difficult social relationships (aOR: 1.27; 95 % CI 1.04-1.55; P = 0.0196), family problems (aOR: 1.32; 95 % CI 1.07-1.63; P = 0.0097), and intimate partner violence (aOR: 1.92; 95 % CI 1.56-2.36; P < .0001) were significantly more likely to misuse opioids than students who did not report experiencing these relationship problems. CONCLUSIONS Relationship problems with peers and family increase AI/AN/NH college student risk for opioid misuse, indicating opportunities for colleges to support programs addressing healthy social relationships as a means to reduce opioid misuse among AI/AN/NH students.
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Affiliation(s)
- Fares Qeadan
- University of Utah School of Medicine, Department of Family and Preventive Medicine, United States.
| | - Erin F Madden
- Wayne State University, Department of Family Medicine and Public Health Sciences, United States
| | - Rona Bern
- University of Utah School of Medicine, Department of Family and Preventive Medicine, United States
| | - Nasim Parsinejad
- University of Utah School of Medicine, Department of Family and Preventive Medicine, United States
| | - Christina A Porucznik
- University of Utah School of Medicine, Department of Family and Preventive Medicine, United States
| | - Kamilla L Venner
- University of New Mexico, Department of Psychology, Center on Alcohol, Substance use, And Addiction (CASAA), United States
| | - Kevin English
- Albuquerque Area Southwest Tribal Epidemiology Center, New Mexico, United States
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Freda PJ, Moore JH, Kranzler HR. The phenomics and genetics of addictive and affective comorbidity in opioid use disorder. Drug Alcohol Depend 2021; 221:108602. [PMID: 33652377 PMCID: PMC8059867 DOI: 10.1016/j.drugalcdep.2021.108602] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/21/2022]
Abstract
Opioid use disorder (OUD) creates significant public health and economic burdens worldwide. Therefore, understanding the risk factors that lead to the development of OUD is fundamental to reducing both its prevalence and its impact. Significant sources of OUD risk include co-occurring lifetime and current diagnoses of both psychiatric disorders, primarily mood disorders, and other substance use disorders, and unique and shared genetic factors. Although there appears to be pleiotropy between OUD and both mood and substance use disorders, this aspect of OUD risk is poorly understood. In this review, we describe the prevalence and clinical significance of addictive and affective comorbidities as risk factors for OUD development as a basis for rational opioid prescribing and OUD treatment and to improve efforts to prevent the disorder. We also review the genetic variants that have been associated with OUD and other addictive and affective disorders to highlight targets for future study and risk assessment protocols.
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Affiliation(s)
- Philip J. Freda
- University of Pennsylvania, Biostatistics, Epidemiology, & Informatics, The Perelman School of Medicine, University of Pennsylvania A201 R…, Philadelphia, Pennsylvania 19104, United States
| | - Jason H. Moore
- Edward Rose Professor of Informatics, Director, Institute for Biomedical Informatics, Director, Division of Informatics, Department of Biostatistics, Epidemiology, & Informatics, Senior Associate Dean for Informatics, The Perelman School of Medicine, University of Pennsylvania, Contact Information: D202 Richards Building, 3700 Hamilton Walk, University of Pennsylvania, Philadelphia, PA 19104-6116
| | - Henry R. Kranzler
- Benjamin Rush Professor in Psychiatry, Department of Psychiatry, University of Pennsylvania, Treatment Research Center, 3535 Market Street, Suite 500, Philadelphia, PA 19104-6178
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