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  Poster Hall

Sun-86 - Misuse of Prescribed Medications for Approved Versus Non-Approved Indications: Predictors and Implications for Ambulatory Care

Scientific Poster Session II - Original Research

Original Research
  Sunday, October 13, 2024
  12:45 PM–02:15 PM

Abstract

Introduction:

Misuse of prescription drugs may result in adverse effects or inadequate pharmacotherapy. Misuse for indication (MUI, e.g., pain relievers for pain, tranquilizers for anxiety) may indicate persistent symptoms, whereas misuse for nonindicated reasons (MUNIR) may indicate desires for other psychoactive effects.

Research Question or Hypothesis:

This study aimed to assess prevalence and predictors of MUI versus MUNIR in 4 therapy classes: opioids, sedatives, stimulants, tranquilizers.

Study Design:

This retrospective cross-sectional analysis used data from the 2021 National Survey on Drug Use and Health (NSDUH).

Methods:

Associations of MUI and MUNIR with independent variables (demographics, prior non-therapeutic drug use) were tested for statistical significance with Pearson chi-square and multivariate logistic regression analysis (a<0.05) using IBM SPSS v29.0.

Results:

Of 2,809 respondents with prescription misuse, 69% had MUI and 31% MUNIR. Compared with MUNIR, MUI were older (e.g., aged >50 years: 18% vs. 34%). Most (71%) MUNIR used illicit drugs or marijuana before age 18. Common MUI reasons included pain relief (49%, opioids) and anxiety (28%, tranquilizers). In bivariate analyses, MUI rates increased with age of first alcohol use, ages >21 years (83%). As past-year days of alcohol use increased, MUI decreased, from 75% who used no alcohol to 61% who regularly used alcohol (p<0.001). The strongest predictors of MUI were any past-year tranquilizer use (adjusted-odds-ratio [AOR]=2.099, 95% confidence interval [CI]=1.745-2.524) and aged >50 years (AOR=1.747, CI=1.386-2.202). Past-year alcohol use >300 days (AOR=0.500, CI=0.361-0.694) and first use of illicit drugs or marijuana before age 18 (AOR=0.677, CI=0.548-0.838) were associated with decreased odds.

Conclusion:

In a national sample of U.S. adults misusing prescription medications, MUI occurred in 69%. MUI was common in respondents aged > 50 years, potentially indicating increasing health conditions or symptoms. MUNIR was prevalent in respondents with long histories of substance use. These findings reinforce the need to determine why misuse occurs to guide appropriate interventions.

Presenting Author

Alexandra Holmes BS, PharmD Candidate
Midwestern University

Authors

Kathleen A. Fairman MA, PhD
Midwestern University, College of Pharmacy-Glendale

Oliver Grundmann PhD, MS, MEd, BPharm
University of Florida

Maria Sarwar BS, PharmD Candidate
Midwestern University Glendale