title: Prescription opioid misuse and mental health among young injection drug users.
abstract: BACKGROUND
  Prescription opioid (PO) misuse is a significant concern in the United States.
  
  
  OBJECTIVE
  This study describes the prevalence and timing of PO misuse, diagnoses of opiate abuse and dependence, and their associations with psychiatric disorders in a sample of young people who inject drugs (PWID).
  
  
  METHODS
  Participants were 570 young (18-25 years) PWID, primarily heroin users, recruited through outreach and respondent-driven sampling. Trained interviewers administered a semi-structured psychiatric interview. Diagnoses of substance use and mental disorders were based on DSM-IV diagnostic criteria.
  
  
  RESULTS
  Estimated rates of lifetime PO abuse and dependence were 19% and 17%, respectively. Past year PO misuse was significantly associated with anti-social personality disorder (ASPD, OR = 2.15, 95% CI 1.43-3.24), past year substance-induced major depression (SIMD, OR = 1.81, 95% CI 1.16-2.83), and prior post-traumatic stress disorder (PTSD, OR = 2.45, 95% CI 1.31-4.60). Among male PO users, PTSD was a significant predictor of PO abuse (prior, OR = 7.62, 95% CI 2.16-26.88; past year, OR = 21.67 95% CI 2.46-190.75), and dependence (prior, OR = 4.82, 95% CI 1.48-15.67; past year, OR = 9.65, 95% CI 1.75-53.32).
  
  
  CONCLUSIONS
  Among young PWID, PTSD is a significant risk factor for PO misuse for both men and women, and men with PTSD are in addition at increased risk for PO abuse and dependence. These findings have implications for harm reduction and substance abuse prevention efforts.
authors.affiliation: Community Outreach Intervention Projects, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago , Chicago, IL , USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Mackesy-Amiti
authors.forename: Geri R
authors.initials: GR
authors.lastname: Donenberg
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Ouellet
mesh_terms: D000293:Adolescent; D016739:Behavior, Addictive; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology*; D009293:Opioid-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D063487:Prescription Drug Misuse / Q000523:psychology; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Heroin; injection drug use; mental health; prescription opioids
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