title: The effects of alcohol, cannabis, and cigarette use on the initiation, reinitiation and persistence of non-medical use of opioids, sedatives, and tranquilizers in adults.
abstract: BACKGROUND
  Non-medical prescription drug use (NMPDU) has been a growing concern due to increased prevalence and severity of consequences. Epidemiological research has identified alcohol, cannabis, and cigarette use to be associated with NMPDU and initiation. However, studies have not examined stages of NMPDU in relation to other substances, which can highlight salient factors associated with high risk stages of NMPDU, such as reinitiation and persistence.
  
  
  METHODS
  This study used an adult sample from the National Epidemiologic Survey of Alcohol and Related Conditions Wave 1 (2001-2002) and Wave 2 (2004-2005) data. We examined non-users, prior users, and current users of opioids and sedatives/tranquilizers at risk of initiation, reinitiation, and persistence between Wave 1 and Wave 2 in relation to early-onset and frequency of cannabis, cigarette, and alcohol use, controlling for sociodemographics.
  
  
  RESULTS
  Early-onset of cigarette and alcohol use increased the odds of opioid use initiation; early-onset of cannabis, cigarette, and alcohol use increased the odds of sedative/tranquilizer use initiation and opioid reinitiation, persistence, while early-onset cannabis increased the odds of sedative/tranquilizer reinitiation and persistence. Frequency of cannabis and cigarette use predicted all three stages of opioid use, initiation/reinitiation of sedatives/tranquilizers, and frequency of cannabis use alone predicted sedative/tranquilizer persistence.
  
  
  CONCLUSIONS
  This study provided evidence that differentiating among those who have experienced initiation, reinitiation, or persistence of NMPDU via early-onset and frequency of alcohol, cigarettes, and cannabis is vital, as there are specific aspects that influence risk. Therefore, tailoring interventions at different stages to reduce NMPDU is crucial.
authors.affiliation: School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, USA. Electronic address: barterb@med.umich.edu.
authors.forename: Brooke J
authors.initials: BJ
authors.lastname: Arterberry
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, 1025 E. 7th Street, Bloomington, IN 47405, USA. Electronic address: shorbal@indiana.edu.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Horbal
authors.affiliation: School of Nursing, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, USA. Electronic address: buu@umich.edu.
authors.forename: Anne
authors.initials: A
authors.lastname: Buu
authors.affiliation: Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7th Street, SPH 116, Bloomington, IN 47405, USA. Electronic address: linhsi@indiana.edu.
authors.forename: Hsien-Chang
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012651:Self Medication / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D014149:Tranquilizing Agents / Q000008:administration & dosage*; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D014149:Tranquilizing Agents
keywords: Alcohol; Cannabis; Cigarette; Early onset; Opioid; Sedative; Tranquilizer