Pharmaceutical Sciences ETDs

Vishal Bali

Publication Date

9-9-2010

Abstract

Background: Previous studies have found that health insurance and other socio-demographic factors are important predictors of non-medical use of prescription drugs (NMUPD), their abuse and dependence, and use of substance abuse treatment. However, the effect of health insurance in specific subgroups of population on NMUPD, their abuse and dependence, and use of substance abuse treatment, is largely unknown. Objective: To determine if the effect of health insurance on NMUPD, their abuse and dependence, and use of substance abuse treatment differs by socio-demographic factors. The study also aims to identify prescription drugs that are used non-medically and to assess the relationship between health insurance and use of such drugs. Methods: This study used data from 2007 National Survey on Drug Use and Health (NSDUH). Sample consisted of individuals who were 12 year and older, non-institutionalized. Bivariate and multiple logistic regression analyses were conducted to estimate the relationship between health insurance, socio-demographic factors on NMUPD, their abuse and dependence, and use of substance abuse treatment. Results: In 2007, self-reported prevalence of NMUPD was eight percent (N=5190). NMUPD was higher among uninsured individuals. In multivariate analysis, age, race, education, marital status, type of health insurance, level of income, past year use of tobacco, and alcohol were significantly associated with NMUPD. Hispanic people with private health insurance, high school graduates with public health insurance, privately insured individuals with family income less than $20,000 and $40,000-$74,999 were more likely to use prescription drugs than others. Drugs most likely to be used non-medically were Vicodin/Lortab/Lorcet (pain relievers), Valium /diazepam (tranquilizers), methamphetamine, Desoxyn/Methedrine (stimulants), and Methaqualone/Sopor/ Quaalude (sedatives). Approximately, one percent of the entire sample and 13% of NMUPD reported abuse dependence on prescription drugs. The classes of prescription drugs most likely to be abused were pain relievers, tranquilizers, stimulants and sedatives. Among individuals who used drugs non-medically, health insurance, age, marital status, general health status and use of tobacco were significant predictors of abuse/dependence. There were no significant interaction effects between health insurance and socio-demographic factors on prescription drug abuse and dependence. The last part of the study assessed if health insurance improved access to substance abuse treatment programs among those who reported NMUPD. Approximately 6% of the entire sample and 73% of the non-medical users and 76% of the prescription drug abusers/dependents reported some use of substance abuse programs. The Multivariate regression models indicated that health insurance was not associated with use of substance use treatment program. In addition, there were no significant interaction effects between health insurance and other socio-demographic and economic factors. Conclusions: NMUPD, their abuse/dependence, is common in the United States. Most of the non-medical users of prescription drugs, its abusers/dependents use pain relievers. Health insurance is associated with NMUPD, its abuse and dependence but not with the use of substance abuse treatment. Certain subgroups such as high school graduates with public health insurance privately insured individuals with family income less than $20,000 and $40,000-$74,999 are less likely to use prescription drugs non-medically. On the other hand, Hispanics with private health insurance are more likely to use prescription drugs non-medically than the others. These individuals are more likely to have lower education as well as poor physical and financial conditions. It is important that non-medical users, prescription drug abusers/dependents are made aware of the harms of NMUPD, their abuse and dependence and the benefits of using substance abuse treatment to overcome these health problems.

First Committee Member (Chair)

Raisch, Dennis

Degree Name

Pharmaceutical Sciences

Second Committee Member

Moffett, Maurice

Level of Degree

Masters

Department Name

College of Pharmacy

Language

English

Document Type

Thesis

Keywords

Medication abuse--Social aspects--United States, Health insurance--Social aspects--United States.

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