Prevalence and drug use correlates of extra-medical use of prescription medications for sleep among adults in the United States: Results of the 2015–2018 National Survey on Drug Use and Health

Abstract

BACKGROUND\nThis paper examines the epidemiology of extra-medical use of prescription medications for sleep among a nationally representative sample of U.S. adults.\n\n\nMETHODS\nWe analyzed data from the 2015-2018 National Surveys on Drug Use and Health. The sample includes 3410\u202fU.S. adults who reported extra-medical use of prescription medications for sleep. Multinomial logistic regression models identified correlates of type of drug used [i.e., sedatives and/or tranquilizers-only (ST-only), prescription pain relievers-only (PPR-only), or sedatives, tranquilizers, and prescription pain relievers (ST\u202f+\u202fPPR)], and logistic regression models identified correlates of reasons for extra-medical use (i.e., sleep-only vs. sleep and recreational).\n\n\nRESULTS\nAbout 60% (95%CI\u202f=\u202f58.9, 63.5) of the sample reported extra-medical use of ST-only, followed by PPR-only (29.9%, 95%CI\u202f=\u202f27.5, 32.5), and ST\u202f+\u202fPPR (8.9%, 95%CI\u202f=\u202f7.7, 10.4). Recreational use was reported by 28.4% (95% CI\u202f=\u202f26.5, 30.4) of the sample. The odds of extra-medical use of PPR-only (aRRR\u202f=\u202f3.1, 95%CI\u202f=\u202f2.1, 4.5) and ST\u202f+\u202fPPR (aRRR\u202f=\u202f1.9, 95%CI\u202f=\u202f1.2, 3.1) as opposed to ST-only, were greater among Non-Hispanic Blacks than Non-Hispanic Whites. Compared to non-alcohol users, those with a past-12\u202fmonths diagnosis of alcohol use disorder were more likely to use ST\u202f+\u202fPPR rather than ST-only (aIRR\u202f=\u202f2.0, 95%CI\u202f=\u202f1.1, 3.7). Non-Hispanic Blacks (aOR\u202f=\u202f0.6, 95%CI\u202f=\u202f0.4, 08) and individuals living in rural areas (aOR\u202f=\u202f0.5, 95%CI\u202f=\u202f0.3, 09) were less likely to report extra-medical use of prescription medications for recreational reasons than Non-Hispanic Whites and those residing in large metropolitan areas, respectively.\n\n\nCONCLUSIONS\nExtra-medical use of PPR-only and ST\u202f+\u202fPPR as an aid to sleep, is prevalent among Non-Hispanic Blacks, young adults, and those residing in rural areas. Most individuals reported that extra-medical use of prescription medications was primarily motivated by sleep reasons, rather than by sleep and recreational reasons. Potential interventions include access to sleep treatments, education on the effectiveness and risk associated with extra-medical use and co-use of prescription medications for sleep, and research on sleep-related disparities.