Philip Veliz

Adolescent context of exposure to prescription opioids and substance use disorder symptoms at age 35: A national longitudinal study

Abstract The objective of this study was to examine the association of context of prescription opioid exposure (ie, medical or nonmedical) in adolescence with the subsequent risk of nonmedical use of prescription opioids (NMUPO) and substance use disorder (SUD) symptoms at age 35. Multiple cohorts of nationally representative probability samples of U.S. high school seniors (n = 4072) were surveyed through self-administered questionnaires and followed longitudinally from adolescence (modal age 18, graduating classes 1976-1996) to age 35 (1993-2013). Main outcome measures were past-year NMUPO and SUD symptoms. The medical and NMUPO during adolescence was significantly associated with NMUPO at age 35. Relative to no prescription opioid exposure, medical use of prescription opioids without any history of NMUPO during adolescence was not associated with SUD symptoms at age 35. In contrast, compared with no prescription opioid exposure during adolescence, the adjusted odds ratios (AORs) associated with SUD symptoms at age 35 were greater among those with a history of both medical use of prescription opioids and NMUPO during adolescence, AOR = 1.49 (95% CI = 1.13-1.97); and among those who reported NMUPO only, AOR = 2.61 (95% CI = 1.88-3.61). The findings indicate medical use of prescription opioids without any history of NMUPO in adolescence is not associated with SUD symptoms at age 35, whereas any NMUPO in adolescence predicts SUD symptoms at age 35. Screening instruments and preventive intervention programs to reduce NMUPO and SUDs must account for the context associated with prescription opioid exposure during adolescence.

Playing through pain: sports participation and nonmedical use of opioid medications among adolescents.

We assessed the nonmedical use of prescription opioids (NMUPO) among adolescents who participate in competitive sports. Using data from Monitoring the Future, we found that adolescent participants in high-injury sports had 50% higher odds of NMUPO than adolescents who did not participate in these types of sports (i.e., nonparticipants and participants in other sports). Detecting certain subpopulations of youths at risk for NMUPO should be a central concern among health care providers.

Competitive Sport Involvement and Substance Use among Adolescents: A Nationwide Study

Background: The empirical research examining the impact of sports participation on alcohol and other drug use has produced mixed results. Part of this problem may be the result of how different types of sports participation create different experiences that shape certain types of behaviors that either facilitate or deter substance use. Objectives. We examined the association between different types of competitive sports participation and substance use among a nationally representative sample of adolescents. Methods: Two recent cross-sections from the Monitoring the Future were merged to capture a large subsection of adolescents who participate in either high-contact sports (football, wrestling, hockey, and lacrosse), semicontact sports (baseball, basketball, field hockey, and soccer), and noncontact sports (cross-country, gymnastics, swimming, tennis, track, and volleyball). Results: Multivariate analyses revealed that adolescents who participated in high-contact sports had higher odds of using substances during the past 30 days and initiating substance use at early ages. Further, adolescents who participated in noncontact sports had lower odds to indicate smoking cigarettes and marijuana during the past 30 days. Conclusions: Parents, educators, and policy makers need to consider that some sporting contexts may be a catalyst to engage in risky behaviors like substance use.

Painfully obvious: A longitudinal examination of medical use and misuse of opioid medication among adolescent sports participants

PURPOSE The objective of this longitudinal study was to assess the prevalence of medical use, medical misuse, and non-medical use of opioid medication among adolescents who participate in organized sports. METHODS Data for this study were taken from the Secondary Student Life Survey. A total of 1,540 adolescents participated in three waves of data collection occurring between the 2009-2010 and 2011-2012 school years, with 82% of the baseline sample completing all three waves. RESULTS Using generalized estimating equation models to analyze the longitudinal data, it was found that male adolescents who participated in organized sports during each wave of the Secondary Student Life Survey had higher odds of being prescribed an opioid medication (i.e., medical use) during the past year (adjusted odds ratio [AOR], 1.86; 95% confidence interval [CI], 1.23-2.82), higher odds of past-year medical misuse of opioid medication as a result of taking too much (AOR, 10.5; 95% CI, 2.42-45.5), and higher odds of past-year medical misuse of opioid medication to get high (AOR, 4.01; 95% CI, 1.13-14.2) compared with males who did not participate in organized sports during the study period. Among females, no association was found between participation in organized sports and medical use, medical misuse, and non-medical use of opioid medication. CONCLUSIONS The results of this study indicate that adolescent males who participate in sports may have greater access to opioid medication, which puts them at greater risk to misuse these controlled substances.

Social contexts of substance use among U.S. high school seniors: a multicohort national study.

PURPOSE To determine the social contexts associated with the past-year substance use (multiple substances, alcohol, marijuana, and nonmedical use of prescription opioids, stimulants, and tranquilizers) among U.S. high school seniors. METHODS A secondary analysis of nationally representative survey data from 10 cohorts (2002-2011) of the Monitoring the Future study, including 24,809 high school seniors. RESULTS The social contexts associated with the past-year substance use varied considerably based on the substance used. The most prevalent location for alcohol, marijuana, and polydrug use was at a party, whereas nonmedical use of prescription stimulants, tranquilizers, and opioids was most likely to occur at home. Most types of substance use occurred in the presence of other people with the exception of nonmedical use of prescription stimulants, which was a more solitary behavior. CONCLUSIONS These exploratory findings indicate that prevention efforts may need to account for differences in social contexts between types of substances used.

Medical and nonmedical use of prescription sedatives and anxiolytics: Adolescents' use and substance use disorder symptoms in adulthood

OBJECTIVES This study assessed the longitudinal associations between medical and nonmedical use of prescription sedatives/anxiolytics (NMPSA) during adolescence (age 18) and substance use disorder (SUD) symptoms during adulthood (age 35). METHODS Multiple cohorts of nationally representative samples of U.S. high school seniors (n=8373) were surveyed via self-administered questionnaires and followed longitudinally from adolescence (age 18, 1976-1996) to adulthood (age 35, 1993-2013). RESULTS An estimated 20.1% of adolescents reported lifetime medical or nonmedical use of prescription sedatives/anxiolytics. Among adolescents who reported medical use of prescription sedatives/anxiolytics, 44.9% also reported NMPSA by age 18. Based on multivariate analyses that included age 18 sociodemographic and other substance use controls, medical use of prescription sedatives/anxiolytics without any history of NMPSA during adolescence was not associated with SUD symptoms in adulthood relative to adolescents with no prescription sedative/anxiolytic use. In contrast, adolescents with a history of both medical and nonmedical use of prescription sedatives/anxiolytics and adolescents who reported only NMPSA had between two to three times greater odds of SUD symptoms in adulthood relative to adolescents with no prescription sedative/anxiolytic use and those who reported only medical use of prescription sedatives/anxiolytics. CONCLUSIONS One in every five U.S. high school seniors reported ever using prescription sedatives/anxiolytics either medically or nonmedically. This study provides compelling evidence that the medical use of prescription sedatives/anxiolytics (without any NMPSA) during adolescence is not associated with increased risk of SUD symptoms in adulthood while any NMPSA during adolescence serves as a signal for SUDs in adulthood.

Competitive sports participation in high school and subsequent substance use in young adulthood: Assessing differences based on level of contact

The objective of this study is to examine how participation in different types of competitive sports (based on level of contact) during high school is associated with substance use 1 to 4 years after the 12th grade. The analysis uses nationally representative samples of 12th graders from the Monitoring the Future Study, who were followed 1 to 4 years after the 12th grade. The longitudinal sample consisted of 970 12th graders from six recent cohorts (2006–2011). The analyses, which controlled for 12th grade substance use, school difficulties, time with friends, and socio-demographic characteristics, found that respondents who participated in at least one competitive sport during the 12th grade had greater odds of binge drinking during the past two weeks (AOR = 2.04; 95% CI = 1.43, 2.90) 1 to 4 years after the 12th grade, when compared to their peers who did not participate in sports during their 12th grade year. Moreover, respondents who participated in high-contact sports (i.e. football, ice hockey, lacrosse, and wrestling) had greater odds of binge drinking (AOR = 1.80; 95% CI = 1.18, 2.72), and engaging in marijuana use during the past 30 days (AOR = 1.81; 95% CI = 1.12, 2.93) 1 to 4 years after the 12th grade when compared to their peers who did not participate in these types of sports during their 12th grade year. Accordingly, the findings indicate important distinctions in sport participation experiences on long-term substance use risk that can help inform potential interventions among young athletes.

Substance Use Among Sexual Minority Collegiate Athletes: A National Study.

ABSTRACT Background: The empirical research examining substance use among sexual minority collegiate athletes is sparse. Problematically, this group may be at a greater risk of substance use due to their marginalized status within the context of sport. Objectives: We examined different types of substance use during the past 30 days, and diagnosis of substance use disorders during the past 12 months, among sexual minority collegiate athletes. Methods: This study uses data from college students for the fall semester between 2008 and 2012 from the American College Health Association-National College Health Assessment. Results: Sexual minority collegiate athletes had greater odds of past 30-day cigarette use, past 30-day alcohol use, past 30-day marijuana use, and indicating being diagnosed or treated for a substance use disorder during the past 12 months when compared to either heterosexual collegiate athletes or heterosexual nonathletes, but had similar odds on these outcomes when compared to sexual minority nonathletes. Sexual minority collegiate athletes also had greater odds of binge drinking during the past 2 weeks when compared to either heterosexual nonathletes or sexual minority nonathletes, but had similar odds on this outcome when compared to heterosexual collegiate athletes. Additional analyses by gender reveal that male sexual minority athletes are at the greatest risk of being diagnosed or treated for a substance use disorder. Conclusions: Possible explanations as to why sexual minority collegiate athletes (particularly males) may be at a greater risk of substance use disorders could include the difficulty of trying to maintain an athletic identity within a social environment that is traditionally homophobic.

Examining potential substance use disorders among former interscholastic athletes

BACKGROUND Despite numerous studies examining the association between competitive sports participation and substance use behaviors among adolescents and young adults, the use of standardized measures to assess potential substance use disorders has been largely neglected. The objective of this study was to examine if past involvement in interscholastic sports (competitive school-sponsored sports) was associated with potential substance use disorders in young adulthood. METHODS Data for this study were taken from the Student Life Survey (SLS). A total of 3442 young adults participated in the SLS during the spring semester in 2013, with 74% of males and 71% of females indicating participation in interscholastic sport during high school. RESULTS Respondents who participated in interscholastic sports during high school had higher odds of positive screens for potential alcohol use disorders when compared with their peers who did not participate in interscholastic sports. No association was detected between interscholastic sports participation and potential drug abuse disorders. Moreover, previous involvement in certain types of sports was found to be associated with positive screens for potential alcohol use disorders (i.e., crew and football) and positive screens for potential drug abuse disorders (i.e., lacrosse) among the sample of young adults. CONCLUSIONS School and community sport organizations should be aware of the potential link between sports participation and potential substance use disorders, and may consider brief substance use screeners during yearly physicals to monitor potential substance use problems among athletes.

Opioid Use Among Interscholastic Sports Participants: An Exploratory Study From a Sample of College Students

Purpose: Involvement in sports increases the risk for injury and the risk for prescription opioid use and misuse. This was an exploratory retrospective study to examine if previous involvement in interscholastic sports was associated with a greater lifetime prevalence of medical prescription opioid use, lifetime risk for diverting prescribed opioids, and lifetime risk for nonmedical prescription opioid use. Method: A Web-based survey was self-administered to a sample of 4,187 full-time undergraduate students at a large public university located in the Midwest. Student demographics, involvement in interscholastic sports during high school, lifetime medical prescription opioid use, lifetime risk for diverting prescribed opioids, and lifetime risk for nonmedical prescription opioid use were measured and analyzed for this study. Results: Multiple logistic regression analyses indicated that those who participated in at least 1 interscholastic sport during high school had greater odds for lifetime medical prescription opioid use on multiple occasions and greater odds for being approached to divert their prescribed opioid medications on multiple occasions when compared with their peers who did not participate in interscholastic sports during high school. Conclusions: The findings indicate some association between previous involvement in interscholastic sports and prescription opioid use and misuse. These findings further suggest that greater awareness should be instilled in parents and coaches regarding this form of substance misuse.