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Gender Differences in Primary Substance of Abuse across Age Groups

April 16, 2014 Comments off

Gender Differences in Primary Substance of Abuse across Age Groups
Source: Substance Abuse and Mental Health Services Administration

+ In 2011, about 609,000 of the 1.84 million admissions to substance abuse treatment were female (33.1 percent), and 1.23 million were male (66.9 percent)
+ Compared with their male counterparts, a larger proportion of female admissions aged 12 to 17 reported alcohol as their primary substance of abuse (21.7 vs. 10.5 percent)
+ Marijuana as the primary substance of abuse was less common among female than male admissions aged 12 to 17 (60.8 vs. 80.7 percent) and 18 to 24 (22.1 vs. 33.4 percent)
+ Within the 65 or older age group, the proportion of female admissions reporting primary abuse of prescription pain relievers (e.g., oxycodone) was nearly 3 times that of their male counterparts (7.2 vs. 2.8 percent)

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Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings

April 8, 2014 Comments off

Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings
Source: Cyberpsychology, Behavior, and Social Networking

Job applicants and incumbents often use social media for personal communications allowing for direct observation of their social communications “unfiltered” for employer consumption. As such, these data offer a glimpse of employees in settings free from the impression management pressures present during evaluations conducted for applicant screening and research purposes. This study investigated whether job applicants’ (N=175) personality characteristics are reflected in the content of their social media postings. Participant self-reported social media content related to (a) photos and text-based references to alcohol and drug use and (b) criticisms of superiors and peers (so-called “badmouthing” behavior) were compared to traditional personality assessments. Results indicated that extraverted candidates were prone to postings related to alcohol and drugs. Those low in agreeableness were particularly likely to engage in online badmouthing behaviors. Evidence concerning the relationships between conscientiousness and the outcomes of interest was mixed.

FDA approves new hand-held auto-injector to reverse opioid overdose

April 4, 2014 Comments off

FDA approves new hand-held auto-injector to reverse opioid overdose
Source: U.S Food and Drug Administration

The U.S. Food and Drug Administration today approved a prescription treatment that can be used by family members or caregivers to treat a person known or suspected to have had an opioid overdose. Evzio (naloxone hydrochloride injection) rapidly delivers a single dose of the drug naloxone via a hand-held auto-injector that can be carried in a pocket or stored in a medicine cabinet.

It is intended for the emergency treatment of known or suspected opioid overdose, characterized by decreased breathing or heart rates, or loss of consciousness.

Drug overdose deaths, driven largely by prescription drug overdose deaths, are now the leading cause of injury death in the United States – surpassing motor vehicle crashes. In 2013, the Centers for Disease Control and Prevention reported the number of drug overdose deaths had steadily increased for more than a decade.

Naloxone is a medication that rapidly reverses the effects of opioid overdose and is the standard treatment for overdose. However, existing naloxone drugs require administration via syringe and are most commonly used by trained medical personnel in emergency departments and ambulances.

Hallucinogens and Dissociative Drugs

February 17, 2014 Comments off

Hallucinogens and Dissociative Drugs
Source: National Institute on Drug Abuse

Offers the latest research findings on hallucinogens and dissociative drugs, describing what they are, how they are abused, and basic facts about different drugs within this classification of drugs.

CRS — Constitutional Analysis of Suspicionless Drug Testing Requirements for the Receipt of Governmental Benefit

February 13, 2014 Comments off

Constitutional Analysis of Suspicionless Drug Testing Requirements for the Receipt of Governmental Benefit (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

For decades, federal policymakers and state administrators of governmental assistance programs, such as the Temporary Assistance for Needy Families (TANF) block grants (formerly Aid to Families with Dependent Children (AFDC)), the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps), the Section 8 Housing Choice Voucher program, and their precursors, have expressed concern about the “moral character” and worthiness of beneficiaries. For example, the Anti-Drug Abuse Act of 1988 made individuals who have three or more convictions for certain drug-related offenses permanently ineligible for various federal benefits. A provision in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 went a step further by explicitly authorizing states to test TANF beneficiaries for illicit drug use and to sanction recipients who test positive. Some policymakers have shown a renewed interest in conditioning the receipt of governmental benefits on passing drug tests. For example, in February 2012, the President signed into law an amendment to the Social Security Act that authorizes states to condition the receipt of certain unemployment compensation benefits on passing drug tests. Additionally, lawmakers in a majority of states reportedly proposed legislation in 2011, 2012, and 2013 that would require drug testing beneficiaries of governmental assistance under certain circumstances, while at least nine state governments over that time have enacted such legislation.

Federal or state laws that condition the initial or ongoing receipt of governmental benefits on passing drug tests without regard to individualized suspicion of illicit drug use may be subject to constitutional challenge. To date, two state laws requiring suspicionless drug tests as a condition to receiving governmental benefits have sparked litigation, and neither case has been fully litigated on the merits. The U.S. Supreme Court has not rendered an opinion on such a law; however, the Court has issued decisions on drug testing programs in other contexts that have guided the few lower court opinions on the subject.

In Harm’s Way: State Response to Sex Workers, Drug Users and HIV in New Orleans

January 1, 2014 Comments off

In Harm’s Way: State Response to Sex Workers, Drug Users and HIV in New Orleans
Source: Human Rights Watch

This 57-page report documents government violations of the right to health and other abuses of at-risk populations in New Orleans. It calls for changes in state and local laws and policies that stigmatize, discriminate against, and facilitate police abuse of sex workers and drug users, and interfere with health services for people at high risk for HIV. The report was released in advance of the third annual Southern Harm Reduction and Drug Policy Conference, which opens in New Orleans on December 12, 2013.

American teens more cautious about using synthetic drugs

December 19, 2013 Comments off

American teens more cautious about using synthetic drugs (PDF)
Source: University of Michigan (Monitoring the Future)

—The use of synthetic marijuana by the nation’s teens dropped substantially this year, and a sharply increasing proportion of them see great risk in using so-called “bath salts.”

Both of these drugs are synthetics sold over the counter in many outlets such as gas stations and convenience stores, as well as on the Internet. They have been the subject of great concern because of their serious and unpredictable consequences for the user’s health. These and other findings come from the University of Michigan’s Monitoring the Future study, which is funded by the National Institute of Drug Abuse.

Prescription Drug Abuse: A Policy Position Paper From the American College of Physicians

December 10, 2013 Comments off

Prescription Drug Abuse: A Policy Position Paper From the American College of Physicians
Source: Annals of Internal Medicine

Prescription drug abuse is found throughout all aspects of the U.S. population and is a serious public health problem. Physicians and other health professionals with prescribing privileges are entrusted with the authority to use medications in the treatment of their patients and therefore have an important role in helping to ensure safe and effective use of this treatment option and the deterrence of its abuse. This paper is intended to provide guidance to prescribers and policymakers regarding measures to effectively address the problem of prescription drug abuse and offers the following recommendations:

1. ACP supports appropriate and effective efforts to reduce all substance abuse. These include educational, prevention, diagnostic, and treatment efforts. As physicians dealing with the health effects of this condition, we also support medical research on addiction and its causes and treatment.

2. ACP supports a comprehensive national policy on prescription drug abuse containing education, monitoring, proper disposal, and enforcement elements.

3. ACP supports the consideration by physicians of the full array of treatments available for the effective treatment and management of pain.

4. ACP supports the establishment of a national Prescription Drug Monitoring Program (PDMP). Until such a program is implemented, ACP supports efforts to standardize state PDMPs through the federal National All Schedules Prescription Electronic Reporting (NASPER) program. Prescribers and dispensers should check PDMPs in their own and neighboring states (as permitted) prior to writing or filling prescriptions for medications containing controlled substances. All PDMPs should maintain strong protections to assure confidentiality and privacy.

5. ACP supports efforts to educate physicians, patients, and the public on the appropriate medical uses of controlled drugs and the dangers of both medical and nonmedical use of prescription drugs.

6. ACP favors a balanced approach to permit safe and effective medical treatment utilizing controlled substances and efforts to reduce prescription drug abuse. However, educational, documentation, and treatment requirements toward this goal should not impose excessive administrative burdens on prescribers or dispensers.

7. ACP recognizes that defined maximum dosage (i.e., morphine equivalent) and duration of therapy limitations are not applicable to every clinical encounter. ACP favors establishment of evidence-based, nonbinding guidelines regarding recommended maximum dosage and duration of therapy that a patient taking controlled substance medications may receive.

8. Patients identified by Medicare, Medicaid, private insurance plans, or law enforcement authorities as being at significant risk of prescription drug abuse may be required to participate in a drug monitoring program and undergo random drug testing. Physicians may be required to report suspected cases of drug abuse, but should not be mandated to conduct random drug testing without the patient’s consent. The financial cost of mandatory drug testing should be borne by the authority requiring the testing; neither the patient nor the physician should bear the financial cost of random drug testing mandated by a third-party authority.

9. ACP recommends the consideration of patient-provider treatment agreements between physician and patients as a tool for the treatment of pain.

10. ACP recommends the passage of legislation by all 50 states permitting electronic prescription for controlled substances.

VA OIG — Healthcare Inspection: Alleged Improper Opioid Prescription Renewal Practices, San Francisco VA Medical Center

December 4, 2013 Comments off

Healthcare Inspection: Alleged Improper Opioid Prescription Renewal Practices, San Francisco VA Medical Center
Source: U.S. Department of Veterans Affairs, Office of Inspector General

The VA Office of Inspector General Office of Healthcare Inspections conducted an inspection in response to complaints concerning improper opioid prescription renewal practices in the Medical Practice Clinic at the San Francisco VA Medical Center (facility), San Francisco, CA. We reviewed the following allegations: (1) attendings on-duty are tasked with evaluating numerous opioid renewal requests for patients with whom they are unfamiliar, (2) providers do not routinely document patients’ opioid prescription renewal problems in the electronic health record, and (3) there have been patient hospitalizations and deaths related to opioid misuse.

We substantiated that attendings on-duty are tasked with evaluating numerous opioid renewal requests for patients with whom they are unfamiliar; however, Veterans Health Administration regulations and local policy do not prohibit such practice.

We partially substantiated that providers do not routinely document patients’ opioid prescription renewal problems in the electronic health record. The providers did not consistently document an assessment for adherence with appropriate use of opioids and monitor patients for misuse, abuse, or addiction. The primary care providers did not consistently complete the templated Narcotic Instructions Note for patients with opioid prescription renewal problems.

We partially substantiated that there have been hospitalizations and deaths of patients related to opioid misuse. Seven patients were hospitalized for opioid overdose; however, the primary care provider, Psychiatry Service, and/or the facility’s Substance Abuse Program assessed and appropriately monitored the patients for misuse. There were no deaths related to opioid overdose.

We recommended that the Facility Director (1) ensure that providers comply with all elements of the management of opioid therapy for chronic pain, as required by Veterans Health Administration and the VA/DoD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, and (2) ensure that the Narcotic Instructions Note is reevaluated for appropriate use in the Medical Practice Clinic and that providers comply with established protocol.

The Veterans Integrated Service Network and Facility Directors concurred with our recommendations and provided an acceptable action plan. (See Appendixes A and B, pages 6–9 for the Director’s comments.) We will follow up on the planned actions until they are completed.

Prescription Drug Abuse: Strategies to Stop the Epidemic

November 13, 2013 Comments off

Prescription Drug Abuse: Strategies to Stop the Epidemic
Source: Trust for America’s Health

Prescription Drug Abuse: Strategies to Stop the Epidemic finds that 28 states and Washington, D.C. scored six or less out of 10 possible indicators of promising strategies to help curb prescription drug abuse. Two states, New Mexico and Vermont, got the highest score, receiving all 10 possible indicators, while South Dakota scored the lowest with two out of 10.

According to the report, prescription drug abuse has quickly become a top public health concern, as the number of drug overdose deaths – a majority of which are from prescription drugs – doubled in 29 states since 1999. The rates quadrupled in four of these states and tripled in 10 more of these states.

Prescription drug related deaths now outnumber those from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and Washington, D.C. Misuse and abuse of prescription drugs costs the country an estimated $53.4 billion a year in lost productivity, medical costs and criminal justice costs, and currently only one in 10 Americans with a substance abuse disorder receives treatment.

Nonmedical Prescription Opioid and Sedative Use Among Adolescents in the Emergency Department

October 30, 2013 Comments off

Nonmedical Prescription Opioid and Sedative Use Among Adolescents in the Emergency Department
Source: Pediatrics

OBJECTIVES:
Nonmedical prescription opiate use (NPOU) and nonmedical prescription sedative use (NPSU) are serious public health concerns. The objectives of this study were to determine the prevalence and emergency department (ED) visit characteristics and other correlates associated with past-year NPOU and NPSU among adolescents and young adults using the ED.

METHODS:
Participants aged 14 to 20 presenting to the ED at the University of Michigan Medical Center between September 2010 and September 2011 were systematically recruited. A computerized self-report screening survey with validated items measuring past-year NPOU, NPSU, substance use, and violence was delivered to participants, and a retrospective chart review was performed.

RESULTS:
Of the 2135 participants (86.0% response rate), 222 (10.4%) reported either NPOU or NPSU. Among the 185 (8.7%) participants that reported NPOU, 14.6% had a current home prescription for an opioid and among the 115 (5.4%) with NPSU, 12.3% had a current home prescription for a sedative. After controlling for demographics (age, gender, race, public assistance), correlates of NPOU or NPSU included other substance use, and drinking and driving or riding with a drinking driver. Additional correlates of NPOU included receiving an intravenous opioid in the ED and for NPSU, dating violence, presenting to the ED for a noninjury complaint, and previous ED visit in the past year.

CONCLUSIONS:
Nearly 1 in 10 young people who use the ED for care report NPOU or NPSU, and only 12.3% and 14.6% report having current home prescriptions for sedatives and opioids. The ED represents a key location for screening and intervention efforts.

Prescription Drug Abuse: Strategies to Stop the Epidemic

October 11, 2013 Comments off

Prescription Drug Abuse: Strategies to Stop the Epidemic
Source: Trust for America’s Health

Prescription Drug Abuse: Strategies to Stop the Epidemic finds that 28 states and Washington, D.C. scored six or less out of 10 possible indicators of promising strategies to help curb prescription drug abuse. Two states, New Mexico and Vermont, got the highest score, receiving all 10 possible indicators, while South Dakota scored the lowest with two out of 10.

According to the report, prescription drug abuse has quickly become a top public health concern, as the number of drug overdose deaths – a majority of which are from prescription drugs – doubled in 29 states since 1999. The rates quadrupled in four of these states and tripled in 10 more of these states.

Prescription drug related deaths now outnumber those from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 states and Washington, D.C. Misuse and abuse of prescription drugs costs the country an estimated $53.4 billion a year in lost productivity, medical costs and criminal justice costs, and currently only one in 10 Americans with a substance abuse disorder receives treatment.

Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings

October 10, 2013 Comments off

Big Five Personality Traits Reflected in Job Applicants’ Social Media Postings
Source: Cyberpsychology, Behavior, and Social Networking

Job applicants and incumbents often use social media for personal communications allowing for direct observation of their social communications “unfiltered” for employer consumption. As such, these data offer a glimpse of employees in settings free from the impression management pressures present during evaluations conducted for applicant screening and research purposes. This study investigated whether job applicants’ (N=175) personality characteristics are reflected in the content of their social media postings. Participant self-reported social media content related to (a) photos and text-based references to alcohol and drug use and (b) criticisms of superiors and peers (so-called “badmouthing” behavior) were compared to traditional personality assessments. Results indicated that extraverted candidates were prone to postings related to alcohol and drugs. Those low in agreeableness were particularly likely to engage in online badmouthing behaviors. Evidence concerning the relationships between conscientiousness and the outcomes of interest was mixed.

Prescription Drug Abuse: Strategies to Stop the Epidemic, 2013

October 7, 2013 Comments off

Prescription Drug Abuse: Strategies to Stop the Epidemic, 2013
Source: Trust for America’s Health (via Robert Wood Johnson Foundation)

The Trust for America’s Health (TFAH) worked with a range of partners and experts to identify promising policies and approaches to reducing prescription drug abuse in America.

This report evaluates states on 10 key approaches to combat prescription drug abuse, based on input and review from public health, medical and law enforcement experts, and using indicators. The report also provides a review of national policy issues and recommendations.

Estimated Percentages and Characteristics of Men Who Have Sex with Men and Use Injection Drugs — United States, 1999–2011

October 7, 2013 Comments off

Estimated Percentages and Characteristics of Men Who Have Sex with Men and Use Injection Drugs — United States, 1999–2011
Source: Morbidity and Mortality Weekly Report (CDC)

Male-to-male sex and illicit injection drug use are important transmission routes for human immunodeficiency virus (HIV) infection. Of all new HIV infections in 2010, 80% were among men, of which 78% were among men who have sex with men (MSM), 6% among male injection drug users (IDU), and 4% among men who have sex with men and inject drugs (MSM/IDU) (1). MSM/IDU might have different prevention needs from men who are either MSM or IDU, but not both. A combination of effective, scalable, and evidence-based approaches that address male-to-male sex and injection drug use behaviors might reduce HIV infections among MSM/IDU. To refine calculations of disease rates attributed to MSM and IDU (2,3) by accounting for MSM/IDU, CDC used data from 1999–2008 National Health and Nutrition Examination Survey (NHANES) to estimate the percentage and number of MSM/IDU in the general population. To further describe demographic similarities and differences of MSM/IDU identified by different surveillance systems, CDC also compared data from four HIV surveillance systems: the 2008 and 2009 National HIV Behavioral Surveillance System (NHBS), the 2011 National HIV Surveillance System (NHSS), and the 2007–2009 Medical Monitoring Project (MMP). Of males aged ≥18 years, MSM/IDU comprised an estimated 0.35% in NHANES, 7%–20% in NHBS, an estimated 4%–8% in NHSS, and 9% in MMP. Across surveillance systems, MSM/IDU accounted for 4%–12% of MSM and 11%–39% of male IDU. Risk reduction programs and interventions targeted toward male IDU populations might be more effective if they also incorporate messages about male-to-male sex.
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Opioid Overdose Prevention Toolkit

October 4, 2013 Comments off

Opioid Overdose Prevention Toolkit
Source: Substance Abuse and Mental Health Services Administration

Equips communities and local governments with material to develop policies and practices to help prevent opioid-related overdoses and deaths. Addresses issues for first responders, treatment providers, and those recovering from opioid overdose.

Seeking Drug Abuse Treatment: Know What To Ask

September 26, 2013 Comments off

Seeking Drug Abuse Treatment: Know What To Ask
Source: National Institute on Drug Abuse

Offers guidance in seeking drug abuse treatment and lists five questions to ask when searching for a treatment program.

CRS — Synthetic Drugs: Overview and Issues for Congress

September 23, 2013 Comments off

Synthetic Drugs: Overview and Issues for Congress (PDF)
Source: Congressional Research Service

Synthetic drugs, as opposed to natural drugs, are chemically produced in a laboratory. Their chemical structure can be either identical to or different from naturally occurring drugs, and their effects are designed to mimic or even enhance those of natural drugs. When produced clandestinely, they are not typically controlled pharmaceutical substances intended for legitimate medical use. Designer drugs are a form of synt hetic drugs. They contain slightly modified molecular structures of illegal or controlled substances, and they are modified in order to circumvent existing drug laws. While the issue of synthetic drugs and their abuse is not new, Congress has demonstrated a renewed concern with the issue.

From 2009-2011, synthetic drug abuse was reported to have dramatically increased. During this time period, calls to poison control centers for incidents relating to harmful effects of synthetic cannabinoids (such as “K2” and “Spice”) and stimulants (such as “bath salts”) increased at what some considered to be an alarming rate. The number of hospital emergency department visits involving synthetic cannabinoids more than doubled from 2010 to 2011. In 2012, however, the number of calls to poison control centers for incidents relating to harmful effects of synthetic cannabinoids and synthetic stimulants decreased. The Monitoring the Future (MTF) survey results from 2012 indicate that annual prevalence rates for use of “bath salts” among college students and adults ages 18-50 was “very low.” In contrast, MTF reports that, among 12th graders, synthetic marijuana is the “second most widely used class of illicit drug after marijuana.” Media reports indicate that a synthetic substance known as “molly,” a psychoactive drug that may be similar or identical to MDMA (3,4-Methylenedioxymethamphetamine), appears to be gaining popularity among youth. In the summer of 2013, seve ral deaths and drug overdoses have been attributed to molly.

The reported harmful effects of synthetic substances range from nausea to drug-induced psychosis. Due to the unpredictable nature of sy nthetic drugs and of human consumption of these drugs, the true effects of many of these drugs are unknown. Many states have responded to the synthetic drug abuse issue by passing synthetic drug laws banning certain synthetic cannabinoids and stimulants.

In 2011, the Attorney General—through the Drug Enforcement Administration (DEA)—used his temporary scheduling authority to place five synthetic cannabinoids and three synthetic stimulants on Schedule I of the Controlled Substances Act (CSA). Concern over the reported increase in use of certain synthetic cannabinoids and stimulants resulted in legislative action to schedule specific substances. The Synthetic Dr ug Abuse Prevention Act of 2012—Subtitle D of Title XI of the Food and Drug Administration Safety and Innovation Act (P.L. 112-144)—added five structural classes of substances in synthetic cannabinoids (and their analogues) as well as 11 synthetic stimulants and hallucinogens to Schedule I of the CSA. In addition, the act extended the DEA’s authority to temporarily schedule substances. In April 2013, Attorney General Holder— through the DEA and in consultation with the Department of Health and Human Services (HHS)—took administrative action to permanently place methylone on Schedule I of the CSA. Most recently in May 2013, Attorney General Holder—again through the DEA—used his temporary scheduling authority to place three additional synthetic cannabinoids on Schedule I of the CSA.

In considering permanent placement of synthetic substances on Schedule I of the CSA, there are several issues on which Congress may deliberate. Policymakers may consider the implications on the federal criminal justice system of scheduling certain synthetic substances. Another issue up for debate is whether Congress should schedule certain synthetic substances or whether these substances merit Attorney General (in consultation with the Secretary of HHS) scheduling based on qualifications specified in the CSA. Congress may also consider whether placing additional synthetic drugs on Schedule I may hinder future medical research. In addition, policymakers may consider whether it is more efficient to place these drugs on Schedule I of the CSA or to treat them as analogue controlled substances under the Controlled Substances Analogue Enforcement Act. In considering enforcement challenges id entified by the DEA, Congress may consider whether to amend the CSA to better facilitate enforcement action against the illicit synthetic drug market.

Report shows that “Bath Salts” drugs were involved in nearly 23,000 emergency department visits in one year

September 18, 2013 Comments off

Report shows that “Bath Salts” drugs were involved in nearly 23,000 emergency department visits in one year
Source: Substance Abuse and Mental Health Services Administration

A new national report reveals that “bath salts,” a group of drugs containing amphetamine-type stimulants, were linked to an estimated 22,904 visits to hospital emergency departments in 2011. The report by the Substance Abuse and Mental Health Services Administration (SAMHSA) is the first national study to track bath salts drugs to hospital emergency department visits since these drugs emerged a few years ago.

The SAMHSA report shows that about two-thirds (67 percent) of emergency department visits involving bath salts also involved the use of another drug. Only 33 percent of the bath salts-related visits to emergency departments involved just the use of bath salts; 15 percent of the visits involved combined use with marijuana or synthetic forms of marijuana, and 52 percent involved the use of other drugs.

In 2011 there were nearly 2.5 million emergency department visits involving drug misuse or abuse.

Non-Medical Use of Prescription Drugs and Health Services Utilization

September 17, 2013 Comments off

Non-Medical Use of Prescription Drugs and Health Services Utilization (PDF)
Source: Journal of Developing Drugs

Objective:
To provide evidence of the economic burden of the non-medical prescription drug (NMPD) use on health services utilization: emergency room (ER) visits and inpatient hospital nights.

Data:
The 2009 National Survey on Drug Use and Health (NSDUH) cross-section (52,267 observations). Study design. We employ propensity score matching techniques controlling for a rich set of covariates to reduce the potential individual heterogeneity bias.

Principal findings:
Our results reveal a positive, statistically significant, and robust relationship between NMPD use and health services utilization both in adolescents and adults. The estimated effects for adults are slightly smaller in magnitude than those for adolescents.

Conclusion:
These results have important policy implications as the burden imposed on society by NMPD use might be greater than initially assumed. Efforts to curb NMPD use such as expansion of Prescription Drug Monitoring Programs (PDMPs), prevention interventions, and increased funds allocated to treat prescription drug abuse might be economically justified.

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