Is employment status in adults over 25 years old associated with nonmedical prescription opioid and stimulant use?
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Nonmedical use of prescription opioid and stimulants (NMUPO and NMUPS, respectively) has declined in recent years, but remains an important public health problem. Evidence regarding their relationships with employment status remains unclear. We determined the relationship between employment status and NMUPO and NMUPS.
We analyzed a cross-sectional, nationally representative, weighted sample of 58,486 adults, ages 26 years and older, using combined 2011–2013 data from the National Survey on Drug Use and Health (NSDUH). We fit two crude and two adjusted multivariable logistic regression models to assess the relationship between our two different outcomes of interest: (1) past-year NMUPO and (2) past-year NMUPS, and our exposure of interest: employment status, categorized as (1) full time, (2) part time, (3) unemployed, and (4) not in the workforce. Our adjusted models featured the following covariates: sex, race, age, marital status, and psychological distress, and other nonmedical use.
Prevalence of NMUPO was higher than NMUPS (3.48 vs. 0.72%). Unemployed participants had the highest odds of NMUPO [aOR 1.45, 95% CI (1.15–1.82)], while those not in the workforce had the highest odds of NMUPS [aOR 1.71, 95% CI (1.22–2.37)]. Additionally, part-time and unemployed individuals had increased odds of NMUPS [aORs, 95% CI 1.59 (1.09–2.31) and 1.67 (1.11–2.37) respectively], while those not in the workforce had decreased odds of NMUPO [aOR 0.82, 95% CI (0.68–0.99)] relative to full-time participants.
There is a need for adult prevention and deterrence programs that target nonmedical prescription drug use, especially among those unemployed or not in the workforce.
KeywordsOpioid Stimulant Nonmedical prescription drug use Employment Epidemiology
Attention-deficit hyperactivity disorder
Nonmedical prescription drug(s)
Nonmedical prescription opioid use
Nonmedical prescription stimulant use
National Survey on Drug Use and Health
Prescription Drug Monitoring Program(s)
Compliance with ethical standards
Role of funding source
The data reported herein come from the National Survey of Drug Use and Health (NSDUH) public use files and made publicly available by the Substance Abuse and Mental Health Services Administration (SAMHSA). This study is IRB exempt. Dr. Martins is currently funded by the US National Institutes of Health (NIH), National Institute of Drug Abuse (NIDA—R01DA037866 and R01DA039454), the Eunice Kennedy Shriver National Institute of Child and Human Development (NICHD—R01HD060072), and by a Columbia University President’s Global Innovation Fund. June Kim is funded by the National Institutes of Health (NIH) National Institute of Drug Abuse (NIDA—5T32DA031099-04). Mirko Savone is funded by the Valerie Fund. Luis Segura is funded by the CONACYT doctoral scholarship.
Conflict of interest
Dr. Martins was a consultant for Purdue Pharma until December 2014 on secondary data analysis of data on nonmedical prescription opioid use and alcohol use unrelated to what is described in this manuscript. All other authors have no conflict of interest to declare.
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