Nonmedical Use of Prescription Medication among Adolescents Using Drugs in Quebec

OBJECTIVE:

To determine the prevalence and factors associated with nonmedical use of prescription medication (NMUPM) among adolescents who use drugs (ages 12 to 17 years) in Quebec.

METHOD:

Secondary data analyses were carried out with data from a 6-month study, namely, the 2010-2011 Quebec Health Survey of High School Students-a large-scale survey that sought to gain a better understanding of the health and well-being of young Quebecers in high school. Bivariate and multivariate logistic regression analyses were conducted to study NMUPM among adolescents who use drugs, according to sociodemographic characteristics, peer characteristics, health indicators (anxiety, depression, or attention-deficit disorder [ADD] with or without hyperactivity), self-competency, family environment, and substance use (alcohol and drug use) factors.

RESULTS:

Among adolescents who had used drugs in the previous 12 months, 5.4% reported NMUPM. Based on multivariate analyses, having an ADD, anxiety disorder, low self-esteem, low self-control, low parental supervision, regular alcohol use, and polysubstance use were associated with increased odds of reporting NMUPM.

CONCLUSIONS:

The observed prevalence of NMUPM was lower than expected. However, the associations noted with certain mental health disorders and regular or heavy use of other psychoactive substances are troubling. Clinical implications are discussed.

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By:   Roy É1, Nolin MA2, Traoré I3, Leclerc P4, Vasiliadis HM5.

• 1Full Professor, Faculty of Medicine, Université de Sherbrooke (http://www.usherbrooke.ca/), Sherbrooke, Quebec; Researcher, Research Chair on Addiction, Université de Sherbrooke, Sherbrooke, Quebec.
• 2Graduate Student, Clinical Sciences Program, Université de Sherbrooke, Sherbrooke, Quebec.
• 3Research Assistant, Direction des statistiques de santé, Institut de la statistique du Québec, Montreal, Quebec.
• 4Public Health Officer, Direction de santé publique de l'agence de la santé et des services sociaux de Montréal, Montreal, Quebec.
• 5Associate Professor, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Quebec; Researcher, Charles LeMoyne Hospital Research Centre, Greenfield Park, Quebec.
• Can J Psychiatry. 2015 Dec 1;60(12):556-63.
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Correlates of PrEP Indication in a Multi-Site Cohort of Young HIV-Uninfected Transgender Women

Transgender women are at high risk of HIV infection, with younger transgender women (YTW) particularly vulnerable. Pre-Exposure Prophylaxis (PrEP) has shown efficacy in reducing HIV acquisition, but little is known about PrEP indication or initiation among YTW. 

Baseline data from 180 YTW age 18-29 years enrolled in Project LifeSkills, an on-going HIV prevention intervention for YTW, were analyzed to examine factors associated with PrEP indication. The sample (mean age = 23.4, SD = 3.2) was comprised largely of women of color (69 %) and of low socioeconomic status (71 % unemployed). 

Overall, 62 % met criteria for PrEP indication, but only 5 % reported ever taking PrEP. Factors associated with increased odds of PrEP indication were: PrEP interest (aOR 3.24; 95 % CI 1.44, 7.33), number of recent anal sex partners (aOR 1.23; 95 % CI 1.04, 1.46), and lower collective self-esteem scores (aOR 0.67; 95 % CI 0.47, 0.94). 

Despite high levels of PrEP indication, there remain low levels of PrEP awareness and uptake among YTW.

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By:  Kuhns LM1, Reisner SL, Mimiaga MJ, Gayles T, Shelendich M, Garofalo R.

• 1Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital, 225 E. Chicago Avenue, Box 161, Chicago, IL, 60611, USA, lkuhns@luriechildrens.org. 

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Pathways and Trajectories Linking Housing Instability and Poor Health among Low-Income Women Experiencing Intimate Partner Violence (IPV): Towards a Conceptual Framework

We used grounded theory to understand pathways and trajectories to housing instability (HI) and poor health among low-income women with experiences of intimate partner violence (IPV). We conducted in-depth interviews during 2010-11 with 41 women (ages 18-45 years) living in Ontario, Canada. 

All women reported depressive symptoms in combination with other health problems. In addition to the direct pathway of IPV to poor health, thematic analysis revealed an indirect multi-tiered pathway with complex trajectories among IPV, HI and poor health. These trajectories included material HI (homelessness, high mobility, evictions, problems paying rent, hiding and landlord discrimination), psychological HI (feeling unsafe, low self-esteem, and poor control) and social trajectories (financial problems, loss of employment, income or social networks and leaving school). 

These trajectories elevated stress and decreased self-care (unhealthy behaviors, substance abuse, and reduced medical compliance) and exacerbated poor health already compromised by IPV. Depending on her specific context, each woman experienced these pathways and trajectories differently. Moreover, the women's experiences differed across three time periods: before, immediately after, and long after leaving an abusive relationship. Finally, we found that for these women, achieving stable housing was crucial for stabilizing their health.

Via: http://ht.ly/SaGQS 

By: Daoud N1,2, Matheson FI1,3,4, Pedersen C1, Hamilton-Wright S1, Minh A1, Zhang J1, O'Campo P1,4.

• 1a Centre for Research on Inner City Health , The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto , Ontario , Canada.
• 2b Department of Public Health, Faculty of Health Sciences , Ben-Gurion University , Beer Sheva , Israel.
• 3c Institute for Clinical Evaluative Sciences.
• 4d Dalla Lana School of Public Health , University of Toronto , Toronto , Ontario , Canada.