Family history of substance use disorder and likelihood of prescription drug misuse in adults 50 and older

Abstract

Objective

Individuals who are family history positive (FHP) for substance use problems have increased risk for substance use, substance use disorders (SUDs), and psychopathology. Links between FHP status and prescription drug misuse (PDM) have not been well investigated; this study examined PDM in adults 50 and older by FHP status.

Methods

Data were from the US NESARC-III (n = 14,667). Participants reported their opioid PDM, tranquilizer/sedative PDM, SUD, psychopathology, and family history status (i.e. first- and second-degree relatives with alcohol/substance use problems). Prevalence rates were estimated by FHP status, and logistic regressions compared FHP and family history negative (FHN) groups.

Results

FHP status was associated with significantly higher rates of PDM (e.g. past-year opioid PDM, FHP: 3.8%, FHN: 1.5%) and SUD from PDM (e.g. past-year SUD, FHP: 1.2%, FHN: 0.2%); also, prevalence varied by family history density, with the highest rates in those with three or more relatives with substance use problems (e.g. past-year opioid PDM: 5.5%). Overall, 32.2% of FHP individuals with past-year PDM had past-year co-occurring SUD and psychopathology diagnoses, versus 11.0% of FHN individuals.

Conclusion

FHP status could inform treatment decisions in adults 50 and older with conditions for which prescription opioids or tranquilizer/sedatives are indicated.

Keywords:

• Opioids
• benzodiazepines
• prescription drug abuse
• older adult
• mental health

Disclosure statement

The authors declare no competing interests.

Funding

This research was supported by the US National Institute on Drug Abuse under Grants R01 DA042146 and R01 DA031160 and by the US National Institute on Aging under Grant R01 AG060939. The NESARC-III was funded by the National Institute on Alcohol Abuse and Alcoholism.

The National Institutes of Health (through NIDA, NIA, and NIAAA) had no role in the study design, analysis and interpretation of data, the writing of the report or in the decision to submit the article for publication. The content is the authors’ responsibility and does not necessarily represent the views of NIDA, NIA, or NIAAA.

Data availability statement

The NESARC-III data are available upon request from the US National Institute on Alcohol Abuse and Alcoholism (NIAAA) at https://www.niaaa.nih.gov/research/nesarc-iii/nesarc-iii-data-access.