Category: Adult Anxiety
The co-occurrence of anxiety and substance use disorders is common among both community and clinical samples and associated with numerous adverse health outcomes (Stewart & Conrod, 2007). In recent years, the rates of non-medical use of prescription drugs (NMUPD) have dramatically increased, with 4-11% of adults reporting past year NMUPD (NIDA, 2015). Despite heightened rates of NMUPD among individuals with anxiety disorders (Huang et al., 2006), few studies have examined factors associated with anxiety disorders and NMUPD. The purpose of the current study was to examine correlates of NMUPD among substance dependent inpatients with anxiety disorders. Relevant correlates were identified based on prior research examining anxiety and substance use, and included sensation seeking, negative urgency (i.e., the tendency to act impulsively when experiencing negative emotion), depression, stress, and anxiety sensitivity (Jeffers et al., 2015).
The current study included 104 patients (51.9% female; 64.4% White; Mage= 33.9 years) in residential substance abuse treatment who met criteria for at least one current anxiety disorder. Most participants met criteria for multiple anxiety disorders (65.5%). Generalized anxiety disorder was the most common diagnosis (48.1%), followed by posttraumatic stress disorder and panic disorder (44.2% each), social anxiety disorder (39.4%), and obsessive-compulsive disorder (21.2%). Participants were administered structured clinical interviews (SCID-I and CAPS) and completed a series of questionnaires.
Overall, 57.7% of participants reported past year NMUPD. Opioid pain medications were the most commonly misused (34.6%), followed by anxiolytics (17.3%), and stimulants (6.7%). A multivariable logistic regression analysis was used to ascertain the relations of age, race, gender, sensation seeking, negative urgency, depression, stress, and anxiety sensitivity to past year NMUPD. The model was statistically significant and explained 56% (Nagelkerke R2) of the variance. Further, age (OR = 0.92, 95%CI [.87 – .98]), gender (reference group = men; OR = 6.68, 95%CI [1.89 – 23.70]), race (reference group = White; OR = 12.67, 95%CI [3.62 – 44.19]), and negative urgency (OR = 5.73, 95%CI [1.56 – 21.07]) were significantly associated with past-year NMUPD.
Findings highlight the importance of negative urgency (relative to other emotional and behavioral mechanisms) to past-year NMUPD among patients with co-occurring anxiety and substance use disorders.
Sara Witcraft– Doctoral Student, University of Mississippi, Oxford, Mississippi
Laura Dixon– Assistant Professor, University of Mississippi
Megan Perry– Doctoral Student, University of Mississippi
Kim Gratz– University of Toledo
Matthew Tull– Professor, University of Toledo