Currie_Cheryl_AGRI_Conference_2010 (1)

Associations between Problem Gambling and Prescription Drug Misuse in Alberta : 

Associations between Problem Gambling and Prescription Drug Misuse in Alberta Cheryl Currie, Don Schopflocher, Cam Wild University of Alberta AGRI Conference Banff AB, April 9, 2010

Outline : 

Outline Prescription drug misuse in context Study background Prevalence and predictors of PDM Associations between PDM and gambling Currie, Schopflocher, Wild. Prevalence and correlates of prescription drug misuse in Alberta [under review]

Prescription Drug Misuse in Context : 

Prescription Drug Misuse in Context Recent increases in the production and use of psychoactive prescription drugs in North America Growing concerns about prescription drug misuse USA – 15 million people misused prescriptions in 2008 2nd most abused category of psychoactive drugs after cannabis

Prescription Drug Misuse in Context : 

Prescription Drug Misuse in Context Most abused prescriptions are those most potent and most available on the licit market Canada is the world’s top per capita consumer of several high-potency opioids (hydromorphone) 3rd heaviest consumers of psychoactive prescriptions in the world Yet to date, little epidemiological information is available about the misuse of psychoactive prescription drugs in this country, despite calls for action

Alberta Addiction Survey - 2002 : 

Alberta Addiction Survey - 2002 Research Questions What was the prevalence of 12-month PDM among adults in Alberta in 2002? What socio-demographic variables and addictive behaviours are associated with PDM?

Methods : 

Methods Telephone survey of 3,511 adults in Alberta Survey length – 15 minutes Collected in 2002 Response rate was 57.4% Data weighted - Alberta 2001 census data

Methods : 

Methods 4 prescription drug misuse questions based on the following definition: - Use in larger amounts than prescribed, for a longer period than prescribed, or use on your own without a physician’s prescription. In the past 12 months, did you misuse: prescription pain killers (e.g., Demerol, Codeine) prescription sedatives (e.g., Seconal, Halcion) prescription tranquilizers (e.g., Librium, Valium) prescription amphetamines (e.g., Preludin, Ritalin)

Results : 

Results Prevalence of past year PDM was 8.2% Prescription pain relievers – 4.9% Sedatives/tranquilizers – 3.2% Stimulants – 0.8% Disabled status was the strongest overall predictor of past-year prescription drug misuse – Disabled adults were 4x more likely to misuse prescriptions than other adults. Adult students also at greater risk.

Slide 11: 

Addictive Behaviour Alcohol Alcohol use ≥ Monthly binge drinking Alcohol dependent Illicit drugs Cannabis use Cocaine/crack user Hallucinogen user Smoking Casual smoker Daily smoker Gambling Current gambler At-risk gambler Problem gambler Prevalence 83.0% 14.4% 3.2% 12.1% 1.7% 1.9% 5.8% 21.7% 64.9% 6.2% 4.7%

Slide 12: 

Addictive Behaviour Alcohol Alcohol use Binge drinker Alcohol dependent Illicit drugs Cannabis user Cocaine/crack user Hallucinogen user Smoking Casual smoker Daily smoker Gambling At-risk gambler Problem gambler Adjusted OR (95% CI) 1.8 (1.2 - 2.9) ns 2.2 (1.3 - 3.7) 2.0 (1.4 - 2.9) 2.7 (1.4 - 5.2) 1.9 (1.1 - 3.6) ns ns 1.5 (0.9 - 2.4) 2.9 (1.9 - 4.5)

Prescription drug misuse by gambling status : 

Prescription drug misuse by gambling status

Prescription drug misuse by gambling category : 

Prescription drug misuse by gambling category Stimulants Sedatives/tranquilizers Pain killers

Slide 15: 

*p = .03

Why? : 

Why? Problem gamblers may be misusing prescriptions to: Cope with gambling losses Deal with gambling urges Stay awake while gambling Reverse may be true Individuals may engage in both PDM and gambling to escape other life stressors Confounding by unmeasured factors

Limitations : 

Limitations Small sample size – further research is needed Cross sectional study – temporal sequence unknown No information on motives for PDM among gamblers or prescription drug use Full CPGI not used – types of gambling favoured by PDMs unknown

Conclusions : 

Conclusions Prescription drug misuse was an important public health concern in Alberta in 2002 At that time, Canada was 4th highest per-capita consumer of prescription narcotics in the world 2009, Canada 3rd highest per-capita user There is an urgent need for an ongoing assessment of this evolving phenomenon

Conclusions : 

Conclusions This study was the first to examine associations between problem gambling and PDM in a population-based sample. The prevalence of PDM among problem gamblers was 21.5%. Further research is needed to shed more light on motives for PDM among problem gamblers.