Misuse of Prescribed and Nonprescribed Substances Among U.S. Cancer Survivors

BACKGROUND

Substance misuse is common among cancer survivors and can negatively impact cancer outcomes.

METHODS

We conducted a cross-sectional study using National Survey on Drug Use and Health data for 2015 to 2020. We included adult respondents with a history of solid tumor cancer. We calculated the weighted prevalence and corresponding SEs (both expressed as percentages) of substance (alcohol, opioid, sedative, stimulant, other) misuse for respondents with any history of solid tumor cancer and, in secondary analyses, respondents diagnosed with cancer in the prior 12 months.

RESULTS

The study included 6,101 respondents with any history of cancer, 1,437 diagnosed in the prior 12 months. Alcohol was the most commonly misused substance. The average prevalence of alcohol misuse was 14.4% (SE 0.60%) across cancer types; it was markedly more common among people with a history or cervical (24.2% [3.0%]) or head and neck cancer (27.4% [7.1%]). The next most common form of substance misuse was opioid misuse (average prevalence: 2.7% [0.25%]). As with alcohol misuse, the prevalence of opioid misuse was higher among those with a lifetime history of cervical cancer (5% [1%]) or head and neck cancer (5% [3%]). Results were generally consistent among cancer survivors diagnosed in the prior 12 months.

CONCLUSIONS

There is a clear opportunity to address substance misuse-particularly alcohol misuse-among cancer survivors. Such efforts should focus on populations with a high prevalence of substance misuse (e.g., cervical and head and neck cancer survivors) and have strong potential to improve cancer-specific and overall health outcomes.

Racial and Ethnic Differences in Cannabis Use and Cannabis Use Disorder: Implications for Researchers

PURPOSE

Heavy and prolonged use of cannabis is associated with several adverse health, legal and social consequences. Although cannabis use impacts all U.S. racial/ethnic groups, studies have revealed racial/ethnic disparities in the initiation, prevalence, prevention and treatment of cannabis use and Cannabis Use Disorder (CUD). This review provides an overview of recent studies on cannabis and CUD by race/ethnicity and a discussion of implications for cannabis researchers.

FINDINGS

The majority of studies focused on cannabis use and CUD among African American/Black individuals, with the smallest number of studies found among Native Hawaiians/Pacific Islanders. The limited number of studies highlight unique risk and protective factors for each racial/ethnic group, such as gender, mental health status, polysubstance use and cultural identity.

SUMMARY

Future cannabis studies should aim to provide a deeper foundational understanding of factors that promote the initiation, maintenance, prevention and treatment of cannabis use and CUD among racial/ethnic groups. Cannabis studies should be unique to each racial/ethnic group and move beyond racial comparisons.

Trends in Therapeutic Services Participation among U.S. Adolescents Affected by Substance Use, 2002-2017

Objective: Substance use continues to pose threats to adolescent health and development in the United States (U.S.). Despite evidence of effectiveness, little is known about adolescent participation in self-help groups (e.g., Alcoholic Anonymous, Alateen) and individual/group counseling for coping with own and another family member's substance use. This study provides new information on the prevalence and trends of adolescent participation in self-help groups and counseling for substance use using a nationally-representative sample. Methods: Data was derived from the 2002-2017 National Survey on Drug Use and Health, which include cross-sectional samples of U.S. adolescents aged 12-17 (n=243,618). Specifically, year-by-year prevalence of program participation was estimated, and then the trends were tested using logistic regression analyses while controlling for sociodemographic factors. Results: We found that U.S. adolescents' participation in self-help groups and counseling for substance use decreased from 5.6% in 2002 to 3.4% in 2017, a 39 percent decline that was significant while controlling for sociodemographic confounds (AOR = 0.969, 95% CI = 0.963-0.974). The decreases were most notable among low-income (-39%) and Hispanic (-49%) adolescents. Conclusion: Findings suggest that barriers to therapeutic service use and potential unmet needs among U.S. adolescents, especially low-income and Hispanic adolescents affected by own and family member's substance use, need to be alleviated to promote healthy recovery.