US Pharm. 2021;46(5):14.
Each year, the CDC notes, about 20% of U.S. adults and nearly 17% of children and adolescents aged 6 to 17 years experience mental illness. The Substance Abuse and Mental Health Services Administration found that 44.8% of adults received mental-health services in 2019, with women (49.7%) outnumbering men (36.8%) by 35%. The percentage of adults receiving mental-health services increased from 38.9% in those aged 18 to 25 years to 47.2% in those older than age 50 years. Misuse of prescription psychotherapeutic drugs is an increasing problem in the U.S.
Prevalence of Mental Illnesses: For mental-health conditions in adults, the annual prevalence was highest for anxiety disorders (19.1%), followed by major depressive episode (7.2%), posttraumatic stress disorder (3.6%), bipolar disorder (2.8%), borderline personality disorder (1.4%), obsessive-compulsive disorder (1.2%), and schizophrenia (<1%).
Overview of Misuse: Of patients misusing prescription psychotropics, 92.4% did so to aid sleep, 70.7% to relax/relieve tension, 26.3% to feel good/get high, and 23.8% to handle feelings/emotions. To relieve tension, 41.1% of patients misused tranquilizers, and reasons for misusing pain relievers included getting high (11.3%), relieving tension (10%), and dealing with emotions/feelings (3.8%). Although from 2018 to 2019 overall misuse of prescription psychotropics dropped by 6%, the rate of decline varied from 0% to 10% depending on the drug’s therapeutic category. Misuse of sedatives remained unchanged at 0.4%, whereas misuse of stimulants declined by 5% and misuse of benzodiazepines and pain relievers each decreased by 10%.
Sedatives, Tranquilizers, and Stimulants: In 2019, tranquilizers, benzodiazepines, and sedatives were misused by 1.9%, 1.8%, and 0.4% of patients, respectively. In 2019, 5.9% of patients misused psychotherapeutics, including pain relievers, tranquilizers/sedatives, and stimulants. Nearly 68% of patients misused sedatives to aid sleep, and 20.9% misused tranquilizers. About twice as many patients misused tranquilizers for tension relief compared with those who misused sedatives for that reason (41.1% vs. 19.6%). However, tranquilizers continued to be more frequently misused than sedatives in order to get high (10.9% vs. 4.1%) or to deal with feelings/emotions (15.8% vs. 4.2%). From 2018 to 2019, overall misuse of prescription psychotropics fell 4.8% (from 6.2% to 5.9%), and there was a threefold greater reduction in misuse of tranquilizers/sedatives (from 2.4% to 2.1%). For stimulants, the most frequent reasons for misuse were to increase alertness (30%), to stay awake (27.7%), and to help with studying (19%). Other reasons were to get high (9.8%), to “see what it’s like” (5.8%), and to help with weight loss (4.1%).
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