Table 2.
Past-year Prevalence of Benzodiazepine Prescription Use and Misuse and Predictors of Benzodiazepine Misuse, Overall and Stratified by Characteristic
| Adults overalla (n=86,186) |
BZD users overalla (n=10,290) |
||||||||
|---|---|---|---|---|---|---|---|---|---|
| BZD use: as-prescribed (n=7,757) Weighted % |
BZD use: misuse (n=2,533) Weighted % |
BZD use: as-prescribed (n=7,757) Weighted % |
BZD use: misuse (n=2,533) Weighted % |
Fb | df | p-value | AORc | 95% CI | |
| Overall | 10.4 | 2.2 | 82.8 | 17.2 | — | — | |||
| Demographic Characteristics | |||||||||
| Age | 188.2 | 3, 139 | <.001 | ||||||
| 18-25 | 5.0 | 5.2 | 49.0 | 51.0 | ref | ||||
| 26-34 | 8.3 | 3.3 | 71.4 | 28.6 | .55** | .46-.66 | |||
| 35-49 | 10.7 | 1.7 | 86.2 | 13.8 | .33** | .27-.41 | |||
| 50-64 | 12.9 | 1.4 | 90.3 | 9.7 | .33** | .26-.43 | |||
| ≥65 | 12.3 | .6 | 95.6 | 4.4 | .23** | .15-.34 | |||
| Gender | 102.3 | 1, 50 | <.001 | ||||||
| Male | 7.3 | 2.3 | 76.3 | 23.7 | ref | ||||
| Female | 13.3 | 2.1 | 86.5 | 13.5 | .74** | .61-.90 | |||
| Race/ethnicity | 4.9 | 3, 146 | .003 | ||||||
| Non-Hispanic white | 12.9 | 2.5 | 83.6 | 16.4 | ref | ||||
| Non-Hispanic black | 5.7 | 1.5 | 79.6 | 20.4 | 1.25 | .94-1.65 | |||
| Hispanic | 6.1 | 1.6 | 78.8 | 21.2 | 1.05 | .79-1.38 | |||
| Other | 5.4 | 1.1 | 82.4 | 17.6 | .95 | .67-1.35 | |||
| Education | 9.4 | 2, 100 | <.001 | ||||||
| <HS | 8.1 | 1.9 | 81.3 | 18.7 | ref | ||||
| HS grad, some college | 10.9 | 2.5 | 81.3 | 18.7 | .99 | .77-1.26 | |||
| College grad or higher | 10.5 | 1.7 | 86.2 | 13.8 | .90 | .67-1.22 | |||
| Household income | 9.4 | 3, 140 | <.001 | ||||||
| <$20,000 | 10.9 | 3.0 | 78.6 | 21.4 | ref | ||||
| $20,000-$49,999 | 10.4 | 2.3 | 81.9 | 18.1 | .98 | .79-1.23 | |||
| $50,000-$74,999 | 10.3 | 1.8 | 85.0 | 15.0 | .77 | .58-1.03 | |||
| ≥$75,000 | 10.2 | 1.8 | 84.9 | 15.1 | .84 | .67-1.06 | |||
| Medicaid | 7.0 | 1, 50 | .01 | ||||||
| No | 10.1 | 2.0 | 83.3 | 16.7 | ref | ||||
| Yes | 12.1 | 3.0 | 80.2 | 19.8 | .99 | .79-1.23 | |||
| Metropolitan | 4.8 | 2, 95 | .01 | ||||||
| Large | 9.7 | 2.1 | 82.0 | 18.0 | ref | ||||
| Small | 11.1 | 2.4 | 82.5 | 17.5 | 1.02 | .83-1.25 | |||
| Nonmetrod | 11.3 | 1.8 | 86.0 | 14.0 | .84 | .67-1.06 | |||
| Past year clinical characteristics | |||||||||
| Presence of MDE | 20.9 | 1, 50 | <.001 | n/a | |||||
| No | 9.2 | 1.8 | 83.8 | 16.2 | — | — | |||
| Yes | 26.4 | 7.2 | 78.5 | 21.5 | — | — | |||
| Suicidal ideation | 92.9 | 1, 50 | <.001 | n/a | |||||
| No | 9.9 | 1.8 | 84.3 | 15.7 | — | — | |||
| Yes | 21.7 | 9.7 | 69.1 | 30.9 | — | — | |||
| Presence of mental illness | 15.1 | 3, 139 | <.001 | ||||||
| None | 7.7 | 1.4 | 84.8 | 15.2 | ref | ||||
| Mild | 18.0 | 3.6 | 83.5 | 16.5 | .90 | .72-1.12 | |||
| Moderate | 22.8 | 6.5 | 77.9 | 22.1 | 1.24 | .93-1.63 | |||
| Severe | 31.7 | 9.8 | 77.3 | 22.7 | 1.19 | .93-1.53 | |||
| Health self-rating | 30.1 | 2, 96 | <.001 | ||||||
| Excellent/Very good | 7.8 | 2.0 | 79.4 | 20.6 | ref | ||||
| Good | 11.2 | 2.4 | 82.7 | 17.3 | .85 | .70-1.04 | |||
| Fair/Poor | 19.2 | 2.3 | 89.2 | 10.8 | .61** | .47-.80 | |||
| Other past-year substance use | |||||||||
| Tobacco | 565.4 | 1, 50 | <.001 | ||||||
| None | 9.5 | 1.0 | 90.7 | 9.3 | ref | ||||
| Any usee | 12.3 | 4.8 | 71.9 | 28.1 | 1.41** | 1.17-1.70 | |||
| Alcohol | 199.5 | 2, 90 | <.001 | ||||||
| None | 9.8 | .8 | 92.8 | 7.2 | ref | ||||
| Past year | 10.4 | 2.0 | 83.5 | 16.5 | 1.42* | 1.08-1.87 | |||
| Abuse/dependence | 13.8 | 10.3 | 57.2 | 42.8 | 2.31** | 1.73-3.09 | |||
| Marijuana | 558.3 | 2, 99 | <.001 | ||||||
| None | 9.8 | 1.0 | 90.7 | 9.3 | ref | ||||
| Past yearf | 14.4 | 8.3 | 63.3 | 36.7 | 1.88** | 1.58-2.24 | |||
| Abuse/dependence | 11.7 | 18.6 | 38.7 | 61.3 | 2.39** | 1.62-3.52 | |||
| Heroin | 90.3 | 2, 86 | <.001 | ||||||
| None | 10.3 | 2.0 | 83.6 | 16.4 | ref | ||||
| Past year | 26.6 | 29.2 | 47.7 | 52.3 | .91 | .41-2.04 | |||
| Abuse/dependence | 23.5 | 40.8 | 36.5 | 63.5 | 1.20 | .76-1.91 | |||
| Prescription opioid | 462.0 | 3, 144 | <.001 | ||||||
| None | 5.9 | .9 | 86.2 | 13.8 | ref | ||||
| Prescription use | 18.3 | 1.7 | 91.5 | 8.5 | .69** | .57-.84 | |||
| Misuse | 15.6 | 19.9 | 44.1 | 55.9 | 4.11** | 3.26-5.18 | |||
| Abuse/dependence | 24.4 | 35.6 | 40.7 | 59.3 | 4.81** | 3.45-6.72 | |||
| Prescription stimulant | 410.6 | 3, 127 | <.001 | ||||||
| None | 9.6 | 1.5 | 86.8 | 13.2 | ref | ||||
| Prescription use | 24.1 | 5.7 | 80.9 | 19.1 | .90 | .74-1.09 | |||
| Misuse | 13.3 | 24.1 | 35.6 | 64.4 | 2.46** | 1.85-3.27 | |||
| Abuse/dependence | 14.7 | 39.6 | 27.1 | 72.9 | 3.40** | 1.72-6.70 | |||
BZD: benzodiazepine; AOR: adjusted odds ratio; CI: confidence interval; MDE: major depressive episode
Under “Adults overall”, a characteristic row presents the prevalence of as-prescribed or misuse within that stratum (e.g., 5.2% of adults 18-25 reported misuse). Under “benzodiazepine users overall”, a row presents the proportion of benzodiazepine use within that stratum that is as-prescribed or misuse (e.g., among adults 18-25, 51.0% benzodiazepine use reported is misuse).
To account for complex survey design, Stata converts the usual Pearson chi square into a F statistic with non-integer degrees of freedom, which have been rounded (https://www.stata.com/manuals13/svysvytabulatetwoway.pdf).
Model is adjusted for all respondent demographic, clinical, and substance use characteristics presented as rows in the table. Presence of MDE and suicidal ideation are not included in the model as per NSDUH instructions (26), as those variables are used to generate the Presence of mental illness variable. Because just 3 of 44 characteristic x age interactions in bivariate tests were statistically significant,d,e,f characteristic-by-age interactions were not included in the adjusted model.
Nonmetro × age interaction in bivariate test p=0.02
Past-year tobacco use × age interaction in bivariate test p=0.002
Past-year marijuana use × age interaction in bivariate test p=0.008
p≤.01,
p≤.001