Nationwide trends in diagnosed sedative, hypnotic or anxiolytic use disorders in adolescents and young adults enrolled in Medicaid: 2001–2019

IF 5.3 1区医学 Q1 PSYCHIATRY Addiction Pub Date : 2025-01-22 DOI:10.1111/add.16749

Greta Bushnell, Kristen Lloyd, Mark Olfson, Tobias Gerhard, Katherine Keyes, Magdalena Cerdá, Deborah Hasin

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Abstract

Background and Aim

Sedative, hypnotic or anxiolytic use disorders (SHA-UD) are defined by significant impairment or distress caused by recurrent sedative, hypnotic or anxiolytic use. This study aimed to measure trends in the prevalence of SHA-UD diagnoses in adolescent and young adult US Medicaid enrollees from 2001 to 2019.

Design

Annual, cross-sectional study, 2001–2019.

Setting

Medicaid Analytic eXtracts (MAX) and Transformed Medicaid Analytic Files (TAF) from 42 US states with complete data.

Participants/Cases

Adolescents (13–17 years) and young adults (18–29 years) with ≥10 months Medicaid enrollment in the calendar year; analytic sample contained 5.7 (2001) to 13.2 (2019) million persons per year.

Measurements

Annual prevalence of SHA-UD in adolescent and young adult Medicaid enrollees [defined as an inpatient or outpatient ICD code (304.1x, 305.4x, F13.1x, F13.2x) in the calendar year] was stratified by sex, race/ethnicity, receipt of a benzodiazepine, z-hypnotic or barbiturate prescription, and selected mental health diagnoses. Absolute and relative percent-changes from 2001 vs. 2019 were summarized. Secondary analyses were restricted to states with more consistent data capture.

Findings

The prevalence of SHA-UD diagnoses statistically significantly increased for adolescents (0.01% to 0.04%) and young adults (0.05% to 0.24%) from 2001 to 2019. Increasing trends were observed in sex and race/ethnicity subgroups, with greatest relative increases among Non-Hispanic Black (624%) and Hispanic (529%) young adults. The trend increased among those with and without a benzodiazepine, z-hypnotic or barbiturate prescription; i.e. young adults with (2001 = 0.39% to 2019 = 1.77%) and without (2001 = 0.03% to 2019 = 0.18%) a prescription. Most adolescents (76%) and young adults (91%) with a SHA-UD diagnosis in 2019 had a comorbid substance use disorder.

Conclusions

Sedative, hypnotic or anxiolytic use disorders (SHA-UD) diagnoses increased 3- to 5-fold between 2001 and 2019 for adolescent and young adult US Medicaid enrollees, with prevalence remaining low in adolescents. The increase over two decades may be attributed to changes in the availability, use and misuse of sedative, hypnotic and anxiolytic medications and to increased detection, awareness and diagnosing of SHA-UD.

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参加医疗补助计划的青少年和年轻人中被诊断为镇静剂、催眠药或抗焦虑药使用障碍的全国趋势：2001-2019。

背景和目的：镇静药、催眠药或抗焦虑药使用障碍（SHA-UD）是指因反复使用镇静药、催眠药或抗焦虑药而引起的显著损害或痛苦。本研究旨在衡量2001年至2019年美国医疗补助计划参保的青少年和年轻人中SHA-UD诊断的流行趋势。设计：年度横断面研究，2001-2019。设置：来自美国42个州的医疗补助分析摘录（MAX）和转换后的医疗补助分析文件（TAF），数据完整。参与者/病例：青少年（13-17岁）和年轻人（18-29岁），在日历年内医疗补助登记≥10个月；分析样本每年包含570万人（2001年）至1320万人（2019年）。测量：青少年和青年医疗补助参保者(定义为住院或门诊ICD代码（304.1x, 305.3 x, F13.1x, F13.2x）的年度SHA-UD患病率按性别、种族/民族、接受苯二氮平类药物、z-催眠或巴比妥类药物处方，以及选定的精神健康诊断进行分层。总结了2001年与2019年的绝对和相对百分比变化。二次分析仅限于数据捕获更一致的州。结果：从2001年到2019年，青少年（0.01%至0.04%）和年轻人（0.05%至0.24%）的SHA-UD诊断患病率有统计学意义上的显著增加。在性别和种族/民族亚组中观察到增加的趋势，非西班牙裔黑人（624%）和西班牙裔年轻人（529%）的相对增幅最大。在服用或未服用苯二氮卓类药物、z-催眠药或巴比妥类药物的人群中，这一趋势有所增加；即有处方（2001年= 0.39%至2019年= 1.77%）和没有处方（2001年= 0.03%至2019年= 0.18%）的年轻人。2019年，大多数被诊断为SHA-UD的青少年（76%）和年轻人（91%）患有共病性物质使用障碍。结论：在2001年至2019年期间，美国医疗补助计划的青少年和年轻人中，镇静、催眠或抗焦虑药物使用障碍（SHA-UD）的诊断增加了3- 5倍，青少年的患病率仍然很低。二十年来的增加可能归因于镇静、催眠和抗焦虑药物的可得性、使用和误用的变化，以及SHA-UD的检测、认识和诊断的增加。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.