Misuse of prescribed psychotropic medication and drug crime offending: A follow-up case-control study of former adolescent psychiatric inpatients

IF 1.1 4区医学 Q3 CRIMINOLOGY & PENOLOGY Criminal Behaviour and Mental Health Pub Date : 2022-06-23 DOI:10.1002/cbm.2254

Mikaela Kontu, Liisa Kantojärvi, Helinä Hakko, Kaisa Riala, Pirkko Riipinen

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引用次数: 1

Abstract

Background

Various psychotropic prescription drugs are known to have potential for misuse. Among teenagers, non-medical use of prescription drugs may predate illicit drug use or occur concomitantly.

Aims

Our aim was to examine prescriptions of psychotropic medications among drug crime offenders and non-criminal controls in a psychiatric inpatient cohort of 13–17-year-olds. Our research question was: were prescribed psychotropic and potentially addictive drugs associated with later drug crime offending.

Methods

Our sample was of all 60 adolescents who had been convicted of a drug crime by young adulthood with a twice-sized control group, matched for gender, age and family-type, from a cohort of 508 adolescents consecutively admitted to a psychiatric inpatient care in Finland between April 2001 and March 2006. Adolescence-related information on substance use and psychiatric disorders was obtained by semi-structured interviews. Follow-up information on crimes and medication purchases was obtained from Finnish nationwide registers. The association of studied factors to drug crime offending was examined using stepwise binary logistic regression analysis.

Results

75% of drug crime offenders and 47% of non-criminal controls had used addictive psychotropic medications during the follow-up period (p < 0.001). 74% of all drug crime offenders' purchases of prescribed addictive drugs occurred within the year preceding drug crimes. Of addictive drugs, the use of clonazepam and gabapentinoids was most likely to associate with drug crime offending (AOR 7.77, p < 0.001). Conduct and substance use disorders diagnosed in adolescence (AOR 3.49, p = 0.010; AOR 2.34, p = 0.050) were predictors for drug crime offending.

Conclusions

Our findings suggest that, when treating young adults with conduct disorder and a history of substance use, physicians should prescribe addictive medications with caution, favouring instead non-addictive medications complemented by psychosocial interventions.

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精神药物处方滥用与毒品犯罪:前青少年精神科住院患者的病例-对照随访研究

背景:各种精神处方药都有被滥用的可能。在青少年中，处方药物的非医疗使用可能先于非法药物使用或同时发生。目的我们的目的是检查在13 - 17岁的精神病住院患者队列中，毒品犯罪罪犯和非犯罪对照的精神药物处方。我们的研究问题是:处方的精神药物和潜在成瘾性药物是否与后来的毒品犯罪有关。方法我们的样本是在2001年4月至2006年3月期间在芬兰精神科住院治疗的508名青少年中，所有60名在成年前被判犯有毒品犯罪的青少年和一个两倍大小的对照组，其性别、年龄和家庭类型相匹配。青少年有关物质使用和精神障碍的信息是通过半结构化访谈获得的。从芬兰全国登记册获得了关于犯罪和药品购买的后续信息。采用逐步二元logistic回归分析，对研究因素与吸毒犯罪的关系进行检验。结果在随访期间，75%的毒品犯罪者和47%的非犯罪对照者使用过精神药物成瘾性药物(p <0.001)。74%的毒品罪犯在毒品犯罪前一年购买处方成瘾性药物。在成瘾性药物中，氯硝西泮和加巴喷丁类药物的使用最有可能与毒品犯罪有关(AOR 7.77, p <0.001)。青少年行为和物质使用障碍诊断(AOR 3.49, p = 0.010;AOR为2.34,p = 0.050)是毒品犯罪的预测因子。结论:我们的研究结果表明，在治疗有行为障碍和药物使用史的年轻人时，医生应该谨慎开成瘾性药物，而不是倾向于非成瘾性药物，辅以社会心理干预。

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来源期刊

Criminal Behaviour and Mental Health Multiple-

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Criminal Behaviour & Mental Health – CBMH – aims to publish original material on any aspect of the relationship between mental state and criminal behaviour. Thus, we are interested in mental mechanisms associated with offending, regardless of whether the individual concerned has a mental disorder or not. We are interested in factors that influence such relationships, and particularly welcome studies about pathways into and out of crime. These will include studies of normal and abnormal development, of mental disorder and how that may lead to offending for a subgroup of sufferers, together with information about factors which mediate such a relationship.