Like kids in a candy store
Analysis of queries about over-the-counter overdosing reveals pervasive abuse
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DRUG ABUSERS AND POTENTIAL ABUSERS SOUGHT INFORMATION ABOUT OTC OR ADVICE ON QUITTING THEIR DRUG ADDICTION ON SOCIAL MEDIA. THE CURRENT CRISIS MAY BE MUCH MORE SERIOUS THAN IT APPEARS.
view moreCREDIT: KYOTOU/JAKE TOBIYAMA
Kyoto, Japan – A non-prescription drug abuse crisis in Japan seems only one overdose away. The demand for a particular anti-cough drug has been rising, along with the social impact of its abuse due to its psychosomatic effects.
The ease of obtaining information online about how to acquire over-the-counter medications or OTCs for achieving overdose, however, does not appear to be the real problem.
Now, a study by a team of researchers at Kyoto University suggests that reliable information about OTC abuse needs to be readily available and effectively disseminated.
"We focused on potential OTC abusers at risk of addiction though they did not show sufficient symptoms to justify or necessitate visits to medical institutions or support facilities," says corresponding author Azusa Kariya of KyotoU's Graduate School of Medicine and School of Public Health.
Users of Japan's largest consumer-generated media -- or CGM -- service, Yahoo! Chiebukuro, post their questions and responses about OTCs primarily to learn more about overdosing, such as access to the drugs, their efficacy and effects, and health risks.
Abuse results from two causes: one is from seeking symptomatic relief from some physical pain and overdosing to the point of addiction. The other occurs when people intentionally overdose to cause either self-harm or psychosomatic changes.
Kariya's team also found that OTC abusers and potential abusers sought advice on quitting their drug addiction on the Yahoo! community website. Most poignantly, the team discovered that OTC overdosers resist consulting others in person, making the CGM a convenient source of anonymously obtained information.
"Our study aims to make sense of our CGM data to identify possible overdosers. We could then be better positioned to cooperate with health professionals and seek support from pharmacies to reduce OTC abuse," adds Kariya.
Kariya's team searched the names of commonly abused OTCs, tracked the keywords overdose and OD, and tallied the number of relevant questions posted on the Yahoo! site.
The number of OD-related queries containing the keyword BRON -- an antitussive and expectorant -- has increased sharply, pointing to the significant impact of community-based websites.
Furthermore, the team extracted 467 items of question data that met the eligibility criteria from 528 items of BRON-tagged text data, generating 26 codes and six categories. Three main themes resulted: expectations for overdose, anxieties about overdose, and troubles in quitting overdose.
"The current crisis that mental health professionals are confronting is just the tip of the iceberg. We must dive below to see the scale of abuse hidden from view," reflects Kariya.
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The paper "Internet-Based Inquiries From Users With the Intention to Overdose With Over-the-Counter" appeared on 23 November 2023 in JMIR Formative Research, with doi: 10.2196/45021
About Kyoto University
Kyoto University is one of Japan and Asia's premier research institutions, founded in 1897 and responsible for producing numerous Nobel laureates and winners of other prestigious international prizes. A broad curriculum across the arts and sciences at undergraduate and graduate levels complements several research centers, facilities, and offices around Japan and the world. For more information, please see: http://www.kyoto-u.ac.jp/en
JOURNAL
JMIR Formative Research
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Internet-Based Inquiries From Users With the Intention to Overdose With Over-the-Counter
New study explores how young people with early-onset psychosis view substance use and interventions
DALLAS (SMU) – A new study led by SMU medical and psychological anthropologist Neely Myers indicates that while young people diagnosed with early psychosis understand the importance of discontinuing use of substances like cannabis, many are ambivalent about stopping.
Myers, who leads SMU's Mental Health Equity Lab, focuses on helping people with psychosis because it's the least understood and most stigmatized among mental health disorders. Psychosis is a collection of symptoms that affect the mind, in which there has been some break with consensus reality. The condition often begins in young adulthood, between the late teens and mid-20s. Myers recruited participants for her study from Coordinated Specialty Care (CSC) programs, which provide comprehensive outpatient mental health treatment to persons experiencing an early onset.
Despite the known prevalence of substance use among this demographic and increasing evidence of its connection to psychosis, there has been a lack of specialized interventions during care to address substance use effectively. This includes cannabis, whose use among teenagers is at its highest level in 30 years, with today's teens more likely to use cannabis than alcohol.
"Most people with psychosis don't worry about substance use until it detrimentally affects them, and even then they are very reluctant to talk about it," Myers said. "Adolescents can look at substance use as a way to be social and manage their own health—for example, to reduce anxiety or physical pain-- but using substances like cannabis can worsen their condition. More research is needed to understand why so that early intervention programs can better support young people’s mental health.”
Published in the journal Early Intervention in Psychiatry, Myers’ study aimed to understand the motivations and concerns surrounding substance use among young adults (ages 18 to 30) in CSC programs by engaging them in 60-90 minute person-centered, semi-structured, audio-recorded Zoom interviews.
Many of the participants understood that they should likely reduce substance use, but displayed ambivalence about their motivations to do so. They did offer feedback on ways to improve care that included more information about substance use, establishing positive peer communities promoting healthy choices, and the need for strategies that address psychological and physical pain without relying on substance use.
Myers has been working on early psychosis care since 2014 in the North Texas area. Her lab partners with EPINET-National, a larger National Institute of Mental Health-funded endeavor to create hubs for research around the country that accelerate advances in early psychosis care and recovery outcomes through learning health care partnerships. In addition to her appointments at SMU, Myers is also an adjunct associate professor in the Department of Psychiatry at UT Southwestern Medical Center.
About SMU
SMU is the nationally ranked global research university in the dynamic city of Dallas. SMU’s alumni, faculty and more than 12,000 students in eight degree-granting schools demonstrate an entrepreneurial spirit as they lead change in their professions, communities and the world.
JOURNAL
Early Intervention in Psychiatry
METHOD OF RESEARCH
Case study
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Perspectives of young adults diagnosed with early psychosis using coordinated specialty care in Texas on substance use and substance use interventions
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