Ty Schepis

Verified

Ty verified their affiliation via an institutional email.

Learn more

Verified

Ty verified their affiliation via an institutional email.

Learn more

• Doctor of Philosophy
• Professor (Full) at Texas State University

Psychostimulant misuse and use disorders are major drivers of morbidity and fatal overdose in the United States, but little is known about how differences in psychostimulant use patterns relate to Diagnostic and Statistical Manual, Diagnostic and Statistical Manual of Mental Disorders, 4th edition and Diagnostic and Statistical Manual of Mental Dis...

Purpose Youth (children and adolescents under 18 yrs) exposed to parental substance use disorder (SUD) are at high risk for poor outcomes that include substance use, psychopathology, and child welfare involvement. With the changing SUD criteria from DSM-IV to DSM-5, revised estimates of youth exposed to parental SUD in the home are needed to provid...

Research suggests that racial/ethnic minoritized individuals have elevated risk for experiencing trauma and developing posttraumatic stress disorder (PTSD) but are less likely to utilize mental health treatment compared to their non-Hispanic White counterparts. However, possessing health insurance may mitigate these disparities. We investigated thi...

Objective Adolescent (12–17 years) and young adult (18–25 years) prescription opioid misuse (POM) is linked to poor health outcomes. We investigated how POM motives vary across these ages and the potential links between motives and other substance use, mental health, and sociodemographic characteristics to help guide screening and prevention. Meth...

Objectives Most US treatment and recovery services are abstinence-based. However, many people in recovery from an alcohol or other drug (AOD) use problem do not abstain completely. This study estimated the prevalence of and characteristics associated with nonabstinence among US adults in recovery. Methods Nonabstinence—operationalized as past-mont...

Objective: Food and alcohol disturbance (FAD) is the use of any compensatory behavior (e.g., skipping meals) within the context of a drinking episode. FAD has two underlying motives: to enhance the effects of alcohol (FAD-AE) and/or compensate for calories consumed from alcohol (FAD-CC). Prior work finds that FAD is positively associated with alco...

Background Substance use and substance use disorders (SUD) are prevalent among college students. Information about the gap between substance use treatment need versus treatment receipt can guide efforts to increase service access. This study examined past-year DSM-5 SUD and receipt of treatment among US college students. Methods Past-year DSM-5 SU...

This study examines trends in medical use, nonmedical use, diversion sources, and perceived procurement difficulty of prescription medications for nonmedical use among US adolescents.

Background This study examined reasons not to drink in young adults in relation to demographics, alcohol use patterns, timing (weekend vs. weekday), and typical drinking motives. Methods Young adults who reported past 30‐day alcohol use and at least one nondrinking day (n = 614; mean age = 21.5 years ±0.53) completed a survey of alcohol‐related me...

Objective: Alcohol involvement is declining among U.S. adolescents, however studies examining population-level trends in alcohol involvement among females and males from diverse racial and ethnic backgrounds are scarce. Therefore, the current study examined alcohol involvement from 2002 to 2019 among Hispanic, Black, and White U.S. adolescent fema...

Objective: Limited prospective data exist about the impact of stimulant therapy for attention-deficit hyperactivity disorder (ADHD) during adolescence on the risk for later prescription drug misuse (PDM; i.e., of benzodiazepines, opioids, and stimulants). Methods: National longitudinal multicohort panels (baseline cohort years 2005-2017) of U.S....

Background To examine the associations between early onset of nonmedical prescription stimulant use (NPSU) and cocaine use. Methods Nationally representative samples of high school seniors were surveyed annually. Data were collected via self-administered questionnaires in nationally representative public and private schools in the United States (1...

This randomized experiment tested whether the inclusion of a “something else” response option for a question about sexual identity in a national health survey would significantly moderate estimated differences between sexual identity subgroups in terms of various health outcomes, including substance use and reproductive health. We conducted seconda...

Importance: The prescribing of stimulant medications for attention-deficit/hyperactivity disorder (ADHD) has increased in the US. Prescription stimulants are one of the most commonly misused controlled substances during adolescence. Despite a 10-fold increase in stimulant-related overdose deaths in the past decade, the transitions from prescriptio...

This handbook is currently in development, with individual articles publishing online in advance of print publication. At this time, we cannot add information about unpublished articles in this handbook, however the table of contents will continue to grow as additional articles pass through the review process and are added to the site. Please note...

Objective: A growing body of research has emerged to characterize differences in posttraumatic stress disorder (PTSD) symptom presentations in individuals from diverse racial and ethnic groups. However, less research has examined if these observed differences can be attributed to bias within PTSD assessments. Knowledge about potential bias in PTSD...

Objective: Prescription benzodiazepines are among the most commonly used and misused controlled medications. The authors aimed to examine transitions from medical use of prescription benzodiazepines to prescription benzodiazepine misuse, prescription opioid misuse, and substance use disorder symptoms during adulthood. Methods: Eleven national co...

Background To assess whether age of onset and duration of stimulant therapy for attention‐deficit/hyperactivity disorder (ADHD) are associated with cocaine, methamphetamine, and prescription stimulant misuse during adolescence. Methods Nationally representative samples of US 10th and 12th grade students (N = 150,395) from the Monitoring the Future...

Importance: Recent information on the prevalence of prescription stimulant therapy for attention-deficit/hyperactivity disorder (ADHD) and nonmedical use of prescription stimulants (NUPS) at the school-level among US secondary school students is limited. Objective: To investigate the school-level prevalence of and association between stimulant t...

Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with higher substance use rates. Stimulant and non-stimulant pharmacotherapy improve adolescent ADHD, but their associations with prescription stimulant misuse (PSM), cocaine, and methamphetamine use are unclear. Using 2005-2020 US Monitoring the Future data, we investigated...

Background: While alcohol use and prescription drug misuse (PDM) are common among adolescents, there is relatively little research on coingestion. This is disquieting as polysubstance use has become a major contributing factor in drug overdose deaths among young people in the United States. Methods: The current research uses multiple years of da...

The United States and many other developed nations are in the midst of an opioid crisis, with consequent pressure on prescribers to limit opioid prescribing and reduce prescription opioid misuse. This review addresses prescription opioid misuse for older adult surgical populations. We outline the epidemiology and risk factors for persistent opioid...

Prescription stimulant misuse (PSM) is most prevalent among college students and is associated with numerous negative academic and psychosocial outcomes. A large body of literature has identified predictors of PSM in this population, however few studies have utilized a person-centered approach to examine how the sources from which students procure...

Objective: Individuals who are family history positive (FHP) for substance use problems have increased risk for substance use, substance use disorders (SUDs), and psychopathology. Links between FHP status and prescription drug misuse (PDM) have not been well investigated; this study examined PDM in adults 50 and older by FHP status. Methods: Dat...

Introduction: Criminal legal system (CLS) exposed adults experience higher rates of substance use, substance use disorder (SUD), and overdose. As most CLS exposed adults are not incarcerated, it is important to focus on CLS exposure across the carceral continuum. Methods: This research used pooled data from adult respondents (N = 206,314) in the...

Nonmedical prescription stimulant use (NPS) is prevalent among undergraduates and associated with several negative consequences. However, no validated measures exist assessing NPS-related consequences. The present study aimed to develop and psychometrically validate a Prescription Stimulant Consequences Questionnaire (PSCQ) for use among college st...

Importance: Although more than 1 in every 3 US individuals will develop a substance use disorder (SUD) in their lifetime, relatively little is known about the long-term sequelae of SUD symptoms from adolescence through adulthood. Objective: To evaluate the longitudinal associations between adolescents' SUD symptom severity with later medical use...

Background and objectives: To examine changes in United States past-year opioid, stimulant, and benzodiazepine prescription drug misuse (PDM) and poly-PDM by demographics. Methods: Data were from the 2015-2019 National Survey on Drug Use and Health (N = 282,768), examining annualized PDM change by demographics. Results: Opioid and poly-PDM sig...

Importance US adults born from 1965 to 1996 had high exposure to controlled medications, yet little is known about how this exposure has affected them over time. Prescription drug misuse (PDM) has increased among adults in the past 2 decades, with related increases in emergency department visits, overdoses, and deaths. Objectives To identify 32-ye...

College students have experienced significant disruptions related to COVID-19, and limited international data suggest they may be at elevated risk for mental health symptom increases related to COVID. Given their potentially elevated risk, our aim was to evaluate differences from pre-college closures to post-closure in mental health symptoms, alcoh...

Simultaneous co-ingestion of prescription medication (e.g., opioid, tranquilizer/sedative, stimulant) and alcohol is associated with overdose and elevated substance use, but no studies have examined prescription drug misuse (PDM) and alcohol co-ingestion in U.S. young adults (18-25 years), despite the high rates of PDM in this age group. We used th...

Objective/Participants In a large, diverse sample of college students (N = 2,230), this online study investigated racial/ethnic differences on type of discriminatory event experienced and perceived stress, and whether discrimination-related stress was associated with mental health symptoms. Methods: Prevalence of lifetime/past year discriminatory e...

Objective To examine prevalence of past-month prescription drug misuse (PDM) and alcohol co-ingestion and its correlates in adults age 50 or older. Methods Data were from the 2015–2018 US National Survey on Drug Use and Health (n = 35,190). PDM-alcohol co-ingestion was defined as prescription opioid, tranquilizer/sedative, or stimulant misuse whil...

Objective Substance use rates have increased in adults 50 years and older, and substance use in this population is associated with significant consequences. Given that little is known about their underlying substance use patterns, the objective was to identify latent classes of adults 50 years and older by past-year substance use, past-month substa...

Objective: Co-use of alcohol and marijuana has increased among college students, though comparisons among simultaneous (i.e., use of both substances such that effects overlap), dual (i.e., use of both substances within a similar time period but without overlapping effects), and marijuana-only use are limited. This study aimed to understand differen...

Background Most research on prescription drug misuse (PDM) focuses on the misuse of specific classes of psychoactive prescription drugs among adolescents or young adults. The current research addressed important gaps in the literature by assessing poly-prescription drug misuse (poly-PDM), the misuse of more than one class of psychoactive prescripti...

Objective: While prescription stimulant misuse (PSM) is common in adolescents and young adults (AYAs), PSM motives are poorly understood. This study examined a number of PSM motives across the AYA age spectrum using the 2015-2018 National Survey on Drug Use and Health. Methods: In all, 86,918 AYAs (aged 14-25 years) were included. Individual PSM...

Objectives Although older adult prescription drug misuse (PDM) is associated with concerning consequences, stimulant PDM and poly- PDM involving multiple medication classes each remain understudied. Our objectives were to examine PDM and poly-PDM prevalence by medication class in US older adults and to identify the mental health, SUD, and health-re...

Importance Recent information on the trends in past-year alcohol abstinence and marijuana abstinence, co-use of alcohol and marijuana, alcohol use disorder, and marijuana use disorder among US young adults is limited. Objectives To assess national changes over time in past-year alcohol and marijuana abstinence, co-use, alcohol use disorder, and ma...

Background and objectives: Prior research has identified that sources of prescription drugs for misuse vary based on educational attainment, which is important as certain sources are associated with adverse outcomes. The current research addressed limitations of the extant literature by creating distinct categories of push factors for high school...

Objectives: Roughly 6.5 million US residents engaged in prescription tranquilizer/sedative (eg, benzodiazepines, Z-drugs) misuse in 2018, but tranquilizer/sedative misuse motives are understudied, with a need for nationally representative data and examinations of motives by age group. Our aims were to establish tranquilizer/sedative misuse motives...

Background The aim was to examine the effects of sexual identity, educational status, and their interaction on the past-year prevalence of controlled prescription use and prescription drug misuse (PDM) in U.S. young adults, 18–25 years. Methods: Data were from the 2015–2017 National Survey on Drug Use and Health (young adult N = 38,298). Past-year...

Purpose U.S. homeschooling increased by 50% over 2007–2016. Homeschooled adolescents may have lower substance use rates, but previous research treated other adolescents as homogeneous despite within-group differences. We used the 2015–2018 National Survey on Drug Use and Health to compare adolescent substance use and psychopathology by homeschooled...

Prescription stimulant misuse (PSM) is common in young adult college students, at over 10% in the past year, and it is associated with other substance use and risk behaviors. Research focused on the real-time drivers of PSM is absent, impeding prevention and intervention. This research aimed to fill that gap by examining the relationships between a...

Background and Objectives The aim of this study was to investigate the social context of nonmedical use of prescription stimulants (NMUPS) among college students who endorsed NMUPS with co‐occurring substance use disorders (SUD) compared with those without co‐occurring SUDs. Methods Presented here are new analyses based on data previously collecte...

Prescription drug misuse (PDM), or medication use without a prescription or in ways not intended by the prescriber, is a notable public health concern, especially in the United States. Accumulating research has characterized PDM prevalence and processes, but age-based or lifespan changes in PDM are understudied. Given age-based differences in the m...

Aims Prescription opioid misuse (POM) contributes to a larger opioid crisis in the US and Canada, with over 17 000 US POM-related overdose deaths in 2017. Our aims were to (1) identify specific profiles of respondents based on POM motives using the US National Survey on Drug Use and Health (NSDUH) and (2) compare profile respondents on sociodemogra...

Objectives: To evaluate age-based differences in prescription opioid misuse (POM) motives and to evaluate substance use and mental and physical health correlates of POM motive categories in older adults. Design: Data were from the National Survey on Drug Use and Health (NSDUH), a nationally representative US survey. Setting: The NSDUH is a hou...

Objective: Prescription opioid misuse (POM) prevalence in US older adults (50 years and older) has increased, and preliminary evidence associates POM with poor outcomes. Despite this, little is known about the health-related quality of life, mental and physical health, and substance use profiles of older adults with current and/or past POM. The ai...

Objective: The opioid crisis has had devastating effects on individuals and communities, and it has rapidly increased in severity. However, we still lack nationally representative information on the diversity of comorbidity patterns among prescription opioid use disorder (P-OUD), other substance use disorders (SUDs), and psychopathology using the n...

Purpose Young adults who do not complete high school are at increased risk for substance use and offending behavior. A limitation of this research is that dropouts are often treated as a homogeneous group, which ignores the various push (e.g., academic failure or disciplinary problems) and pull (e.g., family responsibility or economic need) factors...

Background: Prescription drug misuse is most prevalent during young adulthood (ages 18-25 years). We aimed to identify prescription drug misuse trajectories for three drug classes (opioids, stimulants, and sedatives or tranquilisers) from adolescence into adulthood, assess the extent to which different trajectories are associated with symptoms of...

Much of the southern United States is characterized by unique social, structural, and political systems that may relate to increased stress and poor health outcomes for those living with HIV. Notably, research indicates that Texas has higher survival rates for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) than gen...

Background Given the public health issues associated with prescription opioid misuse, there is surprisingly little research on sources of prescription opioids for misuse. We know that free from friends/relatives is the most common source, that source is associated with patterns of misuse, and that sources vary based on the sociodemographic characte...

Objective: We evaluated the perceived effectiveness of resistance strategies students could employ if approached to give away, trade, or sell their prescription stimulant medication, a growing concern on college campuses. Participants: We sampled undergraduates (N = 1,521) at three demographically dissimilar institutions between Fall 2017 and Spri...

Background: US college students have elevated prescription opioid and stimulant misuse rates, with frequent alcohol use and alcohol-related consequences (ARCs). To date, though, no research has examined relationships between opioid and/or stimulant misuse and alcohol quantity/frequency or ARC variables in college students. Methods: The 2016-17 A...

Background: Older adult prescription tranquilizer/sedative misuse is understudied, despite evidence of increased misuse prevalence and significant associated consequences (e.g., suicidal ideation). Identification of misuse sources could limit such misuse by offering policymakers and clinicians targets to limit diverted tranquilizer/sedative medica...

Objective: To determine the prevalence, remission, and treatment associated with DSM-5 substance use disorders (SUDs) among young adults based on college attendance. Participants: The population-based sample included 2,057 young adults aged 19-23 in college/school and 1,213 not currently attending college/school who participated from April 2012...

Background: US opioid overdose deaths continue to climb, with a 12.0% increase from 2016 to 2017. Fentanyl, a synthetic opioid, has been a major contributor to opioid-related overdose deaths. While fentanyl-related overdose is driven by illicit fentanyl, little is known about individuals who misuse prescription fentanyl, which is also linked to el...

Objective: To examine whether sources of nonmedical use of prescription drugs (NMUPD) involving anxiolytics, opioids, and stimulants were associated with sociodemographic characteristics, NMUPD characteristics (eg, frequency), and other substance use. Method: Nationally representative samples of US high school seniors (N = 18,549) were surveyed...

Objective: To examine the age-specific risk of past-year substance use disorders (SUDs) associated with use and misuse of prescription opioids, stimulants, sedatives and tranquilizers. Methods: The authors analyzed nationally representative data from 114,043 U.S. individuals aged 12 and older in the 2015-2016 National Survey on Drug Use and Heal...

Background: This longitudinal study assesses characteristics associated with adolescents' nonmedical use of prescription opioids (NMUPO) including: frequency, co-ingestion, motives, specific opioid type; sequence of initiation of medical use of prescription opioids and NMUPO in relationship to subsequent substance use disorder (SUD) symptoms. Met...

Objectives Suicide in older adults is a major public health issue. Past research across the US adult population has linked prescription medication misuse with suicidal ideation. No work has evaluated associations between prescription opioid or benzodiazepine misuse and suicidal ideation in older adults, and this work aimed to address that gap. Met...

Objective: Adolescent controlled prescription drug misuse (PDM) co-occurs with significant consequences, including lower educational achievement, substance use disorder (SUD) symptoms, and psychopathology. Nonetheless, adolescent PDM sources and the prevalence of other substance use, SUD, and mental health outcomes associated with sources remain p...

Objective: Mixed findings exist regarding extent and efficacy of nonmedical use of prescription stimulants (NMUPS) for study enhancement (SE). This national study of US high school seniors examined NMUPS for SE and addressed risk/benefit questions: To what extent are students reporting NMUPS specifically for SE, and do these individuals demonstrat...

Background: Prescription tranquilizer/sedative (e.g., alprazolam, zolpidem) misuse (i.e., use in ways not intended by the prescriber or without a prescription) is understudied, with little research identifying misuse correlates. Identification of key correlates could identify subgroups more likely to engage in misuse, allowing for targeted treatme...

Background: Prescription drug misuse (PDM) rates are highest in adolescents and young adults. Little research in these high-risk groups has examined PDM differences by educational status or attainment. This investigation attempted to further our understanding of adolescent and young adult prescription drug use and misuse through examining PDM type...

Despite increasing rates of prescription opioid misuse in adults 50 years of age and older, little research has investigated such misuse in this population. This work aimed to examine sources of misused opioid medication in adults 50 years and older, with comparisons to younger groups. Data were from the 2009-2014 National Survey on Drug Use and He...

Objective: This study examined prescription drug misuse (PDM), sources of PDM, and substance use disorder (SUD) symptoms as a function of educational status among US young adults based on a large nationally representative sample. Methods: Data from the 2009-2014 National Survey on Drug Use and Health came from a sample of 106,845 young adults ag...

This overview of prescription drug abuse includes historical background, key concepts, and discussion of the prevalence of drug abuse, treatments, and policy issues implicated in ending the epidemic. Prescription opioid medication abuse has been declared a national crisis by experts in medicine, substance use, public health, and pain management, cu...

Background: Research indicates healthcare workers' personal substance use may affect quality of care. Investigating factors that correlate with coping through substance use may provide insight into improving quality care. Objectives: This study aims to examine potential correlates of coping through substance use among healthcare workers, with a...

Researchers have begun to identify predictors of who will divert their stimulant prescriptions, as most emerging adults (EAs) who use prescription stimulants nonmedically procure these drugs from a friend or acquaintance with a prescription. Far less research has examined how EAs with attention-deficit/hyperactivity disorder (ADHD) are approached f...

Background: Nonmedical use of prescription opioids (NMUPO) is an ongoing public health challenge, as NMUPO is associated with psychopathology, other drug use and fatal overdose. These concomitant risks are greatest in those with opioid use disorder (OUD), but the development of NMUPO-related use disorder is poorly understood. The primary aim of th...

Background: Based on projections of increasing older adult nonmedical prescription drug use (NMPDU) prevalence, we investigated whether increases had occurred in opioid, tranquilizer and stimulant NMPDU in older adults from 2002-2003 to 2012-2013, using the National Survey on Drug Use and Health (NSDUH). Methods: The NSDUH is a nationally repres...

Substantial evidence links greater impulsivity and stress exposure to poorer smoking cessation outcomes. Results from adolescents also indicate that stress-related change in risk taking can impede cessation attempts. We investigated the effects of stress-related change in impulsivity, risk taking, attention and nicotine withdrawal, and craving in y...

Nonmedical tranquilizer use (NMTU) is a concerning and understudied phenomenon in adolescents, despite being the second most prevalent form of nonmedical use in this population. Thus, this work aimed to examine the sociodemographic and substance use correlates of past-year co-ingestion of a prescription tranquilizer and another substance among adol...

College is a stressful time (Berg, Ritschel, Swan, An & Ahluwalia, 2011). Issues of drinking remain established and challenging in college populations (Rinker & Neighbors, 2013), but some research shows that hope is related to engagement in healthy behaviors regarding alcohol consumption (Berg at al., 2011) however little research focuses on the te...

Background: Adolescent smoking is a major public health concern, and current treatments are only somewhat effective in promoting abstinence. One way to improve treatments is to identify psychosocial characteristics that impede cessation, allowing development of targeted treatments. This study examined the influence of 2 such characteristics, life...

Objective To determine the past-year prevalence rates and correlates of simultaneous co-ingestion of prescription stimulants and other substances among US high school seniors.Methods Nationally representative probability samples of US high school seniors were surveyed as a part of the Monitoring the Future study. The sample consisted of five cohort...

Background Recent warnings from the FDA have highlighted the potential risks associated with zolpidem use. These risks may be especially acute in nonmedical users of zolpidem, but little work has examined the characteristics of such nonmedical users. This study aims to investigate the correlates of nonmedical use of zolpidem (NUPZ) across the lifes...

Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students' interest in participating in an in...

Background: Nonmedical use of prescription medication (NUPM) is associated cross-sectionally with a host of medical and psychosocial consequences. Few studies, however, have examined longitudinal outcomes based on NUPM indicators. This study aimed to address this gap by examining change in health-related quality of life as a function of NUPM statu...