Trajectories of Nonmedical Prescription Drug Misuse

非医疗处方药滥用的轨迹

• 批准号: 8233989
• 负责人: SEAN ESTEBAN MCCABE
• 金额: $ 22.02万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8233989
• 关键词: 18 year old; 21 year old; Accounting; Address; Adolescent; Age; Applications Grants; Behavior; Behavioral; Characteristics; Cross-Sectional Studies; Data; Demographic Factors; Development; Drug Prescriptions; Drug abuse; Employment; Epidemiologic Studies; Epidemiology; Frequencies; Future; Health; Heterogeneity; Individual; Ingestion; Investigation; Knowledge; Lead; Legal; Measurement; Measures; Monitor; Motivation; NIH Program Announcements; Opioid Analgesics; Pain; Pattern; Pharmaceutical Preparations; Prevention; Publishing; Research; Research Design; Risk; Risk Factors; Route; Sampling; Schedule; Screening procedure; Self Medication; Services; Tranquilizing Agents; United States; United States Substance Abuse and Mental Health Services Administration; Variant; adverse outcome; clinical practice; cohort; college; emerging adulthood; improved; misuse of prescription only drugs; prescription drug abuse; psychosocial; public health relevance; social; twelfth grade; young adult

DESCRIPTION (provided by applicant): Nonmedical prescription drug misuse (NPDM) involving scheduled (controlled) medications (i.e., opioid analgesics, stimulants, tranquilizers) has significantly increased over the past two decades in the United States and is most prevalent among individuals 18 years of age. While there have been advances in understanding NPDM, considerable gaps in knowledge remain due to limitations in measurement and study designs and no national studies have examined longitudinal trajectories of NPDM among adolescents and most existing studies fail to account for important characteristics of NPDM such as motives, route of administration, and co- ingestion with other drugs. Findings from our two small exploratory cross-sectional projects (R03DA018239 and R03DA0187272) indicate that there are at least two behavioral subtypes of NPDM (self-treatment and recreational) subsumed under current measures used to assess NPDM, and these behavioral subtypes appear to differ in terms of adverse consequences. However, there is little published information regarding the long- term patterns of misuse and adverse outcomes associated with NPDM among adolescents in the United States. Existing cross-sectional and longitudinal panel data from the Monitoring the Future (MTF) study provide an unprecedented opportunity to address research questions that will lead to a more comprehensive understanding of NPDM and its consequences among adolescents. The objective of the proposed study is to advance our knowledge regarding longitudinal trajectories of NPDM using twelve independent, nationally representative cohorts of approximately 180,000 high school seniors between 1997 and 2008 from the MTF study. The MTF panel sample features twelve separate cohorts of approximately 28,800 high school seniors (modal age 18) who were followed 1-2 years (modal ages 19-20) and 3-4 years (modal ages 21-22) later, resulting in three waves of data. The proposed study aims to 1) assess NPDM and characteristics of NPDM (e.g., motives, route of administration, co-ingestion with other drugs) associated with three prescription drug classes (opioid analgesics, stimulants, tranquilizers), and determine the associations among NPDM, characteristics of NPDM, psychosocial risk factors, and adverse outcomes (e.g., health, legal and social) using cross-sectional and panel data; 2) identify longitudinal trajectories of NPDM of three prescription drug classes (opioid analgesics, stimulants, tranquilizers) across the developmental transition of greatest risk for NPDM- related adverse outcomes using panel data (i.e., ages 18-22), and examine variations in these trajectories by demographic factors, psychosocial risk and protective factors, and NPDM characteristics; and 3) examine the associations among longitudinal trajectories of NPDM of three prescription drug classes (opioid analgesics, stimulants, tranquilizers), important developmental transitions (e.g., college attendance, employment) and adverse outcomes (e.g., health, legal and social) during emerging adulthood using panel data. Findings from this project will substantially advance the current understanding of NPDM among adolescents in the United States, and provide information that will improve the screening, assessment, prevention, and treatment of prescription drug abuse. PUBLIC HEALTH RELEVANCE: Despite a recent increase in nonmedical prescription drug misuse (NPDM) in the United States, relatively little is known about the longitudinal patterns of NPDM among adolescents. The proposed study will inform the development of prevention efforts to reduce NPDM by examining trajectories of NPDM using a nationally representative sample. Findings will help guide clinical practice and future research by examining new research questions related to the developmental course of NPDM. This study has important implications for the identification of individuals at greatest risk for adverse consequences associated with NPDM and those in greatest need of treatment services.

描述（由申请人提供）：涉及计划（受控）药物（即阿片类镇痛药，兴奋剂，替代剂）的非医学处方药滥用（NPDM）在过去的二十年中，在美国的18岁个人中最普遍。尽管在理解NPDM方面取得了进步，但由于测量和研究设计的局限性，知识的差距仍然存在，并且没有国家研究研究NPDM的纵向轨迹，并且大多数现有研究未能说明NPDM的重要特征，例如动机，行政路线，行政路线以及与其他药物的共同点。我们两个小型探索性横截面项目（R03DA018239和R03DA0187272）的发现表明，在当前措施中，至少有两个NPDM（自我治疗和娱乐性）的行为亚型（自我治疗和娱乐性）用于评估NPDM，这些行为亚型在这些行为子类型中差异差异。但是，关于美国青少年中与NPDM相关的长期滥用和不利结果的长期模式的公开信息很少。来自监视未来（MTF）研究的现有横截面和纵向面板数据提供了一个前所未有的机会，可以解决研究问题，这将使人们对NPDM及其在青少年中的后果有更全面的了解。拟议的研究的目的是利用MTF研究的1997年至2008年间，使用十二个独立的，大约180,000名高中生的老年人，提高我们对NPDM纵向轨迹的了解。 MTF面板样本具有十二个单独的同类人群，约有28,800名高中生（模态18岁），后来遵循1-2岁（19-20岁）和3-4岁（21-22岁的模态年龄），导致三波数据浪潮。拟议的研究目的是1）评估NPDM（例如，动机，给药途径，与其他药物的合作）的特征，与三种处方药类别相关的（阿片类镇痛学，兴奋剂，A型替符），并确定NPDM的社会，npdm的特征，以及npdm的特征，npdm，心理症状因素，以及npdmersocial风险因素（themosecial and Chissocial风险因素）（themissigational and Chissocial and Indversiation）（横截面和面板数据； 2) identify longitudinal trajectories of NPDM of three prescription drug classes (opioid analgesics, stimulants, tranquilizers) across the developmental transition of greatest risk for NPDM- related adverse outcomes using panel data (i.e., ages 18-22), and examine variations in these trajectories by demographic factors, psychosocial risk and protective factors, and NPDM characteristics; 3）检查了三种处方药类别（阿片类镇痛药，兴奋剂，镇静剂）的NPDM纵向轨迹之间的关联，重要的发展过渡（例如，使用平层数据的成长掺杂期间，重要的发展过渡（例如，大学出勤率，就业）和不良结果（例如，健康，法律和社交）。该项目的发现将大大提高美国青少年对NPDM的当前理解，并提供将改善筛查，评估，预防和治疗处方药滥用的信息。 公共卫生相关性：尽管最近在美国的非医学处方药滥用（NPDM）增加了，但对青少年NPDM的纵向模式的了解却相对较少。拟议的研究将通过使用全国代表性的样本检查NPDM的轨迹来为减少NPDM的预防努力的发展提供信息。发现将通过研究与NPDM的发展过程有关的新研究问题来帮助指导临床实践和未来的研究。这项研究对确定与NPDM相关的不利后果和最需要治疗服务的个人的识别具有重要意义。