A prospective examination of stimulant diversion and related risk factors for young adults with childhood- or adult-diagnosed ADHD

对儿童或成人诊断为多动症的年轻人的兴奋剂转移和相关危险因素的前瞻性检查

• 批准号: 10200733
• 负责人: BROOKE S.G. MOLINA
• 金额: $ 74万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10200733
• 关键词: Address; Adolescence; Adolescent; Adult; Age; Aging; Area; Attention deficit hyperactivity disorder; Behavior; Behavioral; Child Rearing; Childhood; Cross-Sectional Studies; Data; Decision Making; Development; Diagnosis; Disclosure; Distal; Drug Prescriptions; Environment; Formulation; Impulsivity; Intention; Legal; Medical; National Institute of Drug Abuse; Parents; Pathway interactions; Patients; Pharmaceutical Preparations; Policies; Population; Prevalence; Prevention; Primary Health Care; Prospective Studies; Provider; Published Comment; Race; Recreation; Reporting; Research; Risk; Risk Factors; Role; Sampling; Schedule; Science; Strategic Planning; Time; base; behavioral economics; cognitive enhancement; common treatment; discounting; emerging adult; improved; parental involvement; pediatrician; peer; prevent; prospective; provider factors; recruit; sex; social; socioenvironmental factor; stimulant misuse; trend; willingness; young adult

Project Summary Diversion of ADHD stimulants, by sharing, selling, or trading, is the primary conduit by which these Schedule II controlled drugs reach their peak prevalence of misuse in early adulthood (use without a prescription, overuse of prescribed medication). Yet, understanding of stimulant diversion and contributing factors is limited to speculation from small cross-sectional studies. Dramatically increased rates of stimulant prescribing in recent years (from ~49.2 to 62.8M people), mainly in adults, has heightened concern. The state- of-science on this important topic precludes development of prevention efforts based on variables with inferred causal influence. Additionally, although primary care is the most common treatment setting for ADHD, this population and its risk for diversion in adulthood, including when diagnosis and treatment occurs after childhood, is poorly understood. Due to concern about these trends and reports of associated physical dangers and legal consequences, the FDA recently established a public docket requesting comments on the potential role of abuse- deterrent stimulant formulations. The accompanying review stated a need for information on factors that would inform their decision-making, including characterization of longitudinal pathways to misuse. The proposed study prospectively examines stimulant diversion and hypothesized risk factors among young adults at peak age for stimulant diversion: those initially diagnosed and stimulant-treated in early adulthood, and those stimulant-treated as adolescents by pediatricians and aging now into early adulthood. The combined sample will provide a unique opportunity to examine associations between timing of ADHD treatment, stimulant diversion, and hypothesized risk factors. N=357 adolescents stimulant-treated for ADHD in primary care (U01 DA040213), and 150 newly recruited young adults first diagnosed and treated in adulthood, will be studied (total n = 507). Three annual assessments will span ages 18-24 to allow prospective study of stimulant diversion during the age period of its greatest prevalence. Self- and parent-report and behavioral economics tasks will be used to assess intrapersonal, attitudinal-behavioral, and social-normative risk factors and environmental moderators (parenting and provider factors). The results of this study will aide Priority Focus Area #3 of NIDA’s 2016-2020 Strategic Plan, “Addressing Real World Complexities” by generating findings that will apply to two of the largest, least understood segments of the treated ADHD population—those treated in primary care, and those young adult-diagnosed. Findings will provide crucially needed prospectively gathered data to inform the development of stimulant diversion prevention efforts.

项目概要 通过分享、出售或交易来转移多动症兴奋剂是这些药物的主要渠道 附表二管制药物在成年早期达到滥用流行率高峰（未经批准使用 处方、过度使用处方药）。然而，了解兴奋剂转移和贡献。 因素仅限于小型横断面研究的推测。 近年来，主要针对成人的处方（从约 49.2 人到 6280 万人）引起了国家的广泛关注。 这一重要主题的科学性阻碍了基于推断变量的预防工作的发展 此外，虽然初级保健是多动症最常见的治疗环境，但这 人口及其成年后转移的风险，包括诊断和治疗发生在儿童期之后， 由于对这些趋势的担忧以及相关身体危险和法律的报告，人们对此知之甚少。 FDA 最近制定了一份公共案卷，要求就滥用的潜在作用发表评论- 随附的审查表明需要有关可能的因素的信息。 为他们的决策提供信息，包括描述滥用的纵向途径。 研究前瞻性地检查了年轻人的兴奋剂转移并捕获了危险因素 兴奋剂转移的高峰年龄：在成年早期最初诊断并接受兴奋剂治疗的人，以及 那些在青少年时期接受儿科医生治疗的兴奋剂，现在已进入成年早期。 合并样本将提供一个独特的机会来检查 ADHD 发生时间之间的关联 N=357 名接受兴奋剂治疗的青少年。 初级保健中的多动症 (U01 DA040213)，150 名新招募的年轻人首次得到诊断和治疗 成年后，将进行研究（总数 = 507），将跨越 18-24 岁进行三项年度评估。 自我报告和家长报告中兴奋剂转移最严重的年龄阶段的前瞻性研究。 行为经济学任务将用于评估个人、态度行为和社会规范 风险因素和环境调节因素（养育和提供者因素）这项研究的结果将有所帮助。 NIDA 2016-2020 年战略计划的优先重点领域#3，通过生成“解决现实世界的复杂性” 研究结果将适用于 ADHD 治疗人群中两个最大、最不为人所知的群体—— 在初级保健中接受治疗，而那些年轻人诊断的结果将提供未来急需的信息。 收集数据为制定兴奋剂转移预防工作提供信息。