The Genetic and Environmental Etiology of Non-Medical Use of Prescription Drugs

处方药非医疗用途的遗传和环境病因学

基本信息

批准号：
9306041
负责人：
ERIC G BENOTSCH
金额：
$ 22.88万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-07-01 至 2019-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9306041
关键词：
Address Adolescent Age Alcohol consumption Alcohol or Other Drugs use Alcohols American Amphetamines Analgesics Australia Automobile Driving Basic Science Behavior Biological Cannabis Caucasians Cessation of life Clinical Cocaine Comorbidity Dangerousness Data Data Analyses Death Rate Dependence Development Diagnostic Drops Drug Prescriptions Emergency department visit Employment Environmental Risk Factor Epidemiologic Methods Epidemiology Ethnic Origin Ethnic group Etiology Feeling Female Frequencies Funding Genes Genetic Genetic Risk Hallucinogens Health Heroin High Prevalence Illicit Drugs Individual Inhalant dose form Intervention Knowledge Link Measurement Measures Motivation Nicotine Nicotine Dependence Opioid Opioid Analgesics Outcome Overdose Pattern Pharmaceutical Preparations Phenotype Prevalence Prevention program Public Health Reporting Risk Risk Factors Role Safety Sampling Sex Characteristics Students Substance Use Disorder Suicide Testing Time Treatment outcome Twin Multiple Birth Visit adolescent substance use age difference age group aged alcohol risk attributable mortality cocaine use college craving driving under influence ecstasy ethnic difference experience genetic epidemiology genetic risk factor genome wide association study high risk sexual behavior improved intervention program marijuana use disorder non-drug population based psychiatric symptom psychosocial sedative sex sexual victimization substance use prevention trend university student young adult

项目摘要

Project summary Non-medical use of prescription substances (NMUPS) is the use of a medication without a prescription, in ways other than prescribed, or for the experience or feelings elicited. The picture of NMUPS among young adults is bleak. Each year an estimated 2.4 million North Americans, or ~6,600 initiates per day, use prescription drugs non-medically for the first time, more than one-half are females. NMUPS is highest among young adults aged 18 to 25, with 5.3% reporting current NMUPS. NMUPS is associated with college drop out, worse employment outcomes, sexual victimization, health-jeopardizing behaviors such as driving under the influence, and high-risk sexual behavior, and psychiatric symptoms including suicide. Among adolescents, U.S. college students and young adults, it is also associated with poly-substance use including cocaine, ecstasy, and amphetamine-like substances. More than half of all drug-related emergency room visits in the U.S. can now be linked to NMUPS. NMUPS is a clear threat to public health. Deaths attributable to unintentional drug overdose of opioids and analgesic exceed those for cocaine and heroin, and continue to increase. Moreover, the death toll across all age groups from NMUPS exceeds those for all other illicit substances. Factors driving NMUPS include, but are not limited to, misperceptions about safety, increasing drug availability, along with individual risk factors and motivations. Despite the high prevalence of NMUPS, concomitant death rates, and comorbidity, the basic genetic epidemiology of NMUPS in terms of genetic and environmental risks remains unknown. Without a thorough, empirical understanding of these risk factors, prevention and intervention programs will continue to remain limited. Knowledge of these risks factors and their relation to other substances will also determine whether funding the development of NMUPS-specific diagnostic assessments is also merited. We propose secondary data analyses using two large population-based samples varying by sex, age and ethnicity to address three aims. The first is to describe the patterns of NMUP analgesics and stimulants in two population-based samples of young adults and college-aged students. We will then use basic genetic epidemiological methods to estimate the contribution of genetic and environmental risks in NMUP analgesics and stimulants. Next, advanced genetic epidemiological will be used to estimate the degree of genetic and environmental overlap between NMUP analgesics and stimulants and other licit and illicit substance use. Finally, we determine whether polygenic risk for alcohol, nicotine, cannabis, cocaine, and heroin use and substance use predicts NMUP analgesics and stimulants while examining sex, age and ethnic differences. This knowledge will significantly improve our understanding of the genetic and environmental risks behind the emerging, dangerous trends in NMUPS.

项目概要处方药的非医疗使用 (NMUPS) 是指在没有处方的情况下使用药物，规定之外的方式，或者所引发的经验或感受。 NMUPS在年轻人中的图景成年人是黯淡的。每年估计有 240 万北美人，即每天约 6,600 名初学者使用首次使用非医疗处方药，一半以上是女性。 NMUPS 是最高的 18 至 25 岁的年轻人，其中 5.3% 的人报告当前有 NMUPS。 NMUPS 与大学辍学有关，更糟糕的就业结果、性受害、危害健康的行为，例如在规定下开车影响、高风险性行为以及包括自杀在内的精神症状。在青少年中，美国大学生和年轻人，它还与多种物质的使用有关，包括可卡因、摇头丸、和苯丙胺类物质。在美国，超过一半的与毒品相关的急诊室就诊可以现在已链接至 NMUPS。 NMUPS 对公共健康构成明显威胁。因无意吸毒而导致的死亡阿片类药物和止痛药的过量服用超过了可卡因和海洛因的服用过量，并且还在继续增加。而且， NMUPS 造成的所有年龄段的死亡人数都超过了所有其他非法药物造成的死亡人数。推动 NMUPS 的因素包括但不限于对安全性的误解、药物增加可用性，以及个人风险因素和动机。尽管 NMUPS 患病率很高，伴随死亡率和合并症，NMUPS 在遗传和疾病方面的基本遗传流行病学环境风险仍然未知。如果没有对这些风险因素进行彻底的、实证性的了解，预防和干预方案将继续受到限制。了解这些风险因素及其影响与其他物质的关系也将决定是否资助 NMUPS 特定的开发诊断评估也是值得的。我们建议使用两个基于人口的大型样本进行二次数据分析，样本的性别、年龄和年龄各不相同种族以实现三个目标。首先是描述 NMUP 镇痛剂和兴奋剂在两种情况下的模式基于人群的年轻人和大学生样本。然后我们将使用基本的遗传流行病学方法估计 NMUP 镇痛药中遗传和环境风险的影响和兴奋剂。接下来，将使用先进的遗传流行病学来估计遗传和流行病学的程度 NMUP 镇痛剂和兴奋剂以及其他合法和非法物质使用之间的环境重叠。最后，我们确定酒精、尼古丁、大麻、可卡因和海洛因使用的多基因风险是否和物质使用可预测 NMUP 镇痛药和兴奋剂，同时检查性别、年龄和种族差异。这些知识将显着提高我们对遗传和环境风险背后的理解。 NMUPS 中正在出现的危险趋势。