Mechanisms Linking Nonmedical Prescription Drug Use and Injection Drug Use

连接非医疗处方药使用和注射药物使用的机制

基本信息

批准号：
8231285
负责人：
Scott Peter Novak
金额：
$ 54.44万
依托单位：
RESEARCH TRIANGLE INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-01 至 2015-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8231285
关键词：
AIDS prevention Accident and Emergency department Address Affect Alcohol or Other Drugs use Area Attention Biological Caring Categories Characteristics Clinic Clinical Communicable Diseases Consumption Data Dependence Development Drug Prescriptions Drug usage Drug user Ethnography Euphoria Frequencies Friends Guidelines HIV HIV therapy Health Health Personnel Health Services Health Services Accessibility Hepatitis C virus High Prevalence Illicit Drugs Ingestion Injecting drug user Injection of therapeutic agent Intervention Investigation Life Link Medical Monitor Motivation National Institute of Drug Abuse Needle Sharing Outpatients Overdose Pain Pathway interactions Pattern Pharmaceutical Preparations Pharmacologic Substance Pharmacy facility Population Prevention Prevention program Public Health Public Policy Recruitment Activity Risk Risk Behaviors Sampling San Francisco Severities Social Network Source Substance abuse problem Surveys Testing Theft Time United States Variant Work base design drug withdrawal follow-up health organization high risk innovation life history misuse of prescription only drugs negative mood nonmedical use overdose prevention prevent programs prospective psychologic response social social model substance abuse treatment

项目摘要

This R01 application responds to NIDA PA08-127 ¿Prescription Drug Misuse¿ by investigating the mechanisms linking non-medical prescription drug use (NMPD) with injection drug use (IDU). A central focus is also how these relations differ by HIV status and HIV risk behaviors. Most studies of NMPD have either recruited samples that do not include IDUs or have not examined them as a distinct group. This lack of attention to the unique needs of IDUs may hamper the progress of clinical and public health efforts to prevent, identify, and treat NMPD, and to effectively address HIV risk behaviors and wellness among IDUs. A critical barrier to designing and implementing interventions for NMPD is that the term nonmedical use captures a heterogeneous range of motivations for use. These motivations for NMPD may be broadly categorized as euphoric (e.g., combining illicit and prescription drugs for greater effect) and self-treatment (e.g., use without a legitimate prescription to alleviate physical pain, negative mood, or drug withdrawal). Further, there may be important differences in the sources (e.g., health clinics, Emergency Department [ED], pharmacy, friends) and mechanisms (e.g., theft, sharing) used in procuring prescription medications based on underlying motivations for use. Prior work typically has combined multiple motivations into a single category of NMPD. Therefore, innovative studies, such as those targeting high volume consumers like IDUs, are needed to disaggregate NMPD into subtypes based on motivations for use. Information on NMPD motivational subtypes and associated characteristics (e.g., sequences of onset, patterns and predictors of consumption and acquisition) is an important area for future research, as those using for self-treatment may require different intervention strategies from those who use for euphoria. Using targeted sampling, we will recruit 750 IDUs in San Francisco and collect life history data at a baseline assessment and conduct a 6-month follow-up to: Aim 1: Assess the lifetime patterns of initiation and current consumption practices for IDU and NMPD, and differences in relation to HIV status and HIV risk behaviors; Aim 2: Examine the influence of biological, psychological, and social-contextual characteristics on NMPD and motivational subtypes of NMPD; Aim 3: Characterize the sources, mechanisms, and perceived access to NMPD, and examine differences by motivational subtypes of NMPD; Aim 4: Characterize how access to health care (e.g., substance abuse treatment, HIV care) influences consumption patterns and diversion practices.

该R01对NIDA PA08-127的申请响应通过研究将非医疗处方药物使用（NMPD）与注射药物使用（IDU）联系起来的机制（IDU）。核心重点也是这些关系如何因艾滋病毒状况和艾滋病毒风险行为而有所不同。大多数NMPD的研究都招募了不包括IDU的样本，或者没有将其视为独特的群体。缺乏对IDUS独特需求的关注可能会阻碍临床和公共卫生的进步，以防止，识别，治疗NMPD，并有效解决IDU中的HIV风险行为和健康。针对NMPD设计和实施干预措施的关键障碍是，非医学用途一词捕获了多种使用动机。 NMPD的这些动机可能会被广泛归类为欣快（例如，将非法和处方药结合起来以提高效果）和自我处理（例如，没有合法的处方来减轻身体疼痛，负面情绪或戒断药物）。此外，可能存在重要的差异（例如，卫生诊所，急诊室，ed]，药品，朋友）和机制（例如，盗窃，共享）用于采购基于潜在使用动机的处方药。先前的工作通常将多个动机组合为单一类别的NMPD。因此，需要创新的研究，例如针对IDU等大量消费者的研究，需要根据使用动机将NMPD分解为亚型。有关NMPD动机亚型和相关特征（例如，发作，消费和获取的模式和预测指标）的信息是未来研究的重要领域，因为那些用于自我治疗的人可能需要与欣快感的人不同的干预策略。使用有针对性的抽样，我们将在旧金山招募750个IDU，并在基线评估中收集生活史数据，并进行6个月的随访：AIM 1：评估IDU和NMPD的主动性和当前消费实践的终生模式，以及与HIV状况和HIV风险行为有关的差异；目标2：检查生物学，心理和社会上下文特征对NMPD NMPD和动机亚型的影响； AIM 3：表征源，机制和感知到NMPD的访问，并通过NMPD的动机亚型检查差异；目标4：表征获得医疗保健的机会（例如药物滥用治疗，艾滋病毒护理）如何影响消费模式和转移实践。