Benzodiazepine-related harms in young people: Informing policy, interventions, and prescribing

年轻人中与苯二氮卓相关的危害：为政策、干预措施和处方提供信息

基本信息

批准号：
10369632
负责人：
Greta Bushnell
金额：
$ 19.61万
依托单位：
RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-03-15 至 2023-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10369632
关键词：
Address Adolescent Adolescent Development Adolescent and Young Adult Adult Age Alternative Medicine Anxiety Area Award Benzodiazepines Cessation of life Community Practice Coping Skills Data Data Set Databases Dependence Detection Development Disease Dose Drug Prescriptions Drug abuse Early Intervention Emergency department visit Evaluation Future Health Resources Heterogeneity Individual Intervention Knowledge Lead Life Measures Medicaid Medical Medicine Mental Depression Mental disorders Mentored Research Scientist Development Award Methodology Methods Monitor Morbidity - disease rate Opioid Outcome Overdose Pathway interactions Patients Persons Pharmaceutical Preparations Pharmacologic Substance Policies Provider Public Health Reporting Research Research Design Research Personnel Research Training Risk Risk Factors Running Safety Sampling Sleep Disorders Substance abuse problem Surveys System Time Training Training Programs Training Support Tranquilizing Agents Youth abuse liability age group alternative treatment benzodiazepine abuse benzodiazepine misuse career emerging adult experience improved innovation misuse of prescription only drugs opioid epidemic opioid use overdose death overdose risk prescription monitoring program prescription opioid prevent programs risk stratification sedative substance misuse substance use treatment risk twelfth grade young adult

项目摘要

PROJECT SUMMARY/ABSTRACT. This Mentored Research Scientist Development Award (K01) proposal will develop Dr. Greta Bushnell’s career as an independent investigator, and enable her to advance into a new line of research focused on evaluating misuse and abuse related morbidity of medicines prescribed to young people and the policies and practices that can mitigate these harmful outcomes. This new direction of research requires distinct training in substance abuse policy, misuse and abuse liability of prescription drugs, adolescent development of substance use, analysis of state-level policies, and advanced methods to address confounding control. With a training program supported by an experienced team of investigators, Dr. Bushnell will complete the proposed research, filling key gaps surrounding benzodiazepine (BZD) misuse and abuse related harms in young people and modifiable factors to reduce these harms. This research focus comes at a pertinent time of rising BZD-related morbidity, continued prescribing, lack of safety data in youth at developmental risk for substance use problems, and current opportunities to leverage opioid-related policies to reduce BZD-related harms. Overdose deaths involving BZDs significantly increased in recent years with »11,500 deaths in 2017, partially attributed to the opioid crisis, and in adolescents and young adults there were »39,000 emergency department visits for BZD-related poisonings in 2016. Despite BZDs being frequently prescribed to adolescents (3%) and young adults (6%), there are no estimates on overdose risk following BZD treatment and it is unknown whether and to what extent BZD prescribing to youth inadvertently increases risk of BZD or other substance misuse later in life. Prescription drug monitoring programs (PDMPs) represent a potentially important, but understudied, means to mitigate BZD- related morbidity. PDMPs are state-run surveillance systems collecting patient details on prescriptions for controlled substances with capabilities to detect risky prescribing. Dr. Bushnell will use large, national administrative claims data (2000-2018) covering privately and publicly insured young people (10-29 years) to evaluate whether selected state PDMP features decrease BZD-related harms and risky BZD prescribing in young people (Aim 1). To evaluate individual-level risks, she will quantify overdose risk following BZD treatment in young people compared to alternative treatments and by prescription details (Aim 2) using the national claims datasets with measures from Area Health Resources Files. She will then evaluate whether adolescent BZD treatment increases downstream risks of BZD misuse or harmful substance use in early adulthood (Aim 3) using the nationwide Monitoring the Future sample of high school seniors with panel surveys into early adulthood (»2,450/year, 1976-2016). The proposal will inform an R01 submission on identifying youth-specific risk factors in the progression from treatment with BZDs, or other controlled substances, to abuse and leveraging this knowledge to inform interventions. Addressing these questions and developing this new line of research are only feasible with intensive training, support, and protected time, which the K01 can provide.

项目摘要/摘要。这项指导研究科学家发展奖 (K01) 提案将发展 Greta Bushnell 博士的职业生涯作为一名独立调查员，使她能够进入专注于评估的新研究领域向年轻人开出的药物的误用和滥用相关发病率以及政策和做法可以减轻这些有害后果。这一新的研究方向需要针对药物滥用进行独特的培训。处方药的政策、误用和滥用责任、青少年物质使用的发展、分析国家级政策和先进方法来解决混杂控制问题，并提供培训计划支持。布什内尔博士将由经验丰富的研究团队完成拟议的研究，填补关键空白苯二氮卓类药物（BZD）对年轻人的误用和滥用相关危害以及可改变的因素减少这些危害是这项研究的重点，恰逢 BZD 相关发病率上升的时期，继续说。处方、缺乏存在药物使用问题发育风险的青少年的安全数据以及当前的情况利用阿片类药物相关政策减少与 BZD 相关的危害的机会。近年来显着增加，»2017 年有 11,500 人死亡，部分原因是阿片类药物危机，青少年和年轻人 » 39,000 人次因 BZD 相关中毒而到急诊室就诊 2016. 尽管 BZD 经常被用于青少年 (3%) 和年轻人 (6%)，但没有 BZD 治疗后过量风险的估计，目前尚不清楚 BZD 是否以及程度如何给青少年开处方会无意中增加晚年滥用 BZD 或其他药物的风险。监测计划 (PDMP) 是一种潜在重要但尚未充分研究的缓解 BZD- 的方法。 PDMP 是国家运行的监测系统，收集患者的处方详细信息。布什内尔博士将使用大型国家级管制药物来检测危险处方。行政索赔数据（2000-2018）涵盖私人和公共保险的年轻人（10-29岁）评估选定的州 PDMP 特征是否可以减少与 BZD 相关的危害以及年轻人服用 BZD 的风险为了评估个体风险，她将量化 BZD 治疗后的用药过量风险。年轻人使用国家声明与替代疗法和处方细节（目标 2）进行比较然后，她将评估青少年是否患有 BZD。治疗会增加成年早期滥用 BZD 或使用有害物质的下游风险（目标 3）通过对成年早期的小组调查对全国范围内的高中生未来进行监测（»2,450/年，1976-2016）。该提案将为确定青年特定风险因素的 R01 提交提供信息。从使用 BZD 或其他受控物质治疗到滥用和利用该药物的过程中解决这些问题和开发这一新的研究方向仅仅是为了提供干预措施的知识。通过 K01 可以提供的强化培训、支持和受保护的时间，这一切都可以实现。