METHAMPHETAMINE ABUSE--NATURAL HISTORY,TREATMENT EFFECTS

描述：(申请人摘要) 苯丙胺和甲基苯丙胺(A/M)的使用和后果增加 在过去的四年里戏剧性地。在美国的许多地区，治疗 进入州和联邦资助项目的人数几乎增加了两倍 1992年至1995年。如果这些趋势继续下去，许多地方的治疗系统 各地区必须为客户的大幅增加做好准备。然而， 尽管目前问题日益严重，但A/M在中国的长期使用历史 一些领域，越来越多的立法兴趣，并开始对 开发特定的治疗方案，几乎没有关于 就地治疗的结果或药物使用者的自然病史。 在拟议的项目中，初步面试将提供以下方面的广泛基础 关于A/M用户的信息，重点是400个A/M依赖用户的样本 1995-96年间在洛杉矶县参加治疗项目。这 访谈将涵盖用户在访问之前、期间和之后的历史记录 识别治疗插曲。将进行第二次面谈 大约两年后，在这个队列中，延长后治疗 入院历史总共要5年左右。这项研究将提供一个 全面的数据库，包括人口统计数据、家庭风险因素、 艾滋病相关危险行为、医学史、社会史和犯罪史 药物使用史、治疗使用情况和结果、复发情况 模式。要使用的自然历史方法论允许构建 随时间推移的药物使用模式及其与 治疗事件(S)，背景因素，其他社会服务利用， 以及犯罪、健康和艾滋病毒危险行为的模式。方法： 分析将包括描述性测量、方差分析(ANOVA)和 马诺瓦，对数线性建模，回归和判别分析，生存 方法、马尔可夫模型和结构方程模型。 研究的主要焦点将是并购的不同结果 在社区环境中进行治疗。更具体的问题包括：做 A/M用户对住院治疗和门诊治疗的反应不同； 复发率是否与性别、年龄、种族、 管理或其他客户特征；是复发/恢复 在连续的治疗过程中相似的模式；减少了什么 在治疗过程中的犯罪行为和出院后的维持； 有没有可以描述这种复杂性的多变量模型？ 用户特征和他们的药物使用之间的相互关系以及 治疗职业；每个客户每天的平均治疗费用是多少 这些与客户感受到的好处相比如何。结果将提供 关于A/M使用的基于社区的方案的当前治疗情况的信息 以及它的自然历史作为研究预测因素和 随着时间的推移其使用和治疗结果的后果，以及 制定、实施和修改预防和治疗工作 A/M用户。

DESCRIPTION: (Applicant's Abstract) Amphetamine and methamphetamine (A/M) use and consequences have increased dramatically in the past four years. In many regions of the U.S., treatment admissions to state and federally funded programs have almost tripled from 1992 to 1995. If these trends continue, the local treatment systems in many areas must be prepared for substantial increases in clients. However, despite the currently increasing problem, the long history of A/M use in some areas, increasing legislative interest, and beginning interest in developing specific treatment protocols, little information exists on the outcomes of in-place treatment or the natural history of users of the drug. In the proposed project, an initial interview will provide a broad base of information on A/M users, focusing on a sample of 400 A/M dependent users admired to treatment programs in Los Angeles County in 1995-96. This interview will cover the user's history prior to, during, and after the identifying treatment episode. A second interview will be conducted approximately two years later on this cohort, extending the post treatment admission history to a total of about 5 years. The study will provide a comprehensive database including demographics, family risk factors, AlDS-related risk behaviors, medical, social, and criminal history, lifetime history of drug use, treatment utilization and outcomes, and relapse patterns. The natural history methodology to be used allows construction of drug use patterns over time and examination of their relationship to treatment episode(s), background factors, other social services utilization, and patterns of criminal, health, and HIV risk behaviors. Methods of analysis will include descriptive measures, analysis of variance (ANOVA) and MANOVA, loglinear modeling, regression and discriminant analysis, survival methods, Markov models, and structural equation modeling. The primary focus of the research will be differential outcomes of A/M treatment in the community setting. More specific questions include: do A/M users respond differentially to residential versus outpatient treatment; are relapse rates related to gender, age, ethnicity, route of administration, or other client characteristics; are relapse/recovery patterns similar across successive treatment episodes; what is the decrease in criminal behavior during treatment and is it maintained after discharge; is there a multivariate model which can describe the complex interrelationships among user characteristics and their drug use and treatment careers; what are average costs of treatment per client day and how do these compare to client perceived benefits. Results will provide information on the current treatment in community-based programs for A/M use and its natural history as a basis for studying the predictors and consequences of its use and treatment outcomes over time, and for developing, implementing, and modifying prevention and treatment efforts for A/M users.