MDMA and Other Hallucinogen Use: Onset and Abuse/Dependence

描述（由申请人提供）：此修订后的R01申请，由一位新的研究者提出，要求3年的支持，以研究MDMA（摇头丸）和其他致幻剂使用的流行病学中的性别差异。我们建议对现有数据进行二次数据分析：2001-2004年全国药物使用和健康调查（NSDUH）和全国酒精及相关疾病流行病学调查（NESARC）。我们将研究四个具体目标。第一个目的是检查首次使用MDMA和其他致幻剂的发病率和决定因素的性别差异，包括发病率趋势、开始使用的风险期和最近开始使用的相关性。第二个目的是确定致幻剂使用者中多种药物使用的模式、顺序和相关因素的性别差异，包括注射药物使用（IDU）和甲基苯丙胺、可卡因/快克和海洛因的使用。第三个目的是检查致幻剂使用障碍的自然历史中的性别差异和致幻剂使用障碍的相关关系，包括从首次使用到疾病发作的进展，到其他物质使用障碍的发作，以及与精神障碍的时间关联。第四个目的是调查致幻剂使用者中药物滥用治疗服务使用的流行程度、模式和相关因素的性别差异，包括所接受服务的地点、接受治疗的主要滥用物质以及未满足的治疗需求和使用治疗的障碍。我们提出的分析将有助于确定高危时期的起始和人口亚群的风险使用MDMA和其他致幻剂，以促进目标初级预防计划。研究结果还将明确MDMA/致幻剂使用者的亚组，这些亚组的IDU、多种药物使用、药物滥用或依赖以及其他精神障碍的可能性增加，因此他们可以成为重点项目或干预的目标，以减少慢性MDMA和其他药物滥用的严重后果。我们将更好地了解MDMA/致幻剂使用者使用药物滥用服务的模式、未满足的需求和障碍。考虑到复杂的纵向研究的极高成本，我们建议对已经收集的数据进行二次分析，这是研究致幻剂使用者的分布、相关性、过程、后果和治疗使用的初步和具有成本效益的步骤。

DESCRIPTION (provided by applicant): This revised R01 application, proposed by a new investigator, requests 3 years of support to study gender differences in the epidemiology of MDMA (Ecstasy) and other hallucinogen use. We propose to conduct secondary data analyses of existing data: the 2001-2004 National Surveys on Drug Use and Health (NSDUH) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We will examine four specific aims. The first aim is to examine gender differences in the incidence and determinants of first use of MDMA and other hallucinogens, including incidence trends, risk periods for initiation, and correlates of recent initiation. The second aim is to determine gender differences in the pattern, sequence, and correlates of multi-drug use among hallucinogen users, including injection drug use (IDU) and use of methamphetamine, cocaine/crack, and heroin. The third aim is to examine gender differences in the natural history of hallucinogen use disorders and correlates of hallucinogen use disorders, including the progression from first use to disorder onset, to onsets of other substance use disorders, and temporal associations with mental disorders. The fourth aim is to investigate gender differences in the prevalence, patterns, and correlates of substance abuse treatment service use among hallucinogen users, including the location of services received, the primary abused substance for receiving treatment, and perceived unmet needs for and barriers to treatment use. Our proposed analysis will help identify the heightened risk periods for initiation and demographic subgroups at risk for using MDMA and other hallucinogens to facilitate targeting primary prevention programs. The findings also will specify subgroups of MDMA/hallucinogen users who have an increased likelihood of IDU, multidrug use, drug abuse or dependence, and other mental disorders, so they can be targeted for focused programs or interventions to reduce serious consequences of chronic MDMA and other drug abuse. We will understand better the pattern of, unmet needs for, and barriers to substance abuse service use among MDMA/hallucinogen users. Given the extremely high cost of a sophisticated longitudinal study, our proposed secondary analysis of already collected data is an initial and cost-effective step to study the distributions, correlates, courses, consequences, and treatment use of hallucinogen users.