MDMA and Other Hallucinogen Use: Onset and Abuse/Dependence

描述（由申请人提供）：由一名新研究者提出的修订后的R 01申请要求3年的支持，以研究MDMA（摇头丸）和其他致幻剂使用流行病学中的性别差异。 我们建议对现有数据进行二级数据分析：2001-2004年全国药物使用和健康调查（NSDUH）和全国酒精和相关疾病流行病学调查（NESARC）。我们将研究四个具体目标。第一个目的是研究首次使用摇头丸和其他致幻剂的发生率和决定因素的性别差异，包括发生率趋势、开始使用的风险期和最近开始使用的相关因素。第二个目的是确定致幻剂使用者中多种药物使用的模式、顺序和相关性的性别差异，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。第三个目的是研究致幻剂使用障碍的自然史和致幻剂使用障碍的相关性的性别差异，包括从第一次使用到障碍发作的进展，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率、模式和相关性的性别差异，包括接受服务的地点、接受治疗的主要滥用药物以及认为未满足的治疗需求和障碍。我们提出的分析将有助于确定启动的高风险期和使用MDMA和其他致幻剂的风险人口统计学亚组，以促进针对初级预防计划。研究结果还将详细说明MDMA/致幻剂使用者的亚组，这些亚组的IDU，多药使用，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措施的目标，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。鉴于一个复杂的纵向研究的成本极高，我们提出的二次分析已经收集的数据是一个初步的和具有成本效益的步骤，研究的分布，相关性，课程，后果和治疗使用的致幻剂用户。

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.