MDMA and Other Hallucinogen Use: Onset and Abuse/Dependence

描述（由申请人提供）：由新研究者提出的修订版 R01 申请要求提供 3 年支持，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) 和全国酒精及相关病症流行病学调查 (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，包括发病趋势、开始使用的风险期以及最近开始使用的相关性。第二个目标是确定致幻剂使用者中多种药物使用模式、顺序和相关性的性别差异，包括注射毒品使用 (IDU) 以及甲基苯丙胺、可卡因/强效快克和海洛因的使用。第三个目标是检查致幻剂使用障碍自然史中的性别差异以及致幻剂使用障碍的相关性，包括从首次使用到障碍发作、到其他物质使用障碍发作的进展以及与精神障碍的时间关联。第四个目标是调查致幻剂使用者中药物滥用治疗服务使用的流行率、模式和相关性方面的性别差异，包括接受服务的地点、接受治疗的主要滥用药物以及感知的未满足的治疗使用需求和障碍。我们提出的分析将有助于确定使用 MDMA 和其他致幻剂的起始风险期和人口亚群的高风险期，以促进有针对性的一级预防计划。研究结果还将明确MDMA/致幻剂使用者的亚组，这些亚组更有可能发生IDU、多种药物使用、药物滥用或依赖以及其他精神障碍，因此可以针对他们进行有针对性的计划或干预措施，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/迷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。鉴于复杂的纵向研究成本极高，我们建议对已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且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.