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Mechanisms Linking Nonmedical Prescription Drug Use and Injection Drug Use

连接非医疗处方药使用和注射药物使用的机制

基本信息

批准号：
8637954
负责人：
Scott Peter Novak
金额：
$ 25.47万
依托单位：
RESEARCH TRIANGLE INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-01 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8637954
关键词：
AIDS prevention Accident and Emergency department Address Affect Alcohol or Other Drugs use Area Attention Biological Caring Categories Characteristics Clinic Clinical Communicable Diseases Consumption Data Dependence Development Drug Prescriptions Drug usage Drug user Ethnography Euphoria Frequencies Friends Guidelines HIV HIV risk HIV therapy Health Health Personnel Health Services Health Services Accessibility Hepatitis C virus High Prevalence Illicit Drugs Ingestion Injecting drug user Intervention Investigation Life Link Medical Monitor Motivation National Institute of Drug Abuse Needle Sharing Outpatients Overdose Pain Pathway interactions Pattern Pharmaceutical Preparations Pharmacologic Substance Pharmacy facility Population Prevention Prevention program Public Health Public Policy Recruitment Activity Risk Risk Behaviors Sampling San Francisco Severities Social Network Source Substance abuse problem Surveys Testing Theft Time United States Variant Work base design drug withdrawal follow-up health organization high risk injection drug use innovation life history misuse of prescription only drugs negative mood nonmedical use overdose prevention prevent programs prospective psychologic response social social model substance abuse treatment

项目摘要

This R01 application responds to NIDA PA08-127 ¿Prescription Drug Misuse¿ by investigating the mechanisms linking non-medical prescription drug use (NMPD) with injection drug use (IDU). A central focus is also how these relations differ by HIV status and HIV risk behaviors. Most studies of NMPD have either recruited samples that do not include IDUs or have not examined them as a distinct group. This lack of attention to the unique needs of IDUs may hamper the progress of clinical and public health efforts to prevent, identify, and treat NMPD, and to effectively address HIV risk behaviors and wellness among IDUs. A critical barrier to designing and implementing interventions for NMPD is that the term nonmedical use captures a heterogeneous range of motivations for use. These motivations for NMPD may be broadly categorized as euphoric (e.g., combining illicit and prescription drugs for greater effect) and self-treatment (e.g., use without a legitimate prescription to alleviate physical pain, negative mood, or drug withdrawal). Further, there may be important differences in the sources (e.g., health clinics, Emergency Department [ED], pharmacy, friends) and mechanisms (e.g., theft, sharing) used in procuring prescription medications based on underlying motivations for use. Prior work typically has combined multiple motivations into a single category of NMPD. Therefore, innovative studies, such as those targeting high volume consumers like IDUs, are needed to disaggregate NMPD into subtypes based on motivations for use. Information on NMPD motivational subtypes and associated characteristics (e.g., sequences of onset, patterns and predictors of consumption and acquisition) is an important area for future research, as those using for self-treatment may require different intervention strategies from those who use for euphoria. Using targeted sampling, we will recruit 750 IDUs in San Francisco and collect life history data at a baseline assessment and conduct a 6-month follow-up to: Aim 1: Assess the lifetime patterns of initiation and current consumption practices for IDU and NMPD, and differences in relation to HIV status and HIV risk behaviors; Aim 2: Examine the influence of biological, psychological, and social-contextual characteristics on NMPD and motivational subtypes of NMPD; Aim 3: Characterize the sources, mechanisms, and perceived access to NMPD, and examine differences by motivational subtypes of NMPD; Aim 4: Characterize how access to health care (e.g., substance abuse treatment, HIV care) influences consumption patterns and diversion practices.

该 R01 应用程序通过研究非医疗处方药使用 (NMPD) 与注射药物使用 (IDU) 之间的联系机制来响应 NIDA PA08-127“处方药滥用”。一个中心焦点还在于这些关系如何因艾滋病毒状况和艾滋病毒危险行为而有所不同。大多数 NMPD 研究要么招募了不包括注射吸毒者的样本，要么没有将他们作为一个独特的群体进行检查。缺乏对注射吸毒者独特需求的关注可能会阻碍临床和公共卫生工作的进展，以预防、识别和治疗 NMPD，并有效解决注射吸毒者中的艾滋病毒危险行为和健康问题。设计和实施 NMPD 干预措施的一个关键障碍是，“非医疗用途”这一术语涵盖了各种不同的使用动机。 NMPD 的这些动机可大致分为欣快型药物（例如，将非法药物和处方药结合起来以获得更大的效果）和自我治疗（例如，在没有合法处方的情况下使用药物来减轻身体疼痛、负面情绪或戒断药物）。此外，根据潜在的使用动机，在采购处方药时使用的来源（例如，诊所、急诊室、药房、朋友）和机制（例如，盗窃、共享）可能存在重要差异。之前的工作通常将多种动机结合到一个 NMPD 类别中。因此，需要进行创新性研究，例如针对注射吸毒者等大批量消费者的研究，根据使用动机将 NMPD 分解为亚型。有关 NMPD 动机亚型和相关特征（例如，发作顺序、消耗和获取的模式和预测因素）的信息是未来研究的一个重要领域，因为用于自我治疗的患者可能需要与用于欣快感的患者不同的干预策略。通过有针对性的抽样，我们将在旧金山招募 750 名注射吸毒者，并在基线评估中收集生活史数据，并进行为期 6 个月的随访，以：目标 1：评估注射吸毒者和 NMPD 的起始和当前消费行为的终生模式，以及与艾滋病毒状况和艾滋病毒危险行为相关的差异；目标 2：检查生物、心理和社会背景特征对 NMPD 和 NMPD 动机亚型的影响；目标 3：描述 NMPD 的来源、机制和感知获取途径，并检查 NMPD 动机亚型的差异；目标 4：描述获得医疗保健（例如药物滥用治疗、艾滋病毒护理）如何影响消费模式和转移做法。