Trends in NonMedical Prescription Drug Use, Abuse-Dependence in Adolescence

描述（申请人提供）：尽管人们越来越关注最近处方药的非医疗使用增加，（非医疗使用的定义是“使用处方药超过处方，或没有处方，目的是获得高”），对青少年滥用这些药物有关的问题的性质和程度知之甚少，以及与青少年非医疗处方药使用、滥用和依赖有关的潜在关联和多种药物使用模式。为了填补这一空白，本研究将：1）估计非医疗处方药使用与人口统计学特征的关联（包括居住在城市、郊区或农村地区、社会经济状况和保险状况）、使用频率、异常行为、寻求刺激和心理健康治疗，并测试这些关联是否随时间而变化，2）探索非医疗处方药使用者中的多种药物使用模式，并调查不同多种药物使用亚组中的不同相关性，测试这些关联是否随时间而变化，3）测试非医疗处方药使用的患病率的变化以及与年龄、性别和保险状况亚组的非医疗处方药使用相关的因素，4）测试匪PD的发病模式的年龄是否随时间变化，5）估计非医疗处方药滥用和依赖的患病率随时间的推移，以检查非医疗处方药使用者滥用和依赖的患病率是否随时间的推移而变化，并调查非医疗处方药滥用/依赖与人口统计学特征，NMPD使用频率，偏差行为，感觉寻求，心理健康治疗，和其他药物使用模式随时间的变化，6）探索符合非医疗处方药滥用/依赖标准的青少年中多种药物滥用/依赖的患病率和不同模式，并检验不同的协变量关联，7）检验从开始使用NMPD到依赖NMPD的时间是否随时间变化。在所有目标中，我们将控制邻域特征。我们建议使用八年（1998-2005年）的全国药物使用和健康调查（NSDUH），以前称为全国家庭药物滥用调查（NHSDA）的数据。探索性数据分析、条件logistic回归模型和生存分析技术将用于解决每个特定目标。在这个应用程序中提出的分析，这个丰富的数据库有可能带来重要的贡献，在非医疗处方药的使用趋势的理解，滥用和依赖青少年在美国我们的努力是针对监测数据和动态概念模型，指导病因和预防研究NIDA支持之间的一致性。通过研究青少年中NMPD的激增是否导致青少年中NMPD的定期使用以及NMPD滥用和依赖的增加，我们将能够为制定旨在最大限度地减少NMPD后果的公共政策做出贡献。公共卫生相关性：本申请中提出的对该丰富数据库的分析。（NHDA/NSDUH）有可能为了解美国青少年非医疗处方药使用，滥用和依赖的趋势做出重要贡献，并可能有助于制定公共政策，以尽量减少NMPD的后果。

DESCRIPTION (provided by applicant): Despite increasing concern about recent increases in the non-medical use of prescription drugs (non-medical use is defined as "use of a prescription drug either more than was prescribed, or without a prescription with the intention to get high"), little is known about the nature and extent of the problems related to the misuse of these drugs among adolescents, as well as about the potential correlates and polydrug use patterns associated with non-medical prescription drug use, abuse and dependence in adolescence. To fill this gap, this study will: 1) Estimate associations of non-medical prescription drug use with demographic characteristics (including living in urban, suburban or rural areas, socio-economic status and insurance status), frequency of use, deviant behaviors, sensation-seeking and mental health treatment and test whether these associations change over time, 2) Explore polydrug use patterns among non medical prescription drug users and investigate for different correlate associations within different polydrug use subgroups testing whether these associations change over time, 3) Test for variation in the prevalence of non-medical prescription drug use and factors associated with non-medical prescription drug use by age, gender, and insurance status subgroups, 4) Test whether age of onset pattern of NMPD has changed over time, 5) Estimate the prevalence of nonmedical prescription drug abuse and dependence over time, to examine whether the prevalence of abuse and dependence among nonmedical prescription drug users has changed over time, and to investigate associations of non-medical prescription drug abuse/dependence with demographic characteristics, frequency of NMPD use, deviant behaviors, sensation-seeking, mental health treatment, and patterns of other drug use over time, 6) Explore the prevalence and different patterns of polydrug abuse/dependence among adolescents who meet criteria for nonmedical prescription drug abuse/dependence over time, and test for different covariate associations, 7) test whether time from onset of use of NMPD to dependence on NMPD has changed over time. In all aims we will control for neighborhood characteristics. We propose to use eight years of data (1998-2005) of the National Survey on Drug Use and Health (NSDUH), formerly called the National Household Survey on Drug Abuse (NHSDA). Exploratory data analyses, conditional logistic regression models and survival analyses techniques will be used to address each of the specific aims. Analyses proposed in this application on this rich database have the potential to bring important contributions to the understanding of trends in nonmedical prescription drug use, abuse and dependence among adolescents in the U.S. Our effort is directed at a greater congruence between surveillance data and dynamic conceptual models that are guiding etiologic and prevention research supported by NIDA. By examining whether the surge in NMPD among adolescents has resulted in an increase in regular use of NMPD and of NMPD abuse and dependence among adolescents, we will be able to contribute to the development of public policies that target to minimize consequences of NMPD. PUBLIC HEALTH RELEVANCE: Analyses proposed in this application on this rich database. (NHSDA/NSDUH) have the potential to bring important contributions to the understanding of trends in nonmedical prescription drug use, abuse and dependence among adolescents in the U.S and may contribute to the development of public policies that target to minimize consequences of NMPD.