Methamphetamine Abuse: Long-Term Trajectories, Correlates, Treatment Effects

摘要 十五年来，快速增长的使用和地理渗透率 美国各地的甲基苯丙胺(MA)及其使用的后果 引起了关注，并正在加紧努力，以改善拦截、预防和 治疗战略，重点是为这些战略提供信息的研究。有限 有关于滥用MA的生命过程的信息，特别是作为MA使用者 年龄。需要进一步的研究为制定战略提供经验支持 解决特定于年长用户的问题。拟议的项目是596项目的后续项目 之前研究过的吸毒者，一半来自参与戒毒治疗，一半来自 同样的社区，但在招募时没有事先接受MA治疗。该项目 将使用自然历史访谈收集数据，以添加平均8年的 这些吸毒者的药物使用、治疗和犯罪生涯的详细历史； 这些新数据与以前收集的数据相结合将产生生命历程 轨迹平均持续时间至少为28年，涵盖青少年和成人时期。 其他数据将来自几个州机构的行政记录。这个 样本是35%的女性/65%的男性，33%的西班牙裔/38%的非西班牙裔白人/17%的非洲人- 美国人/12%其他种族。受试者的年龄从大约28岁到74岁(平均 42)在后续研究开始时。分析将描述当前状态和 延长的MA使用历史，检查MA和其他药物的使用模式，包括 病情加重、减速以及可能的停止和恢复；检查药物治疗 使用模式及其与MA使用模式的关系；并确定健康发病率 和死亡率，并评估幸存和死亡用户之间的差异。这项研究 还将评估以前确定的项目的长期结果(14年或更长时间 药物治疗事件(针对从治疗中招募的亚样本)。此外， 研究将根据以下方面估计样本滥用MA的累积社会成本 犯罪活动、监禁、戒毒服务、健康和精神健康 服务和福利系统的参与；它将检查成本的差异 与移动应用的独特模式和用户特征相关。分析方法将 包括增长模型和增长混合模型，以评估MA使用轨迹和 它们与服务利用率、其他事件和选定用户特征的关系。

ABSTRACT A decade and a half of rapidly increasing use of and geographic penetration of methamphetamine (MA) across the U.S. and the consequences of its use have generated concern and increasing efforts to improve interdiction, prevention, and treatment strategies, with a priority on research to inform these strategies. Limited information is available regarding the life course of MA abuse, particularly as MA users age. Further research is needed to provide empirical support for developing strategies to address issues specific to older users. The proposed project is a follow-up of 596 previously studied MA users, half recruited from drug treatment participation, half from the same communities but with no prior treatment for MA use at recruitment. The project will collect data using the Natural History Interview to add an average of 8 years of detailed histories on substance use, treatment, and criminal careers of these MA users; these new data combined with previously collected data will produce life course trajectories averaging at least 28 years in duration, covering teen and adult periods. Additional data will come from administrative records from several state agencies. The sample is 35% female/65% male, 33% Hispanic/38% non-Hispanic White/17% African- American/12% other ethnicity. Subjects will range in age from about 28 to 74 (average 42) at beginning of the follow-up study. Analyses will describe the current status and extended MA use histories, examining patterns of MA and other drug use, including escalation, deceleration, and possible cessation and recovery; examine drug treatment utilization patterns and relationship to MA use patterns; and determine health morbidity and mortality and assess differences between surviving and deceased users. The study will also assess the long-term outcomes (14 or more years) of a previously identified drug treatment episode (for the subsample recruited from treatment). In addition, the study will estimate cumulative social costs of MA abuse for the sample in terms of criminal activity, incarceration, drug treatment services, health and mental health services, and welfare system participation; and it will examine differences in costs related to distinctive patterns of MA use and user characteristics. Analysis methods will include growth models and growth mixture models to assess MA use trajectories and their relationships to services utilization, other events, and selected user characteristics.