Benzodiazepine-related harms in young people: Informing policy, interventions, and prescribing

年轻人中与苯二氮卓相关的危害：为政策、干预措施和处方提供信息

• 批准号: 10565898
• 负责人: Greta Bushnell
• 金额: $ 19.61万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-15 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10565898
• 关键词: Address; Adolescent; Adolescent Development; Adolescent and Young Adult; Adult; Age; Alternative Medicine; Anxiety; Area; Award; Benzodiazepines; Cessation of life; Community Practice; Coping Skills; Data; Data Set; Databases; Dependence; Detection; Development; Disease; Dose; Drug Prescriptions; Drug abuse; Early Intervention; Electronics; Emergency department visit; Evaluation; Future; Harm Reduction; Health Resources; Heterogeneity; Individual; Intervention; Knowledge; Life; Measures; Medicaid; Medical; Medicine; Mental Depression; Mental disorders; Mentored Research Scientist Development Award; Methodology; Methods; Monitor; Morbidity - disease rate; Opioid; Outcome; Overdose; Pathway interactions; Patients; Persons; Pharmaceutical Preparations; Pharmacologic Substance; Policies; Privatization; Provider; Public Health; Reporting; Research; Research Design; Research Personnel; Risk; Risk Factors; Running; Safety; Sampling; Sleep Disorders; Substance abuse problem; Surveys; System; Time; Training; Training Programs; Tranquilizing Agents; Youth; abuse liability; age group; alternative treatment; benzodiazepine abuse; benzodiazepine misuse; career; emerging adult; experience; improved; innovation; misuse of prescription only drugs; opioid epidemic; opioid use; overdose death; overdose risk; prescription monitoring program; prescription opioid; prevent; programs; risk stratification; sedative; substance misuse; substance use; treatment risk; twelfth grade; young adult

PROJECT SUMMARY/ABSTRACT. This Mentored Research Scientist Development Award (K01) proposal will develop Dr. Greta Bushnell’s career as an independent investigator, and enable her to advance into a new line of research focused on evaluating misuse and abuse related morbidity of medicines prescribed to young people and the policies and practices that can mitigate these harmful outcomes. This new direction of research requires distinct training in substance abuse policy, misuse and abuse liability of prescription drugs, adolescent development of substance use, analysis of state-level policies, and advanced methods to address confounding control. With a training program supported by an experienced team of investigators, Dr. Bushnell will complete the proposed research, filling key gaps surrounding benzodiazepine (BZD) misuse and abuse related harms in young people and modifiable factors to reduce these harms. This research focus comes at a pertinent time of rising BZD-related morbidity, continued prescribing, lack of safety data in youth at developmental risk for substance use problems, and current opportunities to leverage opioid-related policies to reduce BZD-related harms. Overdose deaths involving BZDs significantly increased in recent years with »11,500 deaths in 2017, partially attributed to the opioid crisis, and in adolescents and young adults there were »39,000 emergency department visits for BZD-related poisonings in 2016. Despite BZDs being frequently prescribed to adolescents (3%) and young adults (6%), there are no estimates on overdose risk following BZD treatment and it is unknown whether and to what extent BZD prescribing to youth inadvertently increases risk of BZD or other substance misuse later in life. Prescription drug monitoring programs (PDMPs) represent a potentially important, but understudied, means to mitigate BZD- related morbidity. PDMPs are state-run surveillance systems collecting patient details on prescriptions for controlled substances with capabilities to detect risky prescribing. Dr. Bushnell will use large, national administrative claims data (2000-2018) covering privately and publicly insured young people (10-29 years) to evaluate whether selected state PDMP features decrease BZD-related harms and risky BZD prescribing in young people (Aim 1). To evaluate individual-level risks, she will quantify overdose risk following BZD treatment in young people compared to alternative treatments and by prescription details (Aim 2) using the national claims datasets with measures from Area Health Resources Files. She will then evaluate whether adolescent BZD treatment increases downstream risks of BZD misuse or harmful substance use in early adulthood (Aim 3) using the nationwide Monitoring the Future sample of high school seniors with panel surveys into early adulthood (»2,450/year, 1976-2016). The proposal will inform an R01 submission on identifying youth-specific risk factors in the progression from treatment with BZDs, or other controlled substances, to abuse and leveraging this knowledge to inform interventions. Addressing these questions and developing this new line of research are only feasible with intensive training, support, and protected time, which the K01 can provide.

项目总结/摘要。 这个指导研究科学家发展奖（K 01）的建议将发展博士。 作为一个独立的调查员，使她能够进入一个新的研究领域，重点是评估 为青年人开的药物的误用和滥用相关的发病率以及 可以减轻这些有害的后果。这一新的研究方向需要在药物滥用方面进行明确的培训 政策，处方药误用和滥用倾向，青少年药物使用的发展， 国家级的政策和先进的方法来解决混淆控制。在培训计划的支持下 由一个经验丰富的研究小组，博士Bushnell将完成拟议的研究，填补关键空白 周围苯二氮卓类药物（BZD）误用和滥用对年轻人的相关危害以及 减少这些危害。这项研究的重点是在BZD相关发病率上升的相关时间，继续 处方，缺乏药物使用问题的发育风险青年的安全数据， 利用阿片类药物相关政策减少BZD相关危害的机会。涉及BZD的过量死亡 近年来显著增加，2017年有11，500人死亡，部分原因是阿片类药物危机， 在青少年和年轻人中，有> 39，000例BZD相关中毒急诊就诊， 2016.尽管BZD经常被处方给青少年（3%）和年轻人（6%）， BZD治疗后过量风险的估计，尚不清楚BZD是否以及在多大程度上 给年轻人开处方会无意中增加BZD或其他物质滥用的风险。处方药 监测计划（PDMP）是一种潜在的重要手段，但研究不足，以减轻BZD- 相关疾病。PDMP是国家运行的监测系统，收集患者处方的详细信息， 有能力检测危险处方的受控物质。Bushnell博士将使用大型的，全国性的 行政索赔数据（2000-2018年），涵盖私人和公共保险的年轻人（10-29岁）， 评估所选的州Pingdom功能是否减少年轻人中BZD相关危害和BZD处方风险 人（目标1）。为了评估个体水平的风险，她将量化BZD治疗后的过量风险， 年轻人与替代疗法的比较以及使用国家声明的处方细节（目标2） 数据集与地区卫生资源文件的措施。然后她将评估青少年BZD是否 治疗增加了成年早期BZD滥用或有害物质使用的下游风险（目标3）， 在全国范围内对高中毕业生进行的“监测未来”抽样调查中， （» 2，450/年，1976-2016）。该提案将为R 01提交文件提供关于确定青年特有风险因素的信息 从BZD或其他受控物质治疗到滥用和利用这一点的进展 为干预提供信息的知识。解决这些问题和发展这一新的研究路线只是 K 01可以提供高强度的训练、支持和保护时间。