A Prospective Study of the Nonmedical use of Prescription Medications by Adolesce

描述(由申请人提供)：一项关于青少年非医疗使用处方药的前瞻性研究是对当前PA-08-127(以前的PA-07-123)的回应。它建立在研究团队之前的横断面探索性研究(RO3DA018272：RO3DA 018239)的基础上，重点关注青少年和年轻成人人群中非医疗用途的处方药物(NUPM)的性别差异。在之前的探索性研究中，我们的研究团队观察到非医疗用户之间存在显著的异质性，表现为：a)拥有合法处方(或不是合法处方)和b)动机(自我治疗与寻求感觉)。虽然所有四个亚型都以意志为特征，但有两个NUPM亚型涉及自我治疗的动机，而另外两个NUPM亚型涉及与寻求感觉有关的动机。此外，NUPM可能涉及自己或他人的处方药。这项研究的目的是由一个理论模型指导，该模型来自问题行为理论，该模型描述了可能导致NUPM及其后果的风险领域。提出了一种混合方法设计；这项研究包括为期五年的年度、横断面、基于网络的调查，以及包括面对面、半结构化访谈的纵向小组研究。这项研究的目的是：1)调查医疗依从性和NUPM的四个亚型，NUPM亚型之间的共存情况，以及与每种类型相关的人口统计特征；2)确定每种药物分类中NUPM行为的共同模式(睡眠、兴奋剂、焦虑/镇静、疼痛)；3)检查5个评估点上群体成员的稳定性/不稳定性，以及早期吸毒轨迹与药物滥用问题相关的程度；4)确定定性数据与定量数据的融合程度。这项研究的数据对于规划旨在减少青少年中的NUPM的新的预防努力应该是非常宝贵的。公共卫生相关性：在居住在美国的青少年中，预定处方药(如睡眠、兴奋剂、焦虑/镇静剂和疼痛)的医疗和非医疗用途增加，导致这一年龄段的一系列新的健康风险。尽管非医疗使用处方药的情况有所增加，但人们对青少年从事这种行为的原因以及他们行为的负面后果知之甚少。这项研究的目的是增进对青少年使用具有成瘾潜力的处方药的医疗和非医疗用途的了解，以便更好地为预防工作提供信息。

DESCRIPTION (provided by applicant): A Prospective Study of the Nonmedical Use of Prescription Medications by Adolescents is in response to current PA-08-127 (previously PA-07-123). It builds on the research team's previous cross-sectional, exploratory research (RO3 DA018272: RO3 DA 018239) focusing on gender differences in the nonmedical use of scheduled, prescription medications (NUPM) among adolescent and young adult populations. In previous exploratory studies,our research team observed notable heterogeneity among nonmedical users, captured by subtypes characterized by: a) either possession of a legal prescription (or not a legal prescription) and b) motivations (self-treating versus sensation-seeking). While all four subtypes are characterized by volition, two NUPM subtypes involve motives to self-treat, while two other NUPM subtypes involve motives related to sensation-seeking. Additionally, NUPM may involve one's own prescription medication or alternatively, someone else's. The study aims are guided by a theoretical model, drawn from Problem Behavior Theory, which depicts the domains of risk that may lead to NUPM and its consequences. A mixed-method design is proposed; the study includes annual, cross-sectional, web-based surveys over five-years and a longitudinal, panel study that includes face-to-face, semi-structured interviews. The study aims to: 1) investigate the prevalence of medical adherence and the four subtypes of NUPM, the co-occurrence among the subtypes of NUPM, and demographic characteristics associated with each type; 2) identify common patterns of NUPM behaviors across each drug classification (sleep, stimulant, anxiety/sedative, pain); 3) examine the stability/instability of group membership across the 5 points of assessment and the extent to which early trajectories of drug use are associated with substance abuse problems and 4) determine the extent to which the qualitative data converge with quantitative data. Data from this study should be invaluable in planning for new prevention efforts aimed at reducing NUPM among adolescents. Public Health Relevance: The medical and nonmedical use of scheduled prescription medications (e.g. sleep, stimulant, anxiety/sedative, and pain) have increased among adolescents living in the United States, leading to a new set of health risks for this age group. Despite the acknowledged increase in the nonmedical use of prescription medications, relatively little is known about the reasons adolescents engage in this behavior and the negative consequences of their behaviors. The purpose of this study is to advance knowledge about adolescents' medical and nonmedical use of prescription medications with addictive potential in order to better inform prevention efforts.