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

描述（由申请人提供）：一项关于青少年处方药非医疗使用的前瞻性研究是对当前PA-08-127（先前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（RO3 DA018272: RO3 DA 018239）的基础上，重点关注青少年和年轻成年人非医疗使用预定处方药（NUPM）的性别差异。在之前的探索性研究中，我们的研究小组观察到非医疗使用者之间存在显著的异质性，其特征为：a)拥有合法处方（或没有合法处方）和b)动机（自我治疗与寻求感觉）。虽然所有四种NUPM亚型都以意志为特征，但两种NUPM亚型涉及自我治疗动机，而另外两种NUPM亚型涉及与感觉寻求相关的动机。此外，NUPM可能涉及自己的处方药或其他人的处方药。该研究的目标是由一个理论模型指导的，该模型取自问题行为理论，它描述了可能导致NUPM及其后果的风险领域。提出了一种混合设计方法；这项研究包括为期五年的年度、横断面、基于网络的调查，以及一项纵向、小组研究，其中包括面对面、半结构化的访谈。本研究的目的是：1)调查医疗依从性与四种NUPM亚型的流行情况、NUPM亚型之间的共发情况以及各亚型的人口学特征；2)识别不同药物类别（睡眠、兴奋剂、焦虑/镇静、疼痛）中NUPM行为的共同模式；3)检查5个评估点的群体成员的稳定性/不稳定性以及药物使用早期轨迹与药物滥用问题的关联程度；4)确定定性数据与定量数据收敛的程度。这项研究的数据对于规划旨在减少青少年NUPM的新预防工作应该是非常宝贵的。公共卫生相关性：在美国的青少年中，预定处方药（如睡眠、兴奋剂、焦虑/镇静剂和止痛药）的医疗和非医疗使用有所增加，导致这一年龄组出现了一系列新的健康风险。尽管处方药的非医疗使用已得到公认，但人们对青少年从事这种行为的原因及其负面后果所知相对较少。本研究的目的是提高对青少年药物成瘾的医疗和非医疗使用的认识，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.