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

甲基苯丙胺滥用：长期轨迹、相关性、治疗效果

• 批准号: 8067898
• 负责人: MARY-LYNN BRECHT
• 金额: $ 56.47万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-15 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8067898
• 关键词: Accounting; Address; Admission activity; Adult; African American; Age; Alcohol or Other Drugs use; Attention; Award; Behavior; Caring; Characteristics; Chronic Disease; Clinical; Communities; Complex; Criminal Justice; Data; Deceleration; Dependence; Drug Addiction; Drug abuse; Drug usage; Ethnic Origin; Event; Female; Funding; Future; Growth; HIV; Health; Health Services; Hispanics; Imprisonment; Individual; Interview; Knowledge; Length; Life Cycle Stages; Mental Health; Mental Health Services; Methamphetamine; Methamphetamine dependence; Methods; Modeling; Morbidity - disease rate; Natural History; Not Hispanic or Latino; Outcome; Pattern; Penetration; Pharmaceutical Preparations; Prevalence; Prevention; Recording of previous events; Records; Recovery; Recruitment Activity; Research; Risk Behaviors; Sampling; Services; Social Problems; Social Welfare; Staging; Subgroup; System; Teenagers; Thinking; Treatment outcome; aging population; base; career; community based treatment; cost; criminal behavior; critical period; follow-up; health care service utilization; improved; male; methamphetamine abuse; mortality; outreach; policy implication; response; service utilization; social; treatment effect; treatment strategy

DESCRIPTION (provided by applicant): 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. PUBLIC HEALTH RELEVANCE: Findings from this follow-up study will provide additional detail on the life course of methamphetamine (MA) use and an empirical basis for improving strategies for treatment outreach, engagement, service delivery, and continuing care. The accumulated knowledge will have implications for policy regarding the shift in clinical thinking to the long-term management of MA dependence as a chronic disease, the social and health burden of dependence, and importantly, the potential benefits of successful cessation of MA use.

描述（由申请人提供）：十五年来，甲基苯丙胺 (MA) 在美国的使用量和地理渗透率迅速增加，其使用的后果引起了人们的关注，并不断努力改进拦截、预防和治疗策略，并优先开展研究来为这些策略提供信息。关于 MA 滥用的生命历程的信息有限，特别是随着 MA 使用者年龄的增长。需要进一步的研究来为制定解决老年用户特定问题的策略提供实证支持。拟议的项目是对 596 名先前研究的 MA 使用者的跟踪调查，其中一半是通过戒毒治疗招募的，一半来自同一社区，但在招募时没有接受过 MA 使用前的治疗。该项目将使用自然历史访谈收集数据，添加这些 MA 使用者平均 8 年的药物使用、治疗和犯罪生涯的详细历史；这些新数据与之前收集的数据相结合将产生平均至少28年的生命历程轨迹，涵盖青少年和成人时期。其他数据将来自几个国家机构的行政记录。样本中 35% 为女性/65% 为男性，33% 为西班牙裔/38% 非西班牙裔白人/17% 非裔美国人/12% 其他种族。 Subjects will range in age from about 28 to 74 (average 42) at beginning of the follow-up study.分析将描述 MA 的当前状态和长期使用历史，检查 MA 和其他药物使用的模式，包括升级、减速以及可能的停止和恢复；检查药物治疗利用模式以及与 MA 使用模式的关系；确定健康发病率和死亡率，并评估幸存用户和已故用户之间的差异。该研究还将评估先前确定的药物治疗事件（针对从治疗中招募的子样本）的长期结果（14 年或更长）。此外，该研究还将估计样本中MA滥用的累积社会成本，包括犯罪活动、监禁、戒毒治疗服务、健康和心理健康服务以及福利系统参与；它将研究与 MA 使用的独特模式和用户特征相关的成本差异。分析方法将包括增长模型和增长混合模型，以评估 MA 使用轨迹及其与服务利用、其他事件和选定用户特征的关系。公共卫生相关性：这项后续研究的结果将提供有关甲基苯丙胺 (MA) 使用生命历程的更多细节，并为改进治疗外展、参与、服务提供和持续护理策略提供经验基础。所积累的知识将对以下方面的政策产生影响：临床思维转向将 MA 依赖作为一种慢性疾病进行长期管理、依赖的社会和健康负担，以及更重要的是，成功停止使用 MA 的潜在好处。