Mechanisms Linking Nonmedical Prescription Drug Use and Injection Drug Use

连接非医疗处方药使用和注射药物使用的机制

• 批准号: 8114274
• 负责人: Scott Peter Novak
• 金额: $ 55.29万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8114274
• 关键词: AIDS prevention; Accident and Emergency department; Address; Affect; Alcohol or Other Drugs use; Area; Attention; Biological; Caring; Categories; Characteristics; Clinic; Clinical; Communicable Diseases; Consumption; Data; Dependence; Development; Drug Prescriptions; Drug usage; Drug user; Ethnography; Euphoria; Frequencies; Friends; Guidelines; HIV; HIV therapy; Health; Health Personnel; Health Services; Health Services Accessibility; Hepatitis C virus; High Prevalence; Illicit Drugs; Ingestion; Injecting drug user; Injection of therapeutic agent; Intervention; Investigation; Life; Link; Medical; Monitor; Motivation; National Institute of Drug Abuse; Needle Sharing; Outpatients; Overdose; Pain; Pathway interactions; Pattern; Pharmaceutical Preparations; Pharmacologic Substance; Pharmacy facility; Population; Prevention; Prevention program; Public Health; Public Policy; Recruitment Activity; Risk; Risk Behaviors; Sampling; San Francisco; Severities; Social Network; Source; Substance abuse problem; Surveys; Testing; Theft; Time; United States; Variant; Work; base; design; drug withdrawal; follow-up; health organization; high risk; innovation; life history; misuse of prescription only drugs; negative mood; nonmedical use; overdose prevention; prevent; programs; prospective; psychologic; response; social; social model; substance abuse treatment

This R01 application responds to NIDA PA08-127 ¿Prescription Drug Misuse¿ by investigating the mechanisms linking non-medical prescription drug use (NMPD) with injection drug use (IDU). A central focus is also how these relations differ by HIV status and HIV risk behaviors. Most studies of NMPD have either recruited samples that do not include IDUs or have not examined them as a distinct group. This lack of attention to the unique needs of IDUs may hamper the progress of clinical and public health efforts to prevent, identify, and treat NMPD, and to effectively address HIV risk behaviors and wellness among IDUs. A critical barrier to designing and implementing interventions for NMPD is that the term nonmedical use captures a heterogeneous range of motivations for use. These motivations for NMPD may be broadly categorized as euphoric (e.g., combining illicit and prescription drugs for greater effect) and self-treatment (e.g., use without a legitimate prescription to alleviate physical pain, negative mood, or drug withdrawal). Further, there may be important differences in the sources (e.g., health clinics, Emergency Department [ED], pharmacy, friends) and mechanisms (e.g., theft, sharing) used in procuring prescription medications based on underlying motivations for use. Prior work typically has combined multiple motivations into a single category of NMPD. Therefore, innovative studies, such as those targeting high volume consumers like IDUs, are needed to disaggregate NMPD into subtypes based on motivations for use. Information on NMPD motivational subtypes and associated characteristics (e.g., sequences of onset, patterns and predictors of consumption and acquisition) is an important area for future research, as those using for self-treatment may require different intervention strategies from those who use for euphoria. Using targeted sampling, we will recruit 750 IDUs in San Francisco and collect life history data at a baseline assessment and conduct a 6-month follow-up to: Aim 1: Assess the lifetime patterns of initiation and current consumption practices for IDU and NMPD, and differences in relation to HIV status and HIV risk behaviors; Aim 2: Examine the influence of biological, psychological, and social-contextual characteristics on NMPD and motivational subtypes of NMPD; Aim 3: Characterize the sources, mechanisms, and perceived access to NMPD, and examine differences by motivational subtypes of NMPD; Aim 4: Characterize how access to health care (e.g., substance abuse treatment, HIV care) influences consumption patterns and diversion practices.

本R 01申请通过调查非医疗处方药使用（NMPD）与注射药物使用（IDU）之间的联系机制，对NIDA PA 08 -127“处方药滥用”做出回应。一个中心焦点也是这些关系如何因艾滋病毒状况和艾滋病毒风险行为而不同。大多数NMPD研究要么招募了不包括注射吸毒者的样本，要么没有将他们作为一个独特的群体进行研究。这种对注射吸毒者独特需求的缺乏关注可能会阻碍临床和公共卫生工作的进展，以预防，识别和治疗NMPD，并有效地解决注射吸毒者的艾滋病毒风险行为和健康。设计和实施NMPD干预措施的一个关键障碍是，术语非医疗用途涵盖了各种各样的使用动机。NMPD的这些动机可以被广泛地分类为欣快（例如，结合非法和处方药物以获得更大的效果）和自我治疗（例如，在没有合法处方的情况下使用，以减轻身体疼痛，负面情绪或药物戒断）。此外，在源中可能存在重要差异（例如，健康诊所、急诊科[艾德]、药房、朋友）和机制（例如，盗窃、分享），用于基于潜在使用动机购买处方药。先前的工作通常将多种动机结合到单一类别的NMPD中。因此，需要进行创新性研究，例如针对高容量消费者（如注射吸毒者）的研究，以根据使用动机将NMPD细分为亚型。关于NMPD动机亚型和相关特征的信息（例如，发病顺序、消费和获得的模式和预测因素）是未来研究的一个重要领域，因为那些用于自我治疗的人可能需要与那些用于欣快症的人不同的干预策略。我们将采用有针对性的抽样方法，在旧金山弗朗西斯科招募750名注射吸毒者，并在基线评估时收集生活史数据，并进行6个月的随访，以：目标1：评估注射吸毒者和NMPD的初始和当前消费行为的终生模式，以及与HIV状况和HIV风险行为相关的差异;目标2：检查生物，心理和社会背景特征对NMPD和NMPD动机亚型的影响;目的3：描述NMPD的来源、机制和感知途径，并按NMPD的动机亚型检查差异;目标4：描述如何获得医疗保健（例如，药物滥用治疗、艾滋病毒护理）影响消费模式和转移做法。