Trajectories of Nonmedical Prescription Drug Misuse

非医疗处方药滥用的轨迹

• 批准号: 8083034
• 负责人: SEAN ESTEBAN MCCABE
• 金额: $ 22.02万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 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 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8083034
• 关键词: 18 year old; 21 year old; Accounting; Address; Adolescent; Age; Applications Grants; Behavior; Behavioral; Characteristics; Cross-Sectional Studies; Data; Demographic Factors; Development; Drug Prescriptions; Drug abuse; Employment; Epidemiologic Studies; Epidemiology; Frequencies; Future; Health; Heterogeneity; Individual; Ingestion; Investigation; Knowledge; Lead; Legal; Measurement; Measures; Monitor; Motivation; NIH Program Announcements; Opioid Analgesics; Pain; Pattern; Pharmaceutical Preparations; Prevention; Publishing; Research; Research Design; Risk; Risk Factors; Route; Sampling; Schedule; Screening procedure; Self Medication; Services; Tranquilizing Agents; United States; United States Substance Abuse and Mental Health Services Administration; Variant; adverse outcome; clinical practice; cohort; college; emerging adulthood; improved; misuse of prescription only drugs; prescription drug abuse; psychosocial; social; twelfth grade; young adult

DESCRIPTION (provided by applicant): Nonmedical prescription drug misuse (NPDM) involving scheduled (controlled) medications (i.e., opioid analgesics, stimulants, tranquilizers) has significantly increased over the past two decades in the United States and is most prevalent among individuals 18 years of age. While there have been advances in understanding NPDM, considerable gaps in knowledge remain due to limitations in measurement and study designs and no national studies have examined longitudinal trajectories of NPDM among adolescents and most existing studies fail to account for important characteristics of NPDM such as motives, route of administration, and co- ingestion with other drugs. Findings from our two small exploratory cross-sectional projects (R03DA018239 and R03DA0187272) indicate that there are at least two behavioral subtypes of NPDM (self-treatment and recreational) subsumed under current measures used to assess NPDM, and these behavioral subtypes appear to differ in terms of adverse consequences. However, there is little published information regarding the long- term patterns of misuse and adverse outcomes associated with NPDM among adolescents in the United States. Existing cross-sectional and longitudinal panel data from the Monitoring the Future (MTF) study provide an unprecedented opportunity to address research questions that will lead to a more comprehensive understanding of NPDM and its consequences among adolescents. The objective of the proposed study is to advance our knowledge regarding longitudinal trajectories of NPDM using twelve independent, nationally representative cohorts of approximately 180,000 high school seniors between 1997 and 2008 from the MTF study. The MTF panel sample features twelve separate cohorts of approximately 28,800 high school seniors (modal age 18) who were followed 1-2 years (modal ages 19-20) and 3-4 years (modal ages 21-22) later, resulting in three waves of data. The proposed study aims to 1) assess NPDM and characteristics of NPDM (e.g., motives, route of administration, co-ingestion with other drugs) associated with three prescription drug classes (opioid analgesics, stimulants, tranquilizers), and determine the associations among NPDM, characteristics of NPDM, psychosocial risk factors, and adverse outcomes (e.g., health, legal and social) using cross-sectional and panel data; 2) identify longitudinal trajectories of NPDM of three prescription drug classes (opioid analgesics, stimulants, tranquilizers) across the developmental transition of greatest risk for NPDM- related adverse outcomes using panel data (i.e., ages 18-22), and examine variations in these trajectories by demographic factors, psychosocial risk and protective factors, and NPDM characteristics; and 3) examine the associations among longitudinal trajectories of NPDM of three prescription drug classes (opioid analgesics, stimulants, tranquilizers), important developmental transitions (e.g., college attendance, employment) and adverse outcomes (e.g., health, legal and social) during emerging adulthood using panel data. Findings from this project will substantially advance the current understanding of NPDM among adolescents in the United States, and provide information that will improve the screening, assessment, prevention, and treatment of prescription drug abuse. PUBLIC HEALTH RELEVANCE: Despite a recent increase in nonmedical prescription drug misuse (NPDM) in the United States, relatively little is known about the longitudinal patterns of NPDM among adolescents. The proposed study will inform the development of prevention efforts to reduce NPDM by examining trajectories of NPDM using a nationally representative sample. Findings will help guide clinical practice and future research by examining new research questions related to the developmental course of NPDM. This study has important implications for the identification of individuals at greatest risk for adverse consequences associated with NPDM and those in greatest need of treatment services.

描述（由申请人提供）：过去 20 年来，在美国，涉及定期（管制）药物（即阿片类镇痛药、兴奋剂、镇静剂）的非医疗处方药滥用 (NPDM) 显着增加，并且在 18 岁人群中最为普遍。尽管在理解 NPDM 方面取得了进展，但由于测量和研究设计的限制，在知识上仍然存在相当大的差距，并且没有国家研究调查青少年中 NPDM 的纵向轨迹，并且大多数现有研究未能解释 NPDM 的重要特征，例如动机、给药途径以及与其他药物的共同摄入。我们的两个小型探索性横断面项目（R03DA018239 和 R03DA0187272）的结果表明，当前用于评估 NPDM 的措施中至少包含两种 NPDM 行为亚型（自我治疗和娱乐），并且这些行为亚型在不良后果方面似乎有所不同。然而，关于美国青少年中与 NPDM 相关的长期滥用模式和不良后果的公开信息很少。监测未来 (MTF) 研究的现有横断面和纵向面板数据为解决研究问题提供了前所未有的机会，从而更全面地了解 NPDM 及其对青少年的影响。拟议研究的目的是通过使用 1997 年至 2008 年 MTF 研究中约 180,000 名高中生的 12 个独立的、具有全国代表性的队列来增进我们对 NPDM 纵向轨迹的了解。 MTF 小组样本包含 12 个独立队列，由大约 28,800 名高中生（通常年龄 18 岁）组成，他们在 1-2 年（通常年龄 19-20 岁）和 3-4 年（通常年龄 21-22 岁）后进行随访，产生了三波数据。拟议的研究旨在 1) 评估 NPDM 以及与三种处方药类别（阿片类镇痛药、兴奋剂、镇静剂）相关的 NPDM 特征（例如动机、给药途径、与其他药物共同摄入），并利用 横截面数据和面板数据； 2) 使用面板数据（即 18-22 岁）确定三类处方药（阿片类镇痛药、兴奋剂、镇静剂）在 NPDM 相关不良后果最大风险的发展转变过程中的 NPDM 纵向轨迹，并通过人口因素、心理社会风险和保护因素以及 NPDM 特征检查这些轨迹的变化； 3) 使用面板数据检查三类处方药（阿片类镇痛药、兴奋剂、镇静剂）、重要的发展转变（例如大学入学率、就业）和成年初期不良结果（例如健康、法律和社会）的 NPDM 纵向轨迹之间的关联。该项目的研究结果将大大增进目前美国青少年对 NPDM 的了解，并提供改善处方药滥用筛查、评估、预防和治疗的信息。 公共卫生相关性：尽管最近美国非医疗处方药滥用 (NPDM) 有所增加，但人们对青少年中 NPDM 的纵向模式知之甚少。拟议的研究将通过使用全国代表性样本检查 NPDM 的轨迹，为减少 NPDM 的预防工作的发展提供信息。研究结果将通过研究与 NPDM 发展过程相关的新研究问题来帮助指导临床实践和未来的研究。这项研究对于识别与 NPDM 相关的不良后果风险最大的个人以及最需要治疗服务的个人具有重要意义。