VIETNAM DRUG USERS TWO DECADES LATER

这一修改后的申请建议完成后续的经典 越南吸毒者研究。最初的研究是在1972年进行的， 1974年由华盛顿大学医学院评估 毒品和其他药物滥用以及适应问题对平民生活的影响 越南战争的士兵离开一年和三年后， 越南 这项研究的价值因纳入一名平民而得到丰富。 比较样本与一般样本退伍军人匹配。 第一阶段， 截至1994年10月，可行性研究（DA 07939 - 01）已进入第17个月。 受试者的累积死亡率现在达到40多岁， 平均目前站在13.5%的过度抽样退伍军人谁测试 在离开越南时，尿液分析呈阳性， 药物阴性的一般样本退伍军人，1.4%的比较 sample. 在VA医疗利用者中，46.2%的住院和24.4%的 的门诊患者接受了药物滥用或精神病治疗 专家。 第二阶段，仪器阶段（DA 07939 - 03）刚刚 已为1994年10月至1995年7月期间提供资金。第三阶段， 主要研究和目前的申请，要求资金为三年 (July 1995年至1998年6月），与 受访者从1,099名已知活着的人中选出， 在最初的研究中至少采访过一次。数据收集和 分析的目的如下：1）完成与一个 至少830名原始研究受访者。2)收集头发样本 所有受访者同意头发采样。3)更新VA 医疗记录应包括1993年和1994年的使用资料。四、 为了比较物质使用和滥用的患病率， 问题和其他结果4a）样本和尿液分析状态， 4b）根据假设得出的风险状态类别 在最初的研究结果中。 5)绘制物质的模式 在越南战争前至今的时期内使用，包括：5a） 频率和数量; 5b）滥用和依赖; 5c）过渡 不同给药途径的模式;以及5d）过渡模式 跨药物类别。6)为了检验假设阶段的关联性- 具体的风险因素与药物使用过程中的成年年为基础的 关于规范性和适应不良的生命历程的观点和研究结果 从现有的越南退伍军人研究和一般人群和临床 人口后续行动。7)为了检验主要事件之间的因果关系， 结构和物质使用和其他行为指标， 为创伤后应激障碍、犯罪中止、医疗保健开发的因果模型 利用和身体健康后果。8)验证自我报告 通过头发毒品检测对可卡因、阿片类药物和甲基苯丙胺的使用情况进行调查， 估计有340名退伍军人和非退伍军人目前使用的风险， 最初的研究。9)交叉询问自己报告的使用退伍军人医疗服务的情况 自1974年以来，估计有290名活着的VA中的VA医疗记录 医疗保健使用者。

This revised application proposes to complete the follow-up of the classic Vietnam Drug Users Study. The original study was conducted in 1972 and 1974 by the Washington University School of Medicine to assess the extent of drug and other substance abuse and adjustment problems to civilian life of Vietnam War soldiers one year and three years after departure from Vietnam. The value of the study was enriched by inclusion of a civilian comparison sample matched with the general-sample veterans. Phase I, the feasibility study (DA07939-01) is in its 17th month as of October 1994. The cumulative mortality rates of subjects now reaching their mid-40s on average currently stand at 13.5% for oversampled veterans who tested positive for urinalysis, at the time of departure from Vietnam, 5.3% for drug-negative general-sample veterans, and 1.4% among the comparison sample. Among VA medical utilizers, 46.2% of hospitalizations and 24.4% of outpatient visits were treated by substance abuse or psychiatric specialists. Phase II, the instrumentation phase (DA07939-03) has just been funded for the period of October 1994 to July 1995. Phase III, the main study and the current application, requests funds for three years (July 1995 to June 1998) to conduct in-person interviews with the respondents selected from the pool of 1,099 known alive and who were interviewed at least once in the original study. Data collection and analysis aims are as follows: 1) To complete in-person interviews with a minimum of 830 original study respondents. 2) To collect hair samples from all interviewed respondents who consent to hair sampling. 3) To update VA medical records to include utilization information for 1993 and 1994. 4) To compare the prevalence rates of substance use and abuse, psychiatric problems and other outcomes by 4a) sample and urinalysis status at departure and 4b) by risk status categories derived from hypotheses implicit in the original study results. 5) To chart patterns of substance use over the period encompassing pre-Vietnam to present, including: 5a) frequencies and quantities; 5b) abuse and dependence; 5c) transition patterns across routes of administration; and 5d) transition patterns across classes of drugs. 6) To test associations of hypothesized stage- specific risk factors with the course of drug use over adult years based on a normative and maladaptive life course perspective and on findings from existing Vietnam veteran studies and general-population and clinical population follow-ups. 7) To test causal relationships of the major constructs and substance use and other behavioral indicators based on the causal models developed for PTSD, criminal desistance, health care utilization and physical health consequences. 8) To validate self-reported use of cocaine, opiates and methamphetamine by hair drug testing among an estimated 340 veterans and nonveterans at risk for current use based on the original study. 9) To cross-examine self-reported use of VA medical care since 1974 with VA medical records among an estimated 290 living VA medical care utilizers.