Nonmedical Prescription Drug Use among College Students

国家和大学流行病学研究提供了强有力的证据，表明非医疗处方药的使用在美国大学生中正在增加（例如，Johnston等人，2003；Mohler-Kuo等人，2003）。然而，非医疗处方药物的使用很少受到关注，也很少有流行病学研究充分评估那些最有可能滥用处方药物的非医疗使用风险的个体的特征。因此，拟议研究的广泛和长期目标是记录与美国大学生非医疗处方药使用相关的纵向趋势和风险因素。建议的二次分析将利用“大学健康行为研究”（Wechsler等人，2002年），该研究每年（1993年、1997年、1999年、2001年和2004年）收集5个独立国家样本的10,000多名美国大学生的横断面数据；重点将是处方药的非医疗使用，包括阿片类镇痛药、镇静/抗焦虑药和用于治疗注意力缺陷多动障碍（ADHD）的兴奋剂药物。具体目的是：1)评估1993 - 2004年美国大学生非医疗使用处方药的患病率和纵向趋势；2)研究与非医疗处方药物使用风险增加相关的学生水平和机构水平特征；3)比较非医疗处方药物开始使用的年龄与开始使用酒精、大麻和其他药物的年龄，并调查非医疗处方药物开始使用的年龄与过去一年药物滥用和依赖的发生率之间的关系；4)研究高校非医疗处方药物使用与其他药物使用之间的关系，探讨非医疗处方药物使用与医疗处方药物使用之间的关系。几个多变量统计分析将用于检查与非医疗使用相关的患病率和风险因素的纵向趋势。本研究结果将对了解处方药滥用的流行病学、预防和治疗具有重要意义。

National and college-based epidemiological studies provide strong evidence that nonmedical prescription drug use is increasing among U.S. college students (e.g., Johnston et al., 2003; Mohler-Kuo et al., 2003). However, nonmedical prescription drug use has received scant attention and little epidemiological research exists that adequately assesses the characteristics of those individuals most at risk for nonmedical use of abusable prescription drugs. Thus, the broad, long-term objectives of the proposed research are to document longitudinal trends and risk factors associated with nonmedical prescription drug use among U.S. college students. The proposed secondary analyses will utilize the "Study of College Health Behaviors" (Wechsler et al., 2002), which collects cross-sectional data on five independent national samples of over 10,000 U.S. college students each year (1993, 1997, 1999, 2001, and 2004); the focus will be on the nonmedical use of prescription drugs including opiate analgesics, sedative/anxiolytics, and stimulant medications for attention deficit hyperactivity disorder (ADHD). The specific aims are: 1) to assess the prevalence and longitudinal trends of nonmedical use of prescription drugs among U.S. college students between 1993 and 2004; 2) to examine the student-level and institutional-level characteristics that are associated with increased risk for nonmedical prescription drug use; 3) to compare the age of initiation for nonmedical prescription drug use to the ages of initiation for alcohol, marijuana and other drug use as well as investigate the relationship between age of initiation for nonmedical prescription drug use with the prevalence of past year substance abuse and dependence; 4) to examine the association between nonmedical prescription drug use and other drug use at the college-level, and to explore the association between nonmedical and medical use of prescription drugs. Several multivariate statistical analyses will be used to examine the longitudinal trends in the prevalence rates and risk factors associated with nonmedical use. Findings from this research will have important implications for the understanding of the epidemiology, prevention and treatment of prescription drug abuse.