Non-Medical Prescription Drug Use Among High-Risk Youth

说明(由申请人提供)：大量证据表明，将处方药转用于非医疗用途在滥用物质中所占比例迅速增加，特别是在高危青年和青年人口中。然而，关于这些药物的使用信息很少，包括这些物质是什么，它们是如何给药的，以及它们为什么被启动。关于非医疗处方药的许多可用数据，包括阿片类药物、CMS镇静剂和兴奋剂，仅限于调查数据和老年用户群体。缺乏关于高危青年人群非医疗使用处方药的描述性数据。我们建议在两个城市(纽约和洛杉矶)进行一项比较研究，对象是16至25岁的高危青年，他们可能无家可归，参与街头经济，吸食多种毒品和/或注射吸毒者。该项目的目的是：描述为什么高危青年开始使用非医疗处方药；描述现有处方药形式的多样性和他们在管理中采用的行为做法；绘制从使用处方药过渡到其他类型受控物质的社会轨迹；以及评估长期使用处方药对与艾滋病毒和性传播感染有关的行为发生风险增加的后果。该项目的目标将在三个研究阶段得到解决。第一阶段将包括一个为期六个月的社区评估过程(CAP)，以收集每个城市现有的非医疗处方药使用的“当地知识”。第二阶段将包括对纽约和洛杉矶的150名处方药使用者进行为期9个月的定性研究。第三阶段将对纽约和洛杉矶的600名处方药使用者进行为期15个月的横断面定量调查。研究结果将为旨在减少高危青年使用非医疗处方药的社区组织制定课程。关于非医疗处方药使用的公共卫生研究极其有限，目前对高危青年如何在面临危险行为时保持健康生活水平知之甚少。拟议研究的结果将填补流行病学文献中关于高危青年使用非医疗处方药的关键空白，这些高危青年面临负面健康后果的风险，包括药物依赖、药物过量、暴力、受害和接触血源性病原体。

DESCRIPTION (provided by applicant): Substantial evidence suggests that the diversion of prescription drugs for non-medical use accounts for a rapidly increasing share of substances of abuse, particularly among high-risk youth and young adult populations. Yet, there is a scarcity of information about the use of these drugs, including what the substances are, how they are administered, and why they are initiated. Much of the available data on non-medical prescription drugs, which includes opioids, CMS depressants, and stimulants, is limited to survey data and older populations of users. Descriptive data is lacking about the non-medical use of prescription drugs among high-risk youth populations. We are proposing a two-city (New York and Los Angeles) comparative study of high-risk youth aged 16 to 25 who may be homeless, participating in the street economy, polydrug users and/or injection drug users. The project aims are to: describe why high-risk youth initiate non-medical prescription drug use; describe variability in the forms of prescription drugs available and behavioral practices employed in their administration; chart the social trajectory of the transition from prescription drug use into other types of controlled substances; and assess the consequences of chronic use of prescription drugs on increased risk for onset of behaviors associated with exposure to HIV and STIs. The project aims will be addressed during three study phases. Phase One will consist of a six month Community Assessment Process (CAP) to gather existing "local knowledge" about non-medical prescription drug use in each city. Phase Two will comprise a nine month qualitative study of 150 prescription drug users in New York and Los Angeles. Phase Three will constitute a 15 month cross-sectional, quantitative survey of 600 prescription drug users in New York and Los Angeles. Study findings will inform the development of a curriculum for community-based organizations aimed at reducing non-medical prescription drug use among high-risk youth. Public health research on non-medical prescription drug use is extremely limited, and little is currently known about how high-risk youth maintain healthy living standards in the face of their risky behavior. Results from the proposed study will fill a critical gap in the epidemiological literature on non-medical prescription drug use among high-risk youth who are at risk for negative health outcomes, including drug dependence, drug overdose, violence, victimization, and exposure to bloodborne pathogens.