Trends in NonMedical Prescription Drug Use, Abuse-Dependence in Adolescence

描述（由申请人提供）：尽管人们越来越关注最近处方药非医疗使用的增加（非医疗使用的定义是“超过处方使用处方药，或在没有处方的情况下使用处方药以获得快感”），但人们对与青少年滥用这些药物有关的问题的性质和程度以及与非医疗处方药物使用有关的潜在关联和多种药物使用模式知之甚少。青少年的虐待和依赖。为了填补这一空白，本研究将：1)估计非医疗处方药使用与人口特征（包括居住在城市、郊区或农村地区、社会经济状况和保险状况）、使用频率、越轨行为、感觉寻求和心理健康治疗的关联，并测试这些关联是否随时间变化；2)探索非医疗处方药使用者的多种药物使用模式，并在不同的多种药物使用亚组中调查不同的相关关联，检验这些关联是否随时间变化；3)检验年龄、性别和保险状况亚组中非医疗处方药使用流行率和非医疗处方药使用相关因素的变化；4)检验NMPD发病模式的年龄是否随时间变化。5)估计非医疗处方药物滥用和依赖的流行程度随时间的变化，以检查非医疗处方药物滥用和依赖的流行程度是否随时间而变化，并调查非医疗处方药物滥用/依赖与人口统计学特征、NMPD使用频率、异常行为、感觉寻求、心理健康治疗和其他药物使用模式的关系。6)探索符合非医疗处方药物滥用/依赖标准的青少年中多种药物滥用/依赖的流行程度和不同模式，并检验不同的协变量关联；7)检验从NMPD开始使用到对NMPD依赖的时间是否随时间而变化。在所有目标中，我们将控制邻里特征。我们建议使用全国药物使用和健康调查（NSDUH）的8年数据（1998-2005年），以前称为全国药物滥用家庭调查（NHSDA）。探索性数据分析，条件逻辑回归模型和生存分析技术将用于解决每个具体目标。在这个丰富的数据库上，本应用程序中提出的分析有可能为理解美国青少年非医疗处方药使用、滥用和依赖的趋势做出重要贡献。我们的努力是针对监测数据和动态概念模型之间的更大一致性，这些模型正在指导NIDA支持的病因学和预防研究。通过研究青少年中NMPD的激增是否导致了青少年中NMPD的常规使用以及滥用和依赖的增加，我们将能够为制定旨在最大限度地减少NMPD后果的公共政策做出贡献。公共卫生相关性：在这个丰富的数据库中提出的分析。（NHSDA/NSDUH）有可能为了解美国青少年非医疗处方药使用、滥用和依赖的趋势做出重要贡献，并可能有助于制定旨在将NMPD后果降到最低的公共政策。

DESCRIPTION (provided by applicant): Despite increasing concern about recent increases in the non-medical use of prescription drugs (non-medical use is defined as "use of a prescription drug either more than was prescribed, or without a prescription with the intention to get high"), little is known about the nature and extent of the problems related to the misuse of these drugs among adolescents, as well as about the potential correlates and polydrug use patterns associated with non-medical prescription drug use, abuse and dependence in adolescence. To fill this gap, this study will: 1) Estimate associations of non-medical prescription drug use with demographic characteristics (including living in urban, suburban or rural areas, socio-economic status and insurance status), frequency of use, deviant behaviors, sensation-seeking and mental health treatment and test whether these associations change over time, 2) Explore polydrug use patterns among non medical prescription drug users and investigate for different correlate associations within different polydrug use subgroups testing whether these associations change over time, 3) Test for variation in the prevalence of non-medical prescription drug use and factors associated with non-medical prescription drug use by age, gender, and insurance status subgroups, 4) Test whether age of onset pattern of NMPD has changed over time, 5) Estimate the prevalence of nonmedical prescription drug abuse and dependence over time, to examine whether the prevalence of abuse and dependence among nonmedical prescription drug users has changed over time, and to investigate associations of non-medical prescription drug abuse/dependence with demographic characteristics, frequency of NMPD use, deviant behaviors, sensation-seeking, mental health treatment, and patterns of other drug use over time, 6) Explore the prevalence and different patterns of polydrug abuse/dependence among adolescents who meet criteria for nonmedical prescription drug abuse/dependence over time, and test for different covariate associations, 7) test whether time from onset of use of NMPD to dependence on NMPD has changed over time. In all aims we will control for neighborhood characteristics. We propose to use eight years of data (1998-2005) of the National Survey on Drug Use and Health (NSDUH), formerly called the National Household Survey on Drug Abuse (NHSDA). Exploratory data analyses, conditional logistic regression models and survival analyses techniques will be used to address each of the specific aims. Analyses proposed in this application on this rich database have the potential to bring important contributions to the understanding of trends in nonmedical prescription drug use, abuse and dependence among adolescents in the U.S. Our effort is directed at a greater congruence between surveillance data and dynamic conceptual models that are guiding etiologic and prevention research supported by NIDA. By examining whether the surge in NMPD among adolescents has resulted in an increase in regular use of NMPD and of NMPD abuse and dependence among adolescents, we will be able to contribute to the development of public policies that target to minimize consequences of NMPD. PUBLIC HEALTH RELEVANCE: Analyses proposed in this application on this rich database. (NHSDA/NSDUH) have the potential to bring important contributions to the understanding of trends in nonmedical prescription drug use, abuse and dependence among adolescents in the U.S and may contribute to the development of public policies that target to minimize consequences of NMPD.