Risks for Transitions in Drug use Among Urban Adults

描述（由申请人提供）：这是申请的第二次修订。小组略有扩大;预算保持不变;根据审查者的意见对案文进行了大量改写。尽管大量关于药物使用和依赖的流行病学和病因学研究都集中在青少年时期，但对青年期的药物使用知之甚少。青年期是可能从吸毒升级为依赖的时期，也是确定实验性吸毒与慢性吸毒轨迹的时期。由于对青年期过渡的影响可能与青春期不同，因此从儿童期到青春期和成年早期，再到青年期的纵向数据对理解自然史很重要。对吸毒阶段过渡的影响存在于个人和社会环境及其相互作用层面。重要的个人层面的影响包括遗传背景和精神和行为障碍的存在，如抑郁症，酒精障碍，反社会行为和反社会人格障碍。重要的社会环境影响包括成人角色的参与，成年早期替代性替代者的发展以及社区。很可能有不同的途径，药物暴露，使用，依赖性，和缓解之间的那些不同的这些特征，以及对这些特征的前体和前因的早期历史。本申请旨在收集和分析预防研究中心（PRC）研究参与者的访谈和生物学数据，该研究是一项由19所巴尔的摩市公立学校的2311名儿童组成的队列研究，自1985年和1986年（现在接近28-29岁）一年级以来，已有10波数据。先前的评估包括精神和行为问题和障碍，以及上面列出的社会环境特征。建议的评估包括DMA的血液或口腔样本，以及在先前波中评估的许多结构。先前的实地工作表明，超过80%的原始队列可以找到和采访。队列的人口基础方面，以及在巴尔的摩的位置，其高水平的药物使用和大量的非洲裔美国人的样本，是这个项目的重要优势。青年期随访的时机和先前评估的丰富性是无与伦比的。如果预防吸毒以及吸毒成瘾和慢性化的干预措施要行之有效，实施工作必须包括针对最有可能发生这种过渡的年轻人的战略。这些预防策略在针对风险和保护因素时可能最有效，因为我们建议收集的潜在因果影响有可信的证据。

DESCRIPTION (provided by applicant): This is the second revision of an application. The team has expanded slightly; the budget has remained the same; and the text has been extensively rewritten in the light of reviewers' comments. Little is known about drug use in young adulthood, although a great deal of epidemiologic and etiologic research in drug use and dependence has focused on adolescence. Young adulthood is the period in which escalation from drug use to dependence is likely to occur and when trajectories differentiating experimental from chronic drug use are defined. Since influences on transitions in young adulthood likely differ from those in adolescence, longitudinal data that extend from childhood, through adolescence and early adulthood, and into young adulthood are important in understanding natural history. Influences on transitions in stages of drug use exist at the level of the individual and the social environment, and their interactions. Important individual-level influences include genetic background and the presence of psychiatric and behavioral disorders, such as depression, alcohol disorders, antisocial behaviors and antisocial personality disorder. Important social environmental influences include engagement in adult roles, development of alternative reinforcers during young adulthood, and neighborhoods. It is likely that there are distinct pathways to drug exposure, use, dependence, and remission among those who differ on these characteristics, as well as on early history of the precursors and antecedents of these characteristics. This application is to collect and analyze interview and biological data from participants in the Prevention Research Center (PRC) study, a cohort of 2311 children in 19 Baltimore City public schools, with 10 prior waves of data since they were in first grade in 1985 and 1986 (now approaching 28-29 years of age). Prior assessments include psychiatric and behavioral problems and disorders, as well as the social environmental characteristics listed above. Proposed assessments include blood or buccal sample for DMA, and many constructs assessed in prior waves. Prior field work suggests that more than 80% of the original cohort can be located and interviewed. The population-based aspect of the cohort, and the location in Baltimore, with its high level of drug use and large African-American sample, are important advantages of this project. The timing of follow-up in young adulthood, and the richness of prior assessments, is unmatched. If interventions for prevention of drug use, and escalation to dependence and chronicity, are to be effective, the implementation must include strategies targeted for young adults where these transitions are most likely to occur. These prevention strategies can be most effective when targeting risk and protective factors for which there is credible evidence of a potential causal influence such as we propose to gather.