Drug Consumption and Disease Mortality: Population-level Analyses

描述（由申请人提供）：本探索性/开发性项目的主要目的是在人群水平上检查药物消费与疾病之间的关系。该项目将通过一系列回顾性分析大大增进我们对这种关系的了解，这些分析使用了最近发现的关于鸦片剂和大麻素消费的独特、非常丰富和可靠的数据集，这些数据集是在这些物质的消费是法律的时收集的，结合关于各种传染病和病症的流行率和严重程度的同期数据，（包括但不限于霍乱、天花、鼠疫、腹泻和痢疾）以及一组丰富的可能的流行病学相关因素。其实质性目标包括分别测试和/或分析：㈠使用法律的和可靠的人口一级关于毒品消费和死亡率的数据，消费上述物质与上述疾病和病症造成的死亡率之间的关系，㈡鸦片、大麻和酒精之间的差异以及它们的组合与死亡率变化之间的关系，（iii）这些疾病对大量和非大量吸毒人群的不同影响倾向的差异，以及（iv）各种其他流行病学上突出的因素与吸毒在使人群暴露于疾病方面的相互作用。这项研究将涉及应用统计和计量经济学方法分析英属印度大麻和鸦片消费、疾病和其他变量的数据。上述（i）-（iv）的检验将使用经验方法进行，以分析具有空间分量的基于计数的因变量（例如死亡率），需要使用泊松或负二项模型规范。此外，将使用多变量或条件格兰杰因果关系检验来确定是否有证据表明一种现象（例如，药物消费）相对于另一种现象（例如，死亡率）具有时间优先性。公共卫生相关性：NIDA将其作用定义为减少药物滥用造成的危害。为了实现这一目标，有必要了解药物滥用在个人和人口两级与传染病等负面健康结果相联系的机制。该项目的相关性在于，它旨在通过使用最近发现的关于人口一级阿片类药物和大麻素消费的独特、非常丰富和可靠的数据集以及关于各种疾病死亡率的同期数据进行一系列分析，大大提高我们对这些关系的认识。这些分析所产生的知识将有助于药物滥用的知识基础，因为这是第一次用全人口范围的证据补充现有的基于实验室和临床的关于药物与疾病关系的证据。

DESCRIPTION (provided by applicant): The principal aim of this exploratory/developmental project is to examine the relationship between drug consumption and disease at the population level. This project will significantly advance our knowledge of such a relationship with a series of retrospective analyses using a unique recently-discovered and extraordinarily rich and reliable dataset on the consumption of opiates and cannabinoids, collected at a time when the consumption of these substances was legal, in conjunction with contemporaneous data on the prevalence and intensity of a variety of infectious diseases and conditions (including but not restricted to cholera, smallpox, plague, and diarrhea and dysentery) as well as a rich set of possible epidemiologic correlates. The substantive aims include separate tests for and/or analyses of (i) the relationship of the consumption of the above substances with mortality from the above diseases and conditions using legal and reliable population-level data on drug consumption and mortality, (ii) the differences between opium, marijuana, and alcohol and combinations of them in their association with variations in mortality, (iii) the differences between the diseases in their propensity to differentially affect populations of intense and non-intense drug consuming populations, and (iv) the interactions between various other epidemiologically salient factors and drug consumption in exposing populations to diseases. This study will involve the application of statistical and econometric methods to the analysis of data on marijuana and opium consumption, diseases, and other variables in British India. Tests for (i) - (iv) above will be conducted using empirical methods for the analysis of count-based dependent variables (mortality, for example) with a spatial component, necessitating the use of the Poisson or negative binomial model specifications. In addition, multivariate or conditional Granger causality tests will be used to determine if there is evidence for temporal precedence of one phenomenon (drug consumption, for example) in relation to another phenomenon (mortality, for example). PUBLIC HEALTH RELEVANCE: NIDA defines its role in terms of reducing the harm caused by drug abuse. In order to achieve this goal, it is necessary to understand the mechanisms by which drug abuse is linked to negative health outcomes such as infectious disease at both the individual and population levels. This project is relevant in that it aims to significantly advance our knowledge of these relationships with a series of analyses using a unique recently-discovered and extraordinarily rich and reliable dataset on the consumption, at the population level, of opiates and cannabinoids in conjunction with contemporaneous data on mortality from a variety of diseases. The body of knowledge generated by these analyses will contribute to the knowledge base of drug abuse by complementing, for the first time, the existing laboratory- and clinic-based evidence on the drug-disease relationship with population-wide evidence.