Longitudinal Changes in Prescription Drug Misuse and Polysubstance Use in Adolescents and Young Adults

项目摘要/摘要 处方药滥用(Pdm)-以非处方医生预期的方式或非处方使用方式控制药物使用 处方--是青少年和年轻人(AYA)的一个重要公共卫生问题。相对于其他 年龄组、年龄较大的青少年和年轻人的比例最高，与产品数据管理相关的比例也最高 服药过量。此外，18岁时开始实施产品数据管理与35岁时的预后较差有关。关于阿雅的研究 Pdm已经在青少年或年轻人中确立了流行率和进程，但很少有研究表明。 调查不同年龄段人群的年龄-时期-队列(APC)差异和纵向变化。此外， 多产品数据管理(即，来自多个药物类别的产品数据管理)和涉及产品数据管理的多物质使用 在AYAS中未得到充分调查，尽管有证据表明，不使用其他物质的单一药物类别的PDM 1~2成熟。因此，研究团队的长期目标是了解pdm、多pdm和pdm相关内容。 多物质用于影响政策并促进制定筛查和干预措施 以风险最大的AYA为目标。使用具有全国代表性的纵向监测未来(MTF)的数据 和横断面全国药物使用与健康调查(NSDUH)数据集，我们的目标是12-30岁 AYAS将：(1)建立年龄/时期/队列(APC)和纵向差异的PDM患病率和 特征(即SUD症状、动机、来源、类型、发病年龄和共同摄入)；(2)量化APC 和多产品数据管理的纵向模式、产品数据管理(例如，动机)和与纵向多业务相关的政策特征 年龄段的变化，以及起始年龄对年龄段的多段年龄段的影响；(3)评价 与产品数据管理有关的多物质使用(如类阿片和海洛因；精神刺激剂)和因素(如国家一级 PDMP特征)影响涉及产品数据管理的多物质使用过程；以及(4)调查生活的影响 课程因素(婚姻、教育、社会关系、就业、家庭)对产品数据管理课程的影响。 产品数据管理和产品数据管理涉及的多物质使用。变量的选择和分析以生命历程理论为指导 越轨行为和药物使用的证据。这个项目的贡献将是巨大的，因为它的重点是 确定在产品数据管理、多产品数据管理和涉及产品数据管理的多物质使用方面最脆弱的年度协议，所有 持续和重大的公共卫生问题。由于使用了与产品数据管理相关的政策，该项目具有创新性 特征(例如，PDMP特征)、生命历程理论和变量的使用以及未充分利用的分析(例如， APC和混合建模)。最后，科学的严谨性最大限度地被广泛的和免费的专业知识 研究团队发表了两个数据集的历史，使用了有效的测量方法，接受了分析 技术，和强大的分析能力。该项目结果的快速传播可能会影响到 制定最有效的筛选、预防和干预产品数据管理的政策和信息 在高风险的AYA中的后果，所有这些都符合NIDA的使命。

PROJECT SUMMARY/ABSTRACT Prescription drug misuse (PDM) – controlled medication use in ways not intended by the prescriber or use without a prescription – is an important public health issue in adolescents and young adults (AYAs). Relative to other age groups, older adolescents and young adults have the highest rates of PDM and high rates of PDM-related overdose. Also, PDM initiation by age 18 is associated with poorer outcomes at 35 years. Research on AYA PDM has established prevalence and processes in adolescents or young adults, but little research has investigated age-period-cohort (APC) differences and longitudinal change in PDM among AYAs. Furthermore, poly-PDM (i.e., PDM from multiple medication classes) and PDM-involved polysubstance use are underinvestigated in AYAs, despite evidence that single medication class PDM without other substance use is rare. Thus, the long-term goal of the research team is to understand PDM, poly-PDM, and PDM-involved polysubstance use in AYAs to influence policy and facilitate the development of screening and intervention to target AYAs most at-risk. Using data from the nationally representative longitudinal Monitoring the Future (MTF) and cross-sectional National Survey on Drug Use and Health (NSDUH) datasets, our aims in 12-30 year-old AYAs are to: (1) establish age/period/cohort (APC) and longitudinal differences in PDM prevalence and characteristics (i.e., SUD symptoms, motives, source, type, age of initiation, and co-ingestion); (2) quantify APC and longitudinal patterns of poly-PDM, the PDM (e.g., motives) and policy features linked to longitudinal poly- PDM change, and the effects of age of initiation on poly-PDM in AYAs; (3) evaluate longitudinal differences in PDM-involved polysubstance use (e.g., opioids and heroin; psychostimulants), and factors (e.g., state-level PDMP features) influencing course of PDM-involved polysubstance use; and (4) investigate the effects of life course factors (i.e., marriage, education, social bonds, employment, and household) on the course of PDM, poly- PDM and PDM-involved polysubstance use. Variable selection and analyses were guided by life course theories of deviant behavior and substance use. The contribution of this project will be significant because of its focus on identifying the most vulnerable AYAs in terms of PDM, poly-PDM and PDM-involved polysubstance use, all ongoing and significant public health issues. The project is innovative because of the use of PDM-relevant policy features (e.g., PDMP characteristics), use of life course theory and variables, and underutilized analyses (e.g., APC and mixture modeling). Finally, scientific rigor is maximized by the broad and complimentary expertise of the research team, a history of publication with both datasets, use of validated measures, accepted analytic techniques, and strong power for analyses. Rapid dissemination of the findings of this project can influence policy and inform the development of maximally valid screening, prevention, and intervention for PDM and its consequences in high-risk AYAs, all of which is consistent with the mission of NIDA.