Drug Abuse Trajectories in the Transition to Adulthood: Risk Factors and Outcomes

描述（由申请人提供）：在过去的一个月里，全国750万全日制大学生中估计有21%使用过非法药物。此外，我们过去三年的工作已经证明，同时使用非医疗处方药、其他非法药物和大量饮酒都可能影响大学生的健康、安全和福祉。不幸的是，大多数先前对大学生的研究都只关注酒精；少数关于大学生吸毒及相关问题的研究解释力有限，或者没有涵盖广泛的风险因素和后果。关于药物问题（包括药物使用障碍）的持续存在及其在大学毕业后的后遗症的问题仍然没有答案。这种知识差距严重阻碍了预防毒品的努力和为年轻人提供预防性保健服务。2003年，我们的调查小组开始了一项前所未有的由NIDA资助的计划，以解决这一差距，并更多地了解大学生非法使用毒品的自然历史和后果。系统抽样产生1253名学生进行纵向前瞻性研究，其中95%的学生在3年随访后仍积极参与研究。深入的年度访谈产生了包含各种风险因素和结果的丰富数据集。所有的学生，无论学术地位如何，都仍在学习中。这项更新应用建立在我们之前的研究结果的基础上，并建议继续我们对这一有价值的队列进行随访，以回答有关他们过渡到成年期的心理和身体健康结果的新问题。具体而言，它旨在：1)研究药物使用轨迹的持久性，包括药物问题的解决和依赖的发展；2)了解大学生吸毒如何干扰职业目标和适应性社会支持结构等发展里程碑的实现；3)检查药物使用和心理健康与身体健康（包括高危性行为）和生活质量之间的相互关系；并且，4)检查可卡因和非医疗处方药使用的潜在不良长期后果，这两者在我们的样本中都随着时间的推移而显著增加。这种更新为该领域提供了一个难得的机会，可以探索新的跨学科研究领域，并将使用前瞻性多维建模，利用十年的数据来了解他们在大学后时期的健康和功能。这项研究的继续将使NIDA早期在该项目中的投资回报最大化。最终，结果将导致创新的药物滥用干预策略，塑造临床决策，并改善年轻人的卫生服务提供系统。我们雄心勃勃和全面的方法确保了这项纵向前瞻性研究将回答有关如何减少与药物滥用相关的长期个人和家庭动荡的主要问题，使年轻人能够实现他们的个人潜力，并减少对社会不必要的经济成本。

DESCRIPTION (provided by applicant): An estimated 21 percent of the nation's 7.5 million full-time college students have used an illicit drug in the past month. Moreover, our work over the past three years has documented that concurrent nonmedical prescription drug use, other illicit drug use, and heavy drinking can all potentially affect the health, safety and well-being of college students. Unfortunately, most prior research on college students has focused solely on alcohol; the few studies on college student drug use and associated problems have had limited explanatory power or have not covered a wide scope of risk factors and consequences. Questions regarding the persistence of drug problems, (including substance use disorder) and their sequelae after college remain unanswered. This knowledge gap has severely hampered drug prevention efforts and preventive health care services for young adults. In 2003, our investigative team began an unprecedented NIDA- funded initiative to address this gap-and learn more about the natural history and consequences of illicit drug use among college students. Systematic sampling yielded a cohort of 1253 students for a longitudinal prospective study, of which 95 percent are still active in the study after 3 years of follow-up. In-depth annual interviews have yielded a rich dataset containing a wide array risk factors and outcomes. All students, regardless of academic status, are still being studied. This renewal application builds on our previous findings and proposes to continue our follow-up of this valuable cohort to answer new questions about psychosocial and physical health outcomes as they transition to adulthood. Specifically, it aims to: 1) study the persistence of drug use trajectories, including the resolution of drug problems and development of dependence; 2) understand how college drug use might interfere with achieving developmental milestones such as occupational goals and adaptive social support structures; 3) examine the reciprocal relationships over time of drug use and mental health in relation to physical health (including high-risk sexual behaviors) and quality of life; and, 4) examine potential adverse long-term consequences of cocaine and nonmedical prescription drug use, which have both significantly increased over time in our sample. This renewal offers the field a rare opportunity to probe into new transdisciplinary areas of research, and will use prospective multidimensional modeling that will take advantage of ten years of data to understand their health and functioning in the post-college period. The continuation of this study will maximize the return on NIDA's earlier investment in the project. Ultimately, the results will lead to innovative drug abuse intervention strategies, shape clinical decision-making, and improve health service delivery systems for young adults. Our ambitious and comprehensive approach ensures that this longitudinal prospective study will answer major questions about how to reduce the long-term personal and family turmoil associated with drug abuse, enable young adults to fulfill their individual potential, and reduce unnecessary economic costs to society.