Nonmedical prescription drug misuse among US older adults: subtypes,motives, and diversion sources

项目摘要/摘要 研究小组发表的工作和数据有力地表明， 老年人的非医疗处方药使用(NMPDU)正在增加。也就是说，NMPDU的细节 这一组的过程几乎是未知的，只有三项已发表的研究包括老年人和 检查NMPDU相关性。研究团队的长期目标是更好地了解非医疗用户 和NMPDU流程(例如，动机、分流来源)在整个生命周期内，通过以下方式帮助干预开发人员 确定治疗目标和非医疗用户的弱势亚群。在此应用程序中，使用来自 多年的全国药物使用与健康调查(NSDUH)，[IMS国家处方审计 和NVSS多死因档案]，总体目标是：一，更好地描述老年人的特征 成人阿片类药物、镇静剂(主要由苯二氮类药物组成)、[兴奋剂和镇静剂]NMPDU 建立关联性、分流来源、动机和其他关键NMPDU指标[及其与 NMPDU相关死亡率]；第二，评估NMPDU相关关系中的潜在调节因素；以及 与其他NMPDU过程相关的因素(例如，性别)；第三，建立老年人的潜在阶层 阿片类药物、镇静剂、[兴奋剂和镇静剂]的非医疗使用者。变量选择由一个 不同发展阶段风险因素综合发展模型的改编版 所有发现都将与年轻队列中的结果进行比较，要么直接进行分析，要么通过 与之前出版的作品进行比较。这项提议的理由是更好地描述了老年人 成人NMPDU，包括相关因素、转移来源、动机和NMPDU亚组，将提供更清晰的信息 限制老年人NMPDU发病率的干预目标及其潜在后果 非医疗用途。这项建议的贡献将是重大的，因为它将允许临床医生识别 老年非医疗使用者，特别是那些最容易受到NMPDU相关后果影响的人，以及 它将允许干预开发人员更好地制定强有力的预防和治疗计划，以限制和/或治疗 老年人中的NMPDU。此外，这里提出的研究具有创新性，因为它代表了一种 通过应用公认的技术和分析，显著偏离该领域的当前状态，所有 以前由研究团队使用，以更好地描述非医疗用户的弱势群体 而我们对此知之甚少的是老年人。其他创新来源包括使用具有全国代表性的 和大样本，包括[多个数据集和]各种NMPDU指标，以更好地表征 参与NMPDU的老年人，以及检查社会人口和其他方面的分析精选 以发展为基础的NMPDU关键进程主持人。快速传播所衍生的知识 这一建议有可能为制定最有效的干预方案提供信息，以防止 或减少老年人NMPDU及其后果，所有这些都与NIDA的使命一致。

PROJECT SUMMARY/ABSTRACT Published work by the research team and data strongly suggest that prevalence rates and consequences of nonmedical prescription drug use (NMPDU) in older adults are increasing. That said, the specifics of NMPDU processes in this group are virtually unknown, with only three published studies that include older adults and examine NMPDU correlates. The long-term goal of the research team is to better understand nonmedical users and NMPDU processes (e.g., motives, diversion sources) across the lifespan, aiding intervention developers by identifying treatment targets and vulnerable subgroups of nonmedical users. In this application, using data from multiple years of the National Survey on Drug Use and Health (NSDUH), [the IMS National Prescription Audit and the NVSS Multiple Causes of Death files], the overall objectives are to: one, to better characterize older adult opioid, tranquilizer (primarily composed of benzodiazepines), [stimulant and sedative] NMPDU by establishing correlates, diversion sources, motives, and other key NMPDU indicators [and their relationships with NMPDU-related mortality]; two, to evaluate potential moderators in the NMPDU-correlate relationships, and factors (e.g., sex) associated with other NMPDU processes; and three, to establish latent classes of older adult nonmedical users of opioids, tranquilizers, [stimulants and sedatives]. Variable selection was guided by an adapted version of the Comprehensive Developmental Model of risk factors across different developmental periods, and all findings will be compared to those in younger cohorts, either directly in analyses or through comparison to previously published work. The rationale for this proposal is that better characterization of older adult NMPDU, including correlates, diversion sources, motives, and NMPDU subgroups will provide clearer targets for interventions to limit rates of NMPDU in older adults and the potential consequences of such nonmedical use. The contribution of this proposal will be significant because it will allow clinicians to identify older adult nonmedical users, particularly those who are most vulnerable to NMPDU-related consequences, and it will allow intervention developers to better craft robust prevention and treatment programs to limit and/or treat NMPDU in older adults. Furthermore, the research proposed here is innovative because it represents a significant departure from the current state of the field by applying accepted techniques and analyses, all previously utilized by the research team, to better characterize a vulnerable group of nonmedical users about whom very little is known, older adults. Other sources of innovation include the use of a nationally representative and large sample, inclusion of [multiple data sets and] a wide variety of NMPDU indicators to better characterize older adults engaged in NMPDU, and selection of analyses that examine sociodemographic and other developmentally-based moderators of key NMPDU processes. Rapid dissemination of the knowledge derived from this proposal has the potential to inform the development of maximally valid intervention options to prevent or reduce older adult NMPDU and its consequences, all of which is consistent with the mission of NIDA.