PRESCRIPTION DRUG USE IN THE US POPULATION: GATEWAY EFFECTS AND FAMILY PATTERNS

描述（由申请人提供：本提案要求提供4年支持（2014年12月1日至2018年11月30日），对两项国家研究的数据进行二次分析，以了解美国人群中不同人群非医疗处方药（NMPDU）（兴奋剂、镇静剂、安定剂、止痛药）使用的自然史和风险因素。将实现四个目标。(1)确定NMPDU在药物参与发展序列中的位置，特别是Gateway药物、尼古丁、酒精和大麻在NMPDU进展中的作用，并比较青少年和成人（NSDUH）。(2)（a）明确父母与子女之间对NMPDU的关联，（B）将父母与子女之间对NMPDU的关联与其他三种药物类别（香烟、酒精、大麻）的关联进行比较，（c）确定邻里因素对父母与子女之间对NMPDU（NSDUH）的关联的作用。(3)指定在不同社区背景下NMPDU的遗传易感性程度（添加健康）。(4)目的（1）-（3）中比较男性与女性以及三个人种/种族组。分析将在两个国家数据集中进行：（1）全国药物使用和健康调查的多项调查，这是美国12岁及以上一般人群药物使用的年度全国代表性调查。将分析总样本以及匹配的亲子配对的子样本。(2)全国青少年健康纵向研究中的双胞胎、全同胞、半同胞对和表亲的全国样本，这是一项针对前7 - 12年级学生的四波纵向研究。邻里特征的影响，包括基于人口普查的指标的邻里劣势和亚州区域率的NMPDU，也将被考虑。在药物参与的发展序列中的位置的分析，亲子二人组的国家样本的分析，遗传易感性的评估和邻里特征对NMPDU的影响代表特别独特和新颖的方面提出的研究。该流行病学研究计划解决了该国的一个关键公共卫生问题，并通过提供对NMPDU的多方面了解，将为旨在减少NMPDU的预防和干预措施的制定和实施提供信息，并提出在动物模型中进行测试的假设。

DESCRIPTION (provided by applicant: This proposal requests four years of support (12/01/2014-11/30/2018) to conduct secondary analyses of data from two national studies to gain an understanding of the natural history and risk factors for non-medical prescription drug use (NMPDU) (stimulants, sedatives, tranquilizers, pain relievers) in different groups in the US population. Four aims will be pursued. (1) To determine the position of NMPDU in the developmental sequence of drug involvement and, in particular, the role of Gateway drugs, nicotine, alcohol and marijuana, in the progression to NMPDU and compare adolescents and adults (NSDUH). (2) (a) To specify the association between parent and child on NMPDU, (b) to compare the association between parent and child on NMPDU with the association on three other drug classes: cigarettes, alcohol, marijuana, (c) to identify the role of neighborhood factors on the association between parent and child on NMPDU (NSDUH). (3) To specify the extent of genetic liability for NMPDU in the context of different neighborhoods (Add Health). (4) To compare males vs. females and three racial/ethnic groups in Aims (1) - (3). Analyses will be conducted in two national data sets: (1) multiple surveys of the National Survey on Drug Use and Health, the annual nationally representative survey of drug use in the general US population aged 12 and older. The total samples as well as subsamples of matched parent-child pairs will be analyzed. (2) National samples of twins, full sibling, half-sibling pairs, and cousin in the National Longitudinal Study of Adolescent Health, a four-wave longitudinal study of former 7th-12th graders. The effects of neighborhood characteristics, including census-based indicators of neighborhood disadvantage and substate region rates of NMPDU, will also be considered. The analysis of the position of NMPDU in the developmental sequence of drug involvement, the analysis of a national sample of parent-child dyads, the assessment of genetic liability and the impact of neighborhood characteristics on NMPDU represent particularly unique and novel aspects of the proposed research. This program of epidemiological research addresses a crucial public health problem in the nation and, by providing a multifaceted understanding of NMPDU, will inform the development and implementation of prevention and intervention efforts designed to reduce NMPDU, and suggest hypotheses to be tested in animal models.