Non-Medical Prescription Drug Use Among High-Risk Youth

说明（由申请人提供）：大量证据表明，处方药转用于非医疗用途在滥用物质中所占的比例迅速增加，特别是在高危青年和青年成人群体中。然而，缺乏关于这些药物使用的信息，包括这些物质是什么，如何给药，以及为什么要开始使用。关于非医疗处方药（包括阿片类药物、CMS抑制剂和兴奋剂）的许多现有数据仅限于调查数据和老年使用者。缺乏关于高风险青年人群中处方药非医疗使用情况的描述性数据。我们建议对16至25岁的高风险青年（纽约和洛杉矶）进行比较研究，这些青年可能无家可归，参与街头经济，多重吸毒者和/或注射吸毒者。该项目的目的是：描述为什么高危青年开始使用非医疗处方药物；描述可获得的处方药形式的可变性以及在给药过程中所采用的行为实践；绘制从使用处方药过渡到使用其他类型管制药物的社会轨迹；并评估长期使用处方药对与接触艾滋病毒和性传播感染相关的行为发生风险增加的影响。该项目的目标将分三个研究阶段进行。第一阶段将包括一个为期六个月的社区评估过程（CAP），以收集每个城市现有的关于非医疗处方药使用的“当地知识”。第二阶段将包括对纽约和洛杉矶的150名处方药使用者进行为期9个月的定性研究。第三阶段将对纽约和洛杉矶的600名处方药使用者进行为期15个月的横断面定量调查。研究结果将为社区组织编制旨在减少高风险青年非医疗处方药物使用的课程提供信息。关于非医疗处方药物使用的公共卫生研究非常有限，目前对高危青少年如何面对他们的危险行为保持健康的生活水平知之甚少。拟议研究的结果将填补流行病学文献中关于高风险青年非医疗处方药使用的一个重要空白，这些青年面临负面健康后果的风险，包括药物依赖、药物过量、暴力、受害和接触血源性病原体。

DESCRIPTION (provided by applicant): Substantial evidence suggests that the diversion of prescription drugs for non-medical use accounts for a rapidly increasing share of substances of abuse, particularly among high-risk youth and young adult populations. Yet, there is a scarcity of information about the use of these drugs, including what the substances are, how they are administered, and why they are initiated. Much of the available data on non-medical prescription drugs, which includes opioids, CMS depressants, and stimulants, is limited to survey data and older populations of users. Descriptive data is lacking about the non-medical use of prescription drugs among high-risk youth populations. We are proposing a two-city (New York and Los Angeles) comparative study of high-risk youth aged 16 to 25 who may be homeless, participating in the street economy, polydrug users and/or injection drug users. The project aims are to: describe why high-risk youth initiate non-medical prescription drug use; describe variability in the forms of prescription drugs available and behavioral practices employed in their administration; chart the social trajectory of the transition from prescription drug use into other types of controlled substances; and assess the consequences of chronic use of prescription drugs on increased risk for onset of behaviors associated with exposure to HIV and STIs. The project aims will be addressed during three study phases. Phase One will consist of a six month Community Assessment Process (CAP) to gather existing "local knowledge" about non-medical prescription drug use in each city. Phase Two will comprise a nine month qualitative study of 150 prescription drug users in New York and Los Angeles. Phase Three will constitute a 15 month cross-sectional, quantitative survey of 600 prescription drug users in New York and Los Angeles. Study findings will inform the development of a curriculum for community-based organizations aimed at reducing non-medical prescription drug use among high-risk youth. Public health research on non-medical prescription drug use is extremely limited, and little is currently known about how high-risk youth maintain healthy living standards in the face of their risky behavior. Results from the proposed study will fill a critical gap in the epidemiological literature on non-medical prescription drug use among high-risk youth who are at risk for negative health outcomes, including drug dependence, drug overdose, violence, victimization, and exposure to bloodborne pathogens.