Methamphetamine Abuse: Long-Term Trajectories, Correlates, Treatment Effects

摘要 十五年来， 美国各地的甲基苯丙胺（MA）及其使用的后果 引起关注，并加大努力，以改善拦截，预防， 治疗战略，并优先进行研究，为这些战略提供信息。有限 关于MA滥用的生命过程的信息，特别是作为MA使用者， 年龄需要进一步研究，为制定战略提供经验支持， 解决老年用户特有的问题。该项目是596个项目的后续项目。 先前研究的MA使用者，一半从药物治疗参与中招募，一半从 相同的社区，但在招募时没有接受过MA治疗。项目 将使用自然历史访谈收集数据，以增加平均8年的 关于这些MA使用者的物质使用、治疗和犯罪生涯的详细历史; 这些新的数据与以前收集的数据相结合， 轨迹平均持续时间至少28年，涵盖青少年和成人时期。 其他数据将来自几个州机构的行政记录。的 样本为35%女性/65%男性，33%西班牙裔/38%非西班牙裔白色/17%非洲裔- 美国人/12%其他种族受试者的年龄范围为约28至74岁（平均 42)在后续研究开始时。分析将描述目前的状况， 扩展MA使用历史，检查MA和其他药物使用的模式，包括 升级，减速，可能的停止和恢复;检查药物治疗 使用模式和与MA使用模式的关系;并确定健康发病率 和死亡率，并评估存活和死亡用户之间的差异。研究 还将评估以前确定的长期结果（14年或更长时间） 药物治疗事件（针对从治疗中招募的子样本）。此外该 这项研究将估计滥用MA的累积社会成本， 犯罪活动、监禁、戒毒服务、健康和心理健康 服务和福利制度的参与;它将研究成本的差异 这与千年生态系统评估使用的独特模式和用户特点有关。分析方法将 包括增长模型和增长混合模型，以利用轨迹评估并购， 它们与服务利用率、其他事件和所选用户特征的关系。

ABSTRACT A decade and a half of rapidly increasing use of and geographic penetration of methamphetamine (MA) across the U.S. and the consequences of its use have generated concern and increasing efforts to improve interdiction, prevention, and treatment strategies, with a priority on research to inform these strategies. Limited information is available regarding the life course of MA abuse, particularly as MA users age. Further research is needed to provide empirical support for developing strategies to address issues specific to older users. The proposed project is a follow-up of 596 previously studied MA users, half recruited from drug treatment participation, half from the same communities but with no prior treatment for MA use at recruitment. The project will collect data using the Natural History Interview to add an average of 8 years of detailed histories on substance use, treatment, and criminal careers of these MA users; these new data combined with previously collected data will produce life course trajectories averaging at least 28 years in duration, covering teen and adult periods. Additional data will come from administrative records from several state agencies. The sample is 35% female/65% male, 33% Hispanic/38% non-Hispanic White/17% African- American/12% other ethnicity. Subjects will range in age from about 28 to 74 (average 42) at beginning of the follow-up study. Analyses will describe the current status and extended MA use histories, examining patterns of MA and other drug use, including escalation, deceleration, and possible cessation and recovery; examine drug treatment utilization patterns and relationship to MA use patterns; and determine health morbidity and mortality and assess differences between surviving and deceased users. The study will also assess the long-term outcomes (14 or more years) of a previously identified drug treatment episode (for the subsample recruited from treatment). In addition, the study will estimate cumulative social costs of MA abuse for the sample in terms of criminal activity, incarceration, drug treatment services, health and mental health services, and welfare system participation; and it will examine differences in costs related to distinctive patterns of MA use and user characteristics. Analysis methods will include growth models and growth mixture models to assess MA use trajectories and their relationships to services utilization, other events, and selected user characteristics.