Degenhardt Louisa, Coffey Carolyn, Carlin John B, Moran Paul, Patton George C
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Addiction. 2007 Aug;102(8):1269-79. doi: 10.1111/j.1360-0443.2007.01906.x.
Despite good evidence of increased availability and use of amphetamines world-wide, relatively little is known about the epidemiology of young adult amphetamine use; relationships with social functioning, other drug use and mental health at this age; nor of the adolescent predictors of such use. We examined these issues using a representative cohort of young people followed-up in Victoria, Australia.
A stratified, random sample of 1943 adolescents was recruited from secondary schools across Victoria at age 14-15 years. This cohort was interviewed on eight occasions until the age of 24-25 years (78% follow-up at that age). Cross-sectional and predictive associations were assessed using logistic regression.
At age 24 years, 12% of the sample had used amphetamines in the past year, with 1-2% using at least weekly. Young adult amphetamine use was predicted strongly by adolescent drug use and was associated robustly with other drug use and dependence in young adulthood. Associations were stronger for more frequent users. Among young adults who had not been using amphetamines at age 20 years, the strongest predictor of use at age 24 years was the use of other drugs, particularly cannabis, at 20 years. Psychological distress did not predict independently an increased likelihood of amphetamine use in this cohort.
Young people in Australia using amphetamine at age 24 years are highly likely to be significant polydrug users. The risks for both initiation of young adult amphetamine use, and maintenance of such use, pertain to the heavy use of other drugs. Interventions for heavy amphetamine users at this age are likely to require attention to multiple drug problems.
尽管有充分证据表明全球苯丙胺的可获得性和使用量有所增加，但对于年轻成年人使用苯丙胺的流行病学情况、该年龄段使用苯丙胺与社会功能、其他药物使用及心理健康之间的关系，以及青少年使用苯丙胺的预测因素，我们了解得相对较少。我们利用澳大利亚维多利亚州一个具有代表性的年轻人队列对这些问题进行了研究。
从维多利亚州的中学中随机抽取了1943名14至15岁的青少年作为分层样本。该队列接受了八次访谈，直至24至25岁（该年龄的随访率为78%）。使用逻辑回归评估横断面和预测性关联。
在24岁时，12%的样本在过去一年中使用过苯丙胺，其中1%至2%的人至少每周使用一次。青少年药物使用是年轻成年人使用苯丙胺的有力预测因素，并且与年轻成年人中的其他药物使用和药物依赖密切相关。对于使用频率更高的使用者，这种关联更强。在20岁时未使用苯丙胺的年轻成年人中，24岁时使用苯丙胺的最强预测因素是20岁时使用其他药物，尤其是大麻。在这个队列中，心理困扰并不能独立预测使用苯丙胺的可能性增加。
在澳大利亚，24岁使用苯丙胺的年轻人极有可能是大量使用多种药物的人。年轻成年人开始使用苯丙胺以及持续使用苯丙胺的风险都与大量使用其他药物有关。针对这个年龄段大量使用苯丙胺的使用者进行干预可能需要关注多种药物问题。
