Nargiso Jessica E, Ballard Erica L, Skeer Margie R
Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, Massachusetts.
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts.
J Stud Alcohol Drugs. 2015 Jan;76(1):5-20.
The purpose of this study was to identify the strongest and most consistent risk and protective factors associated with nonmedical use of prescription drugs (NMUPD) in multiple contexts, specifically in community-, school-, interpersonal-, and individual-level domains.
A literature search was conducted to review studies published from 2006 to 2012 that examined NMUPD among adolescents. Included were original research studies that focused specifically on risk and protective factors or review articles that included a section on factors associated with NMUPD. Risk and protective factors were included only if a minimum of two methodologically sound research studies reviewed the variable.
A variety of risk and protective factors were associated with adolescent NMUPD. At the community level, evidence suggested that ease of access increased the risk of NMUPD. Parental and peer prescription drug use and approval of NMUPD were associated with misuse of prescription drugs within the interpersonal domain. At the school level, academic failure/low educational attainment was associated with high school student NMUPD. However, results for college students' academic failure and NMUPD were inconclusive. At the individual level, previous use of substances was found to be a significant risk factor for NMUPD, as was adolescent aggressive/delinquent behavior and lower [corrected] perceived risk or harm of use.
NMUPD is a serious concern among adolescents and emerging adults. Several areas exist for prevention efforts within the context of the community, school, interpersonal, and individual domains. Thus, to curb NMUPD, multifaceted approaches are needed that target factors across multiple domains.
本研究旨在确定在多种背景下，特别是在社区、学校、人际和个人层面领域中，与非医疗目的使用处方药（NMUPD）相关的最强且最一致的风险因素和保护因素。
进行文献检索，以回顾2006年至2012年发表的关于青少年非医疗目的使用处方药的研究。纳入的研究包括专门关注风险和保护因素的原创性研究，或包含与非医疗目的使用处方药相关因素章节的综述文章。只有当至少两项方法学上合理的研究对该变量进行了综述时，才纳入风险和保护因素。
多种风险和保护因素与青少年非医疗目的使用处方药有关。在社区层面，有证据表明获取的便利性增加了非医疗目的使用处方药的风险。父母和同伴使用处方药以及对非医疗目的使用处方药的认可与人际领域内的处方药滥用有关。在学校层面，学业失败/低教育程度与高中生非医疗目的使用处方药有关。然而，大学生学业失败与非医疗目的使用处方药的结果尚无定论。在个人层面，发现既往使用物质是一个重要的风险因素，青少年的攻击/犯罪行为以及较低的（校正后）对使用风险或危害的认知也是如此。
非医疗目的使用处方药是青少年和刚成年人群体中一个严重的问题。在社区、学校、人际和个人领域的背景下，存在几个预防工作的领域。因此，为了遏制非医疗目的使用处方药，需要采取多方面的方法来针对多个领域的因素。
