McCabe Sean Esteban, Veliz Philip, Wilens Timothy E, Schulenberg John E
Institute for Research on Women and Gender, University of Michigan, Ann Arbor; Substance Abuse Research Center, University of Michigan.
Institute for Research on Women and Gender, University of Michigan, Ann Arbor.
J Am Acad Child Adolesc Psychiatry. 2017 Mar;56(3):226-233.e4. doi: 10.1016/j.jaac.2016.12.008. Epub 2016 Dec 25.
To assess the prospective 17-year relationship between the medical and nonmedical use of prescription stimulants during adolescence (age 18 years) and educational attainment and substance use disorder (SUD) symptoms in adulthood (age 35 years).
A survey was self-administered by nationally representative probability samples of US high school seniors from the Monitoring the Future study; 8,362 of these individuals were followed longitudinally from adolescence (age 18, high school senior years 1976-1996) to adulthood (age 35, 1993-2013).
An estimated 8.1% reported medical use of prescription stimulants, and 16.7% reported nonmedical use of prescription stimulants by age 18 years. Approximately 43% of adolescent medical users of prescription stimulants had also engaged in nonmedical use of prescription stimulants during adolescence. Among past-year adolescent nonmedical users of prescription stimulants, 97.3% had used at least one other substance during the past year. Medical users of prescription stimulants without any history of nonmedical use during adolescence did not differ significantly from population controls (i.e., non-attention-deficit/hyperactivity disorder [ADHD] and non-stimulant-medicated ADHD during adolescence) in educational attainment and SUD symptoms in adulthood. In contrast, adolescent nonmedical users of prescription stimulants (with or without medical use) had lower educational attainment and more SUD symptoms in adulthood, compared to population controls and medical users of prescription stimulants without nonmedical use during adolescence.
Nonmedical use of prescription stimulants is common among adolescents prescribed these medications. The findings indicate youth should be carefully monitored for nonmedical use because this behavior is associated with lower educational attainment and more SUD symptoms in adulthood.
评估青少年期（18岁）处方兴奋剂的医疗和非医疗使用与成年期（35岁）教育程度及物质使用障碍（SUD）症状之间未来17年的关系。
来自“监测未来”研究的具有全国代表性的美国高中高年级学生概率样本进行了自我管理调查；其中8362人从青少年期（18岁，1976 - 1996年高中高年级）到成年期（35岁，1993 - 2013年）进行了纵向跟踪。
估计8.1%的人报告在18岁前有过处方兴奋剂的医疗使用，16.7%的人报告有过处方兴奋剂的非医疗使用。约43%的青少年处方兴奋剂医疗使用者在青少年期也有过处方兴奋剂的非医疗使用。在过去一年中使用过处方兴奋剂的青少年非医疗使用者中，97.3%在过去一年中还使用过至少一种其他物质。在青少年期没有任何非医疗使用史的处方兴奋剂医疗使用者在成年期的教育程度和SUD症状方面与总体对照组（即青少年期无注意力缺陷多动障碍[ADHD]且未使用兴奋剂治疗的ADHD患者）没有显著差异。相比之下，与总体对照组以及青少年期无非医疗使用史的处方兴奋剂医疗使用者相比，青少年期处方兴奋剂非医疗使用者（无论有无医疗使用）在成年期的教育程度较低，SUD症状较多。
在开具这些药物处方的青少年中，非医疗使用处方兴奋剂很常见。研究结果表明，应密切监测青少年的非医疗使用情况，因为这种行为与成年期较低的教育程度和较多的SUD症状有关。
