在青春期注意力缺陷/多动性障碍的兴奋剂使用后,在青春期使用可卡因或甲基胺
Sean Esteban McCabe1,2,3,4, John E Schulenberg1,3,5, Timothy E Wilens1,6,7
1Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor.
JAMA network open
|July 11, 2023
概括
青少年ADHD兴奋剂治疗没有增加后来的非法兴奋剂使用. 然而,青少年对处方兴奋剂的滥用显著增加了青少年使用可卡因和甲基胺的风险.
科学领域:
- 神经科学和行为健康
- 公共卫生和流行病学
背景情况:
- 对注意力缺陷/多动障碍 (ADHD) 的处方兴奋剂的使用在美国有所增加.
- 处方兴奋剂经常被青少年滥用,过量服用死亡人数显著增加.
- 从处方兴奋剂过渡到可卡因和甲基胺等非法物质的过程尚不清楚.
研究的目的:
- 调查青少年处方兴奋剂暴露与年轻成年人可卡因/甲胺使用之间的纵向联系.
- 要区分与处方ADHD兴奋剂治疗与处方兴奋剂滥用 (PSM) 相关的风险.
主要方法:
- 一项全国纵向研究追踪了2005-2017年美国12年级学生.
- 参与者每年被评估6年,直到23-24岁.
- 结果包括过去一年在年轻成人时期使用可卡因和甲基胺.
主要成果:
- 青少年ADHD兴奋剂治疗与年轻成年人可卡因或甲基胺使用的增加没有显著联系.
- 青少年滥用处方兴奋剂 (没有ADHD治疗) 显示后来的可卡因/甲基胺使用率明显更高 (aOR=2.64).
- 人口控制 (没有兴奋剂暴露) 作为风险评估的比较组.
结论:
- 青少年的ADHD兴奋剂治疗似乎没有提高后续非法兴奋剂使用的风险.
- 青春期处方兴奋剂的滥用是过渡到可卡因或甲基胺使用的重要风险因素.
- 对青少年PSM的查和监测对于预防未来的物质使用障碍至关重要.
相关概念视频
Attention-Deficit/Hyperactivity Disorder
132
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity. It affects approximately 5-8% of children globally, with around 60-70% of cases persisting into adulthood. ADHD has significant implications for educational attainment, social interactions, and occupational success.
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings....
132
CNS Stimulants: Cocaine, Amphetamines and Cannabinoids
255
CNS stimulants, such as cocaine, amphetamines, and cannabinoids, have varying structures and mechanisms of action that lead to different therapeutic effects and side effects. Cocaine, with its molecular formula C17H21NO4, is a tropane alkaloid and a tertiary amino compound. It has two chemical forms: the hydrochloride salt and the "freebase." The former is in powder form, while the latter involves removing the hydrochloride salt to create a form that can be smoked. Cocaine exerts its...
255
Stimulants
249
Stimulants are substances that enhance neural activity and elevate dopamine levels in the brain, leading to their highly addictive nature. These drugs include cocaine, amphetamines, MDMA, caffeine, and nicotine, each with distinct mechanisms of action and varied health implications.
Cocaine can be administered via snorting, injection, or smoking. It primarily functions by blocking the reuptake of dopamine, resulting in a euphoric high characterized by an intense sensation of happiness and...
Cocaine can be administered via snorting, injection, or smoking. It primarily functions by blocking the reuptake of dopamine, resulting in a euphoric high characterized by an intense sensation of happiness and...
249
Drug Abuse and Addiction: Pharmacological Phenomena
544
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
544
Substance Use Disorders Affecting Sleep
198
Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
Understanding the concepts of physical dependence,...
198
Adrenergic Agonists: Indirect-Acting Agents
1.7K
Indirect-acting adrenergic agonists potentiate the effects of endogenous catecholamines through different mechanisms without directly binding to adrenoceptors.
One mechanism involves depleting stored catecholamines by displacing them from synaptic vesicles. These agents, known as "displacers," are transported into vesicles at the expense of noradrenaline. Examples include amphetamine and tyramine, which lack a catechol moiety, resulting in prolonged action, improved oral...
One mechanism involves depleting stored catecholamines by displacing them from synaptic vesicles. These agents, known as "displacers," are transported into vesicles at the expense of noradrenaline. Examples include amphetamine and tyramine, which lack a catechol moiety, resulting in prolonged action, improved oral...
1.7K


