1 sampson & laub (2004). criminology, 41 (3): 555-592
TRANSCRIPT
Drug Abuse Epidemiology Datasets
Wilson M. Compton, M.D., M.P.E.Director, Division of Epidemiology, Services and Prevention Research
National Institute on Drug Abuse
16 May 2007
3
Primary ConceptsPrimary Concepts
1.Do the major datasets provide good secondary analysis scientific opportunities?
2.How can NIDA promote use of these resources?
Ultimate Goal is to Enhance the Process of Scientific Discovery
5
Changes in Current Smoking Among US Students Before/After Launch of the "truth" Campaign in 2000Grade 1997 2002 Change 1997-1999 2000-2002
All 28.0 18.0 –35.7 –3.2 (–3.8, –2.6) –6.8 (–7.5, –6.1)
8th 19.4 10.7 –44.8 –3.4 (–4.6, –2.1) –9.0 (–10.4, –7.6)
10th 29.8 17.7 –40.6 –4.6 (–5.6, –3.6) –8.7 (–9.8, –7.5)
12th 36.5 26.7 –26.8 –1.8 (–2.7, –1.0) –5.1 (–6.1, –3.9)
Farrelly et al, AJPH 2005;95:425-431
Odds of smoking
Media market exposure (48 states shown) of the national "truth" campaign, 2000–2002
Ave. Cumulative GRP x 10,000
6
0
1
2
3
4
5
Odd Ratio for Reporting Chance to Buy Drugs
Aggression, Delinquency, and Opportunity to Buy Drugs: NHSDA
Rosenberg & Anthony, Drug Alc Dependence 2001;63:245-252
Delinquency
Aggression
Low
Low
Low
High
High
Low
High
High
* P < .01 Compared to Low/Low
Reference Group
*
*
7
10
20
30
40
50
60
70
80
90
Cigarettes Alcohol Marijuana Cocaine Rx
White
Afr-Am
Lifetime Prevalence of Use Among Whites and African Americans 12+ Years Old (NSDUH 2004)
Denise Kandel, NIDA Trajectories Conference 11/13/2006]
Per
cent
age
of L
ifetim
e U
se
***
***
***
*** ***
8
10
20
30
40
50
60
70
80
12-17 18-25 26-34 35-49
White 2004Afr-Am 2004
Current Smoking by Age Among White and African American Lifetime Smokers in 2004 and in the 1973-1978 Birth Cohorts in 1990, 1996 and 2004 (NHSDA/NSDUH )
Per
cent
age
of L
ast M
onth
Use
Age CategoryDenise Kandel, NIDA Trajectories Conference 11/13/2006
9
Current Smoking by Age Among White and African American Lifetime Smokers in 2004 and in the 1973-1978 Birth Cohorts in 1990, 1996 and 2004 (NHSDA/NSDUH )
10
20
30
40
50
60
70
80
12-17 18-25 26-34 35-49
Per
cent
age
of L
ast M
onth
Use
Age Category
White 1973-78 birth cohortAfr-Am 1973-78 birth cohort
1990
1990
1996
1996
20042004
2004
2004
Denise Kandel, NIDA Trajectories Conference 11/13/2006
10
Current Smoking by Age Among White and African American Lifetime Smokers in 2004 and in the 1973-1978 Birth Cohorts in 1990, 1996 and 2004 (NHSDA/NSDUH )
10
20
30
40
50
60
70
80
12-17 18-25 26-34 35-49
Per
cent
age
of L
ast M
onth
Use
Age Category
White 2004Afr-Am 2004
White 1973-78 birth cohortAfr-Am 1973-78 birth cohort
1990
1990
2004
2004
1996
1996
2004
20042004
2004
2004
2004
Denise Kandel, NIDA Trajectories Conference 11/13/2006
11
1011121314151617181920212223
Cigarettes Alcohol Marijuana Cocaine Rx
White
Afr-Amer
Mean Ages of Onset of Substances Among Whites and African Americans 18-49 Years Old (NSDUH 2004)
Mea
n A
ge o
f O
nset
***
*** ***
***
*
Denise Kandel, NIDA Trajectories Conference 11/13/2006
12
Last Year Dependence Among Lifetime Users Age 12+ Among Whites and African Americans (NSDUH 2004)
5
10
15
20
25
Nicotine Alcohol Marijuana Cocaine Non-RX
White
Afr-Am
Per
cen
t D
epen
den
t
***
***
**
Denise Kandel, NIDA Trajectories Conference 11/13/2006
13
Last Year Dependence Among Lifetime MJ Users by Age Among Whites & African Americans (NSDUH 2004)
Per
cent
age
of L
ast
Yea
r D
epen
denc
e
Age Category
WhiteAfr-Am
Denise Kandel, NIDA Trajectories Conference 11/13/2006
5
10
15
20
25
30
12-17 18-25 26-34 35-49
14
5
10
15
20
25
30
12-17 18-25 26-34 35-49
Last Year Dependence Among Lifetime Cocaine Users by Age Among Whites and African Americans (NSDUH 2004)
Per
cent
age
of L
ast
Yea
r D
epen
denc
e
Age Category
WhiteAfr-Am
Denise Kandel, NIDA Trajectories Conference 11/13/2006]
15
1.5%
0.5%0.3%
2.3%
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
Misuse Disorder
1991-1992 NLAES 2001-2002 NESARC
Prescription Drug Misuse and Disorders in 1991-1992 (NLAES) and 2001-2002 (NESARC)
Blanco C et al., in press
* P < 0.01
*
*
16
1. Examples of National U.S. Cross-Sectional Data
1. Examples of National U.S. Cross-Sectional Data
1) Monitoring the Future (MTF)
2) National Survey on Drug Use and Health (NSDUH)
3) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)
4) National Comorbidity Survey (NCS) and related
5) Youth Risk Behavior Survey (YRBS)
6) Treatment Episode Data Set (TEDS)
7) Drug Abuse Warning Network (DAWN)
17
Select Examples of Other Large Data SetsSelect Examples of Other Large Data Sets
1) Adolescent Treatment Studies
2) SPF-SIG data
3) Criminal Justice Datasets
4) Medicaid and Medicare Administrative Data
5) V.A. Health Care Data
6) Large Managed Care Systems (e.g. Group Health Plan, Kaiser)
7) NIDA’s Clinical Trials Network (CTN) Database: www.ctndatashare.org
19Jackson et al. J Abnormal Psychology 2005;114:612-626
Smoking Intensity Decreasing Across Birth Cohorts But Stable Across Time (MTF Data)Smoking Intensity Decreasing Across Birth
Cohorts But Stable Across Time (MTF Data)
21
NSPY Study: Distinguishing Vulnerable/Resolute Non-Using Adolescents
NSPY Study: Distinguishing Vulnerable/Resolute Non-Using Adolescents
0.0%
37.5%
57.8%66.2%
0.0%9.6%
19.3%26.0%
0%
20%
40%
60%
80%
100%
Round 1 Round 2 Round 3 Round 4
Vulnerable Resolute
Crano WD, NSPY Users Group Meeting May 2007
Sample with complete data at all rounds, Ages 12-18 (N = 2111)
Predictors:
Demographic
Social
Academic
Parental
Peer
Other substances
Marijuana Use
22
Benefit Cost Markedly Greater for Life Course View of Heroin Addiction (DATOS)
05
10152025303540
1 Tx Episode Life CourseZarkin et al. Health Economics 005;14:1133-1150
24
1) Monitoring the Future (MTF)
2) National Survey of Parents and Youth (NSPY)
3) Drug Abuse Treatment Outcomes Study (DATOS)
4) Adolescent Health (AddHealth)
5) National Longitudinal Survey of Youth (NLSY)
6) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)
2. Examples of National U.S. Longitudinal Data
2. Examples of National U.S. Longitudinal Data
25
Select Examples of Other Large Data SetsSelect Examples of Other Large Data Sets
1) Adolescent Treatment Studies
2) Multi-wave locally representative data
Great Smoky Mountain Study
and more than 50 others….
27
Access to DataAccess to Data
1) SAMHDA Website http://www.icpsr.umich.edu/SAMHDA/
28
Access to DataAccess to Data
1) SAMHDA Website http://www.icpsr.umich.edu/SAMHDA/
2) UCLA Data Program Project (Bentler, PI) and Penn State Prevention Methods Center (Collins, PI)
3) Confidentiality concerns
29
Knowledge of data setsKnowledge of data sets
1) Common problem in using data collected by someone else
2) Solutions: Seminars, publications, user-groups
1) NSPY User Group
2) NESARC User Group
30
3. Improving Use of Data3. Improving Use of Data
1) Support for secondary work• Gene Environment Development
Initiative (GEDI)
2) Support for release and access to data?
3) Developing common metrics for newly proposed studies that are not primarily concerned with drug abuse/addiction?
31
ConclusionsConclusions
Multiple rich sources of data exist and provide opportunities for developing and testing important hypotheses.
Promoting the effective and efficient use of these data requires management and strategic planning.