Introduction to neuropharmacology and neurodegenerative diseases
Neuropharmacology: Epidemiology
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Transcript of Neuropharmacology: Epidemiology
Epidemiology of Drug Use
Brian J. Piper, Ph.D.
Epidemiology
• Study of diseases in population• Descriptive, not inferential (+ who, - why)
– Nitrites “poppers”– LSD
http://bmj.bmjjournals.com/epidem/epid.1.html
Goals
• Monitoring the Future (MtF): self-report survey of 8th - 12th grades
• National Household Survey of Drug Use and Health (NHSDUH): interviews of age 12+
• Drug Abuse Warning Network (DAWN): ER reports
• United Nations World Drug Report
http://www.monitoringthefuture.org/http://www.oas.samhsa.gov/public.cfm
Monitoring the Future
• National survey, conducted annually by NIDA of secondary school (8th, 10th, or 12th), college students, and adults (<45 yrs)
• Missing data (drop-outs = 15%, not attending) = under-estimation
• Concern about labels (inadvertent marketing)• Self-report
– Knowledge (e.g. steroids, diet pills, club drugs)– Memory (e.g. How many drinks?)– Taboo
http://www.monitoringthefuture.org/
Demographics
• Compares use by:– Year (1975 – present)– Sex– Ethnicity– Parental education– Region– College plans
?
Year & Grade
Illicit = Scheduled drugs including marijuana, heroin, cocaine, methamphetamine, LSDNot Illicit: EtOH, cigarettes, inhalants, Ritalin for medical purposes
When does use start?
What about ethnicity?
• Ranking:– African-American– Hispanic– White
Subjective Effects
AlcoholAmphetaminesCocaineHeroinLSDMarijuanaOther HallucinogensOther Narcotics
Subjective Effects
Young Adults: 19-30
How do college student differ from others in Alcohol and Nicotine Use?
How do college student differ from others in Alcohol and Nicotine Use?
D.A.R.E.
• Founded in 1983 by Daryl Gates• Police officers give lectures to middle school• Found in 80% of U.S. school districts, 54
nations• Cohen’s d = (MeanD.A.R.E. – MeanControl )/ SDpop
d = 0.30 small, 0.50 medium, 0.70 large
http://www.dare.com/home/default.asp
Does D.A.R.E work?
Ennett S.T. (1994). American Journal of Public Health, 84, 1394-1401.
National Household Surveyon Drug Use & Health
• Face to Face 4 hour Interview (N=4,500)
• Nationally representative
• Excludes prisoners, transients
• Statistical Significance: *p < .05
• But clinical (real world) significance?
https://nsduhweb.rti.org/
Treatment Options
Treatment Options
Drug Abuse Warning Network
• Nationwide reports of ER/ED visits
• 242 hospitals nationwide
• Drug is “implicated”– Overdose– Suicide– Accident
2009
http://www.samhsa.gov/data/2k11/DAWN/2k9DAWNED/HTML/DAWN2k9ED.htm
http://www.samhsa.gov/data/2k11/DAWN/2k9DAWNED/HTML/DAWN2k9ED.htm
EthnicityAlcohol Illicit
White 59.6% 50.1%
Black 19.2% 26.9%
Hispanic 12.4% 13.1%
Other/Unknown 8.8% 9.9%
http://www.samhsa.gov/data/2k11/DAWN/2k9DAWNED/HTML/DAWN2k9ED.htm
EthnicityAlcohol Illicit National (2010 Census)
White 59.6% 50.1% 63.7%
Black 19.2% 26.9% 12.6%
Hispanic 12.4% 13.1% 16.3%
Other/Unknown 8.8% 9.9% 7.4%
http://www.samhsa.gov/data/2k11/DAWN/2k9DAWNED/HTML/DAWN2k9ED.htm
UNWDR
• United Nations World Drug Report
• Pooled data from various countries with various methods
• Provides information about drug use, treatment, and drug seizures
Annual Use
Injection Drug Use
Summary
• Data Sources:– Monitoring the Future (Survey)
– National Household Survey on Drug Use & Health (Interview)
– Drug Abuse Warning Network (ED)
– Patterns: • Year• Age• Ethnicity• Other: College Plans
Thought question
• Design an empirically based drug education program for high-school students.– What drugs would you target?– What ages?– Would ethnicity or other factors be involved in
your design making process?
http://learn.genetics.utah.edu/content/addiction/drugs/mouse.html