The non-medical use of Pharmaceuticals has been a long-standing problem in the United States, and since the 1970s the use of """"""""club drugs"""""""" has been a problem among adolescents and young adults. A recent trend has been the incursion of prescription drugs into the club culture, with the concomitant health consequences associated with their abuse. Because of their young age and their tendency to mix numerous drugs during any given drug binge, club drug users tend to be a highly vulnerable population. Within this context, the specific aims of this application are to;1) recruit a sample of 750 out-of-treatment prescription and club drugs abusers ages 18-39 and at baseline assess their life histories of alcohol and drug abuse onset and progression, and extent of current alcohol and prescription, club and other drug use;2) at 6, 12 and 18 months, assess changes in onset, progression, and extent of respondents'alcohol and prescription, club and other drug use;3) at baseline, 6, 12 months and 18 months, assess the mechanisms of access to prescription drugs among the sampled drug users;4) at baseline, 6, 12 and 18 months, investigate the impact of quantity, frequency, types and duration of prescription and club drug abuse on the nature and extent of health and social consequences within this population, including: sexual risk-taking and coercion;drug interactions and overdose;chronic drug use;impairment of daily activities;physical problems;mental health problems;and legal problems;and 5) examine the impact of gender and other potential correlates (sexual identity, sexual history, current sexual behaviors, drug history, and current drug use) on onset, progression, and extent of prescription, club and other drug abuse and the nature and extent of health and social consequences. The study sample will reflect the race/ethnic distribution of the Miami population: 30 percent white/Anglo, 50 percent Hispanic, and 20 percent African-American, with a gender distribution of 50 percent female and 50 percent male. A variety of statistical techniques will be used to describe the population, the epidemiology of prescription and other drug use in the club culture, and the nature and prevalence of related consequences. The short-term objectives are to describe the changing nature of prescription drug abuse/club drug use and their consequences in the Miami club culture. A broader long-term goal is to better understand current patterns of the abuse of prescription drugs and their incursion into the club culture, in order that strategies can be developed for reducing the abuse and diversion of these drugs in Miami and other communities. Such strategies and policies may ultimately reduce the abuse and diversion of prescription drugs, as well as make them more readily available to the patients for whom they are intended.
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