PROJECT SUMMARY/ABSTRACT
Published work by the research team and data strongly suggest that prevalence rates and consequences of
nonmedical prescription drug use (NMPDU) in older adults are increasing. That said, the specifics of NMPDU
processes in this group are virtually unknown, with only three published studies that include older adults and
examine NMPDU correlates. The long-term goal of the research team is to better understand nonmedical users
and NMPDU processes (e.g., motives, diversion sources) across the lifespan, aiding intervention developers by
identifying treatment targets and vulnerable subgroups of nonmedical users. In this application, using data from
multiple years of the National Survey on Drug Use and Health (NSDUH), [the IMS National Prescription Audit
and the NVSS Multiple Causes of Death files], the overall objectives are to: one, to better characterize older
adult opioid, tranquilizer (primarily composed of benzodiazepines), [stimulant and sedative] NMPDU by
establishing correlates, diversion sources, motives, and other key NMPDU indicators [and their relationships with
NMPDU-related mortality]; two, to evaluate potential moderators in the NMPDU-correlate relationships, and
factors (e.g., sex) associated with other NMPDU processes; and three, to establish latent classes of older adult
nonmedical users of opioids, tranquilizers, [stimulants and sedatives]. Variable selection was guided by an
adapted version of the Comprehensive Developmental Model of risk factors across different developmental
periods, and all findings will be compared to those in younger cohorts, either directly in analyses or through
comparison to previously published work. The rationale for this proposal is that better characterization of older
adult NMPDU, including correlates, diversion sources, motives, and NMPDU subgroups will provide clearer
targets for interventions to limit rates of NMPDU in older adults and the potential consequences of such
nonmedical use. The contribution of this proposal will be significant because it will allow clinicians to identify
older adult nonmedical users, particularly those who are most vulnerable to NMPDU-related consequences, and
it will allow intervention developers to better craft robust prevention and treatment programs to limit and/or treat
NMPDU in older adults. Furthermore, the research proposed here is innovative because it represents a
significant departure from the current state of the field by applying accepted techniques and analyses, all
previously utilized by the research team, to better characterize a vulnerable group of nonmedical users about
whom very little is known, older adults. Other sources of innovation include the use of a nationally representative
and large sample, inclusion of [multiple data sets and] a wide variety of NMPDU indicators to better characterize
older adults engaged in NMPDU, and selection of analyses that examine sociodemographic and other
developmentally-based moderators of key NMPDU processes. Rapid dissemination of the knowledge derived
from this proposal has the potential to inform the development of maximally valid intervention options to prevent
or reduce older adult NMPDU and its consequences, all of which is consistent with the mission of NIDA.