Document text
Principal Investigator: Greta Bushnell
Organization: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
Fiscal Year: 2024
Award: $58,998
Funding agency: National Institute on Drug Abuse
PROJECT SUMMARY/ABSTRACT.
This Mentored Research Scientist Development Award (K01) proposal will develop Dr. Greta Bushnell’s career
as an independent investigator, and enable her to advance into a new line of research focused on evaluating
misuse and abuse related morbidity of medicines prescribed to young people and the policies and practices that
can mitigate these harmful outcomes. This new direction of research requires distinct training in substance abuse
policy, misuse and abuse liability of prescription drugs, adolescent development of substance use, analysis of
state-level policies, and advanced methods to address confounding control. With a training program supported
by an experienced team of investigators, Dr. Bushnell will complete the proposed research, filling key gaps
surrounding benzodiazepine (BZD) misuse and abuse related harms in young people and modifiable factors to
reduce these harms. This research focus comes at a pertinent time of rising BZD-related morbidity, continued
prescribing, lack of safety data in youth at developmental risk for substance use problems, and current
opportunities to leverage opioid-related policies to reduce BZD-related harms. Overdose deaths involving BZDs
significantly increased in recent years with »11,500 deaths in 2017, partially attributed to the opioid crisis, and in
adolescents and young adults there were »39,000 emergency department visits for BZD-related poisonings in
2016. Despite BZDs being frequently prescribed to adolescents (3%) and young adults (6%), there are no
estimates on overdose risk following BZD treatment and it is unknown whether and to what extent BZD
prescribing to youth inadvertently increases risk of BZD or other substance misuse later in life. Prescription drug
monitoring programs (PDMPs) represent a potentially important, but understudied, means to mitigate BZD-
related morbidity. PDMPs are state-run surveillance systems collecting patient details on prescriptions for
controlled substances with capabilities to detect risky prescribing. Dr. Bushnell will use large, national
administrative claims data (2000/2001-2018) covering privately and publicly insured young people (10-29 years)
to evaluate whether selected state PDMP features decrease BZD-related harms and risky BZD prescribing in
young people (Aim 1). To evaluate individual-level risks, she will quantify overdose risk following BZD treatment
in young people compared to alternative treatments and by prescription details (Aim 2) using the national claims
datasets with measures from Area Health Resources Files. She will then evaluate whether adolescent BZD
treatment increases downstream risks of BZD misuse or harmful substance use in early adulthood (Aim 3) using
the nationwide Monitoring the Future sample of high school seniors with panel surveys into early adulthood
(»2,450/year, 1976-2016). The proposal will inform an R01 submission on identifying youth-specific risk factors
in the progression from treatment with BZDs, or other controlled substances, to abuse and leveraging this
knowledge to inform interventions. Addressing these questions and developing this new line of research are only
feasible with intensive training, support, and protected time, which the K01 can provide.
Terms: <12th grade><21+ years old><Address><Adolescent><Adolescent Development><Adolescent Youth><Adolescent and Young Adult><Adult><Adult Human><Age><Alternative Medicine><Anxiety><Area><Ataractics><Award><Benzodiazepine Compounds><Benzodiazepines><Cessation of life><Community Practice><Coping Skills><Data><Data Bases><Data Set><Databases><Death><Dependence><Detection><Development><Disease><Disorder><Dose><Drug Prescribing><Drug Prescriptions><Drug abuse><Drugs><ED visit><ER visit><Early Intervention><Electronics><Emergency care visit><Emergency department visit><Emergency hospital visit><Emergency room visit><Evaluation><Future><Harm Minimization><Harm Reduction><Health Resources><Heterogeneity><Individual><Intervention><Intervention Strategies><Investigators><K01 Award><K01 Mechanism><K01 Program><Knowledge><Life><Measures><Medicaid><Medical><Medication><Medicine><Mental Depression><Mental disorders><Mental health disorders><Mentored Research Scientist Development Award><Mentored Training Award><Methodology><Methods><Monitor><Morbidity><Morbidity - disease rate><Opiates><Opioid><Outcome><Overdose><Pathway interactions><Patients><Persons><Pharmaceutical Agent><Pharmaceutical Preparations><Pharmaceuticals><Pharmacologic Substance><Pharmacological Substance><Policies><Prescription Drug Monitoring Program><Prescription medication misuse><Privatization><Provider><Psychiatric Disease><Psychiatric Disorder><Public Health><Reporting><Research><Research Design><Research Personnel><Research Scientist Development Award><Researchers><Risk><Risk Factors><Running><Safety><Sampling><Sleep Disorders><Study Type><Substance abuse problem><Survey Instrument><Surveys><System><Time><Training><Training Programs><Tranquilizing Agents><Tranquillizing Drugs><Youth><Youth 10-21><abuse liability><abuse of drugs><abuse of substances><abuse potential><abuses drugs><adult youth><adulthood><age group><ages><alternative treatment><benzodiazepine abuse><benzodiazepine misuse><career><coping strategy><data base><depression><developmental><drug/agent><early adulthood><electronic><electronic device><emerging adult><experience><high school senior><improved><innovate><innovation><innovative><interventional strategy><juvenile><juvenile human><licit opioid><medication prescription><mental illness><misuse of prescription only drugs><non-medical prescription drug use><nonmedical prescription drug use><opiate consumption><opiate crisis><opiate drug use><opiate intake><opiate medication><opiate use><opioid consumption><opioid crisis><opioid drug use><opioid epidemic><opioid intake><opioid medication><opioid use><overdose death><overdose fatalities><overdose risk><pathway><pharmaceutical><prescribed medication><prescribed opiate><prescribed opioid><prescription drug misuse><prescription misuse><prescription monitoring program><prescription opiate><prescription opioid><prevent><preventing><programs><psychiatric illness><psychological disorder><risk stratification><sedative><sleep diseases><sleep dysfunction><sleep illness><sleep problem><stratify risk><study design><substance abuse><substance misuse><substance use><substance using><tranquilizer><treatment risk><twelfth grade><young adult><young adulthood>