Adolescents’ legitimate use of prescription opioids is associated with increased risk for misusing the painkillers when they are adults, according to a new study. This especially holds true for teens who disapprove of illegal drug use and have little experience using drugs.
“The findings are somewhat counterintuitive. … To the extent (physicians are) concerned about the potential for future misuse, it’s the kids who they might not have expected who are at highest risk,” said Richard A. Miech, Ph.D., research professor at the University of Michigan’s Institute for Social Research.
Dr. Miech co-authored the study “Prescription Opioids in Adolescence and Future Opioid Misuse (Miech R, et al. Pediatrics. Oct. 26, 2015, http://pediatrics.aappublications.org/content/early/2015/10/21/peds.2015-1364).
Researchers used data from the University of Michigan’s Monitoring the Future study, which surveys 12th-graders across the country and then follows up with a sample of them in the years after. They then created a model to predict future opioid misuse after high school using characteristics like whether the students previously had used marijuana and their attitudes toward drugs.
The team found that those who were prescribed opioids as adolescents had a 33% higher risk of misusing them by age 23 compared to those who never had been prescribed the drugs.
Of the eight strata the team developed to predict risk, those in the second and third lowest perceived risk groups — those who had negative attitudes about drugs and little experience using them were significantly more likely to misuse opioids in the future than any other stratum.
However, frequency of opioid misuse among the people in those two groups was low, typically with five or fewer uses in the last year. The most common reasons respondents gave for misuse were “to feel good or get high” and “to relax or relieve tension,” according to the report.
Researchers theorized that adolescents initially perceived as low-risk may have gone on to misuse opioids due to the novelty. After having used them legitimately, they may have perceived them as safe and pleasurable, the report stated.
There were a few limitations to the study, including a lack of details about the initial opioid prescription and family history. The study also did not include people who dropped out of school before 12th grade.
Dr. Miech said the study helps fill a gap in research about opioid use among adolescents
and can help physicians and parents alike make more informed decisions.