Prescription opioid misuse has become a leading cause of unintentional injury and death among adolescents and young adults in the United States. However, there is limited information on how adolescents and young adults obtain prescription opioids. There are also inadequate recent data on the prevalence of additional drug abuse among those misusing prescription opioids. In this study, we evaluated past-year prevalence of prescription opioid use and misuse, sources of prescription opioids, and additional substance use among adolescents and young adults.
This was a retrospective analysis of the National Survey on Drug Use and Health (NSDUH) for the years 2015 and 2016. Prevalence of opioid use, misuse, use disorder, and additional substance use were calculated with 95% confidence intervals (CIs), stratified by age group and other demographic variables. Sources of prescription opioids were determined for respondents reporting opioid misuse. We calculated past-year prevalence of opioid use and misuse with or without use disorder, sources of prescription opioids, and prevalence of additional substance use. We included 27,857 adolescents (12–17 years of age) and 28,213 young adults (18–25 years of age) in our analyses, corresponding to 119.3 million individuals in the extrapolated national population. There were 15,143 respondents (27.5% [95% CI 27.0–28.0], corresponding to 32.8 million individuals) who used prescription opioids in the previous year, including 21.0% (95% CI 20.4–21.6) of adolescents and 32.2% (95% CI 31.4–33.0) of young adults. Significantly more females than males reported using any prescription opioid (30.3% versus 24.8%, P < 0.001), and non-Hispanic whites and blacks were more likely to have had any opioid use compared to Hispanics (28.9%, 28.1%, and 25.8%, respectively; P < 0.001). Opioid misuse was reported by 1,050 adolescents (3.8%; 95% CI 3.5–4.0) and 2,207 young adults (7.8%; 95% CI 7.3–8.2; P < 0.001). Male respondents using opioids were more likely to have opioid misuse without use disorder compared with females (23.2% versus 15.8%, respectively; P < 0.001), with similar prevalence by race/ethnicity. Among those misusing opioids, 55.7% obtained them from friends or relatives, 25.4% from the healthcare system, and 18.9% through other means. Obtaining opioids free from friends or relatives was the most common source for both adolescents (33.5%) and young adults (41.4%). Those with opioid misuse reported high prevalence of prior cocaine (35.5%), hallucinogen (49.4%), heroin (8.7%), and inhalant (30.4%) use. In addition, at least half had used tobacco (55.5%), alcohol (66.9%), or cannabis (49.9%) in the past month. Potential limitations of the study are that we cannot exclude selection bias in the study design or socially desirable reporting among participants, and that longitudinal data are not available for long-term follow-up of individuals.
Results from this study suggest that the prevalence of prescription opioid use among adolescents and young adults in the US is high despite known risks for future opioid and other drug use disorders. Reported prescription opioid misuse is common among adolescents and young adults and often associated with additional substance abuse, underscoring the importance of drug and alcohol screening programs in this population. Prevention and treatment efforts should take into account that greater than half of youths misusing prescription opioids obtain these medications through friends and relatives.
Joel Hudgins and coworkers study reported use and misuse of prescription opioids and other substances among adolescents and young adults in the United States.
Prescription opioid misuse is a leading cause of unintentional injury and death among adolescents and young adults.
There is limited information on the source of prescription opioids among adolescents and young adults or whether those misusing prescription opioids engage in use of additional substances and drugs of abuse.
Understanding these factors will inform strategies to ensure judicious opioid prescribing and effective treatment approaches.
Using the National Survey on Drug Use and Health for the years 2015 and 2016, we determined past-year prevalence of prescription opioid use, sources of prescription opioids, and additional substance use among adolescents and young adults ages 12–25.
We found that 27.5% of respondents, corresponding to an estimated 32.8 million individuals, used prescription opioids in the previous year, including 21.0% of adolescents and 32.2% of young adults.
The prevalence of opioid misuse was 3.8% among adolescents and 7.8% among young adults.
Most individuals misusing prescription opioids obtained them for free from a friend or relative or from a single prescriber.
Individuals with prescription opioid misuse reported high prevalence of use of other substances, including cocaine, hallucinogens, heroin, and inhalants.
The prevalence of prescription opioid use is high among adolescents and young adults in the United States despite known risks for progression to opioid and other substance use disorders in this population.
Prevention and treatment efforts should take into account that adolescents and young adults misusing prescription opioids obtain these drugs most commonly from friends and relatives or from a single prescriber.
Healthcare providers should consider screening all adolescents and young adults with opioid misuse for additional substance use and should have established intervention plans available to maximize the opportunity to provide substance use treatment to this population.