Extramedical Use of Prescription Pain Relievers by Youth Aged 12 to 21 Years in the United States
ABSTRACT OBJECTIVE: To identify when youth are most likely to start using prescription pain relievers to get high or for other unapproved indications outside the boundaries of what a prescribing physician might intend (ie, extramedical use). DESIGN: Cross-sectional surveys of adolescent cohorts, 2004 to 2008. SETTING: The United States. PARTICIPANTS: Large nationally representative samples of youth in the United States who had been assessed for the 2004 through 2008 National Survey on Drug Use and Health, yielding data from 138 729 participants aged 12 to 21 years. MAIN OUTCOME MEASURES: Estimated age-specific risk of starting extramedical use of prescription pain relievers, year by year, and confirmation of age at peak risk by tracing the experience of individual cohorts during this period. RESULTS: The estimated peak risk of starting extramedical use of prescription pain relievers occurs in midadolescence, well before the college years. The age at peak risk is 16 years, when an estimated 2% to 3% become newly incident users. Smaller risk estimates are observed at age 12 to 14 years and at age 19 to 21 years. CONCLUSIONS: For initiatives to prevent youth from using prescription pain relievers to get high or for other unapproved indications, a focus on the last year of high school and the post-secondary school years may be too little too late. Practice-based approaches are needed in addition to public health interventions based on effective alcohol and tobacco prevention programs during the earlier adolescent years.
SourceAvailable from: Maryann Mazer-Amirshahi[Show abstract] [Hide abstract]
ABSTRACT: In recent years, there has been increased emphasis on treating pain in emergency departments (EDs), coinciding with mounting concerns regarding the abuse potential of prescription opioids. In this study, we describe trends in opioid prescribing in pediatric patients in the US EDs over the past decade. Data from the 2001-2010 National Hospital Ambulatory Medical Care Survey were analyzed and pain-related visits were identified. Pain-related ED visits by pediatric patients (≤19 y) where an opioid analgesic was administered or prescribed were tabulated by age category and year. Specific opioids analyzed included codeine, hydrocodone, hydromorphone, morphine, and oxycodone. The use patterns of nonopioid pain relievers were also investigated. Results were further stratified by Drug Enforcement Agency schedule and pain-related diagnosis. The overall use of opioid analgesics in pain-related pediatric ED visits increased from 11.2% to 14.5% between 2001 and 2010 (P = 0.015). The use of Drug Enforcement Agency schedule II agents doubled from 3.6% in 2001 to 7.0% in 2010 (P < 0.001), whereas there was no significant increase in the use of schedule III, IV, and V agents (P = 0.34). Hydrocodone was the most frequently prescribed opioid analgesic. Increased opioid use was most dramatic in ED visits that involved adolescents. There was no significant increase in the use of nonopioid analgesics in pediatric ED patients (P = 0.086). Opioid use for pain-related pediatric ED visits has increased significantly from 2001 to 2010, particularly among adolescents. Emergency department providers must be vigilant in balancing pain relief with minimizing the adverse effects of opioid analgesics.Pediatric emergency care 03/2014; DOI:10.1097/PEC.0000000000000102 · 0.92 Impact Factor
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ABSTRACT: The purpose of this longitudinal study (N = 2,745) was to determine whether adolescents' recent medical use of anxiolytic or sleep medication was associated with increased incidence of using someone else's prescription for these classes of medication (nonmedical use). Data were collected from adolescents attending 5 Detroit area secondary schools between December and April in 3 consecutive academic years between 2009 and 2012. Respondents were assigned to the following 3 mutually exclusive groups for the analyses: (1) never prescribed anxiolytic or sleep medication (in their lifetime); (2) prescribed anxiolytic or sleep medication in their lifetime, but not during the study period; or (3) prescribed anxiolytic or sleep medication during the study period. Almost 9% of the sample had received a prescription for anxiolytic or sleep medication during their lifetime, and 3.4% had received at least 1 prescription during the 3-year study period. Compared with adolescents never prescribed anxiolytic or sleep medication, adolescents prescribed these medicines during the study period were 10 times more likely to engage in nonmedical use for reasons such as "to get high" or "to experiment" (adjusted odds ratio [ORadj.] = 10.15; 95% CI [3.97-25.91]), and 3 times more likely to engage in nonmedical use to self-treat anxiety or to sleep (ORadj. = 3.24; 95% CI [1.67-6.29]). Adolescents prescribed anxiolytics during their lifetime but not during the 3-year study were 12 times more likely to use another's anxiolytic medication, compared with adolescents never prescribed anxiolytics (ORadj. = 12.17; 95% CI [3.98-37.18]). These risk factors have significant implications for later substance use problems. (PsycINFO Database Record (c) 2014 APA, all rights reserved).Psychology of Addictive Behaviors 11/2014; 29(1). DOI:10.1037/adb0000026 · 2.09 Impact Factor
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ABSTRACT: Roughly 25 years ago, the United States National Institute on Drug Abuse (US NIDA) initiated the creation of public use datasets for its National Household Survey on Drug Abuse, since re-named the National Survey on Drug Use and Health (NSDUH). The Substance Abuse and Mental Health Services Administration (SAMHSA), which assumed responsibility for the survey in 1992, has continued and expanded this effort to make the survey data available to researchers. During 2012, SAMHSA created a "Restricted-Use Data Analysis System" (R-DAS) to provide researchers with the capability to create tabulations using restricted NSDUH variables not otherwise available on the public-use files.Drug and Alcohol Dependence 08/2014; 143. DOI:10.1016/j.drugalcdep.2014.07.017 · 3.28 Impact Factor