Summary: A new study examines rising rates of prescription opioid use disorder and heroin use among adolescents and young adults.
Source: Columbia University Medical Center.
Odds of prescription opioid use disorder rose 37 percent among nonmedical users aged 18 to 25.
Researchers at Columbia University’s Mailman School of Public Health report an increase in the probability of past-year prescription opioid use disorder among nonmedical prescription opioid users aged 18 to 34 in 2014 compared with 2002. This analysis is the first to examine decade-long trends in prescription opioid use disorder—defined by meeting DSM criteria for abuse or dependence and indicating a need for treatment—among adolescents and young adults who used prescription opioids without a medical prescription. The study evaluated three age groups: adolescents (12 to 17 years), emerging adults (18 to 25 years), and young adults (26 to 34 years). Results were published in the journal Addictive Behaviors.
The authors found that emerging adults experienced a 37 percent increase in the odds of having a prescription opioid use disorder, while young adults saw their odds double, rising from 11 percent to 24 percent. In contrast, the prevalence among adolescents remained relatively stable over the same period. The analysis used data from the National Survey on Drug Use and Health covering 2002 through 2014.
In addition to increases in opioid use disorder, the researchers observed substantial rises in heroin use among nonmedical prescription opioid users. Over the study period, the odds of past-year heroin use increased approximately four-fold for emerging adults and nine-fold for young adults who used opioids without a prescription. Specifically, past-year heroin use among emerging adults increased from about 2 percent to 7 percent, and among young adults from about 2 percent to 12 percent. The study also reports that nearly 80 percent of people who initiated heroin use between ages 12 and 21 had previously begun using prescription opioids between ages 13 and 18, indicating a common progression from nonmedical prescription opioid use to heroin initiation for many younger users.
“Given this and the high probability of nonmedical use among adolescents and young adults in general, the potential development of prescription opioid use disorder among youth and young adults represents an important and growing public health concern,” said Silvia Martins, MD, PhD, associate professor of Epidemiology and the study’s first author.
Despite these concerning increases in opioid use disorder and heroin use among certain age groups, the overall past-year prevalence of nonmedical prescription opioid use declined in some groups between 2002 and 2014. Among adolescents, prevalence fell from 8 percent to 5 percent; among emerging adults it declined from 11 percent to 8 percent; and prevalence among young adults remained steady at 6 percent. These contrasting trends—fewer people reporting nonmedical prescription opioid use overall, but a greater proportion of those users meeting criteria for opioid use disorder—highlight a shift in the severity of problems experienced by a subset of users.
Dr. Martins emphasized the need for public awareness and action: “Our analyses present evidence to raise awareness and urgency to address these rising and problematic trends among young adults. While increases in prescription opioid use disorder may be influenced by health policy, medical practice, pharmaceutical industry activities, and patient behavior, it is critical that the public—especially youth—understand the risks and potential harms when prescription opioids are used without consistent medical supervision.”
Co-authors include Luis E. Segura, Julian Santaella-Tenorio, Alexander Perlmutter, and Katherine M. Keyes of the Mailman School of Public Health; Magdalena Cerdá of the University of California, Davis; Miriam C. Fenton of Rutgers University Institute for Health; Lilian A. Ghandour of the American University of Beirut; Carla L. Storr of the University of Maryland School of Nursing; and Deborah S. Hasin of the Mailman School of Public Health and the New York State Psychiatric Institute and the Department of Psychiatry at Columbia University.
Funding: The study was supported by the National Institute on Drug Abuse (DA031099; 1R01HD060072; 1R01DA037866-01), K01 AA021511, and the New York State Psychiatric Institute.
Dr. Deborah S. Hasin is principal investigator of a separate study on a measure of addiction to prescription opioids that received support through InVentive Health Consulting, which aggregates funding from multiple pharmaceutical companies. The other authors report no financial conflicts of interest.
NeuroscienceNews thanks Stephanie Berger for submitting this research summary.
Source: Stephanie Berger — Columbia University Medical Center
Image source: Image provided for illustrative purposes and noted as public domain in the original reporting.
Original research: Prescription opioid use disorder and heroin use among 12–34 year-olds in the United States from 2002 to 2014. Addictive Behaviors. Published online August 30, 2016. doi:10.1016/j.addbeh.2016.08.033