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About a quarter of high school seniors have taken prescription opioids, medically or nonmedically, but exposures have declined over the past 2 years, according to a study.
“The recent declines in medical use of prescription opioids and nonmedical use of prescribed opioids from 2013 through 2015 found in the current study coincide with similar recent declines in U.S. opioid analgesic prescribing,” reported Sean Esteban McCabe, PhD, of the University of Michigan, Ann Arbor, and his associates (Pediatrics 2017 March 20. doi: 10.1542/peds.2016-2387). “Among adolescents who report both medical use of prescription opioids and nonmedical use of prescribed opioids, medical use before initiating nonmedical use of prescribed opioids tended to be most prevalent, and this pattern may be driven by the one-third of adolescents who report nonmedical use of prescribed opioids involving leftover opioid medications from their own previous prescriptions.”
The researchers analyzed data from the Monitoring the Future study from 1976 through 2015, an annual cross-sectional survey of high school seniors from 135 public and private high schools in the United States. Cohorts were nationally representative and varied in size from 2,181 to 3,791 students.
Students were asked whether they had ever been prescribed opioids by a doctor and how often they had ever taken opioids nonmedically. The list of opioids included all the ones available that year, including Vicodin, OxyContin, Percodan, Percocet, Demerol, Ultram, methadone, morphine, opium, and codeine.
Use of opioids for any reason ranged from 16.5% to 24% over the 4 decades, with medical use ranging from a low of 8.5% in 2000 to a peak of 14.4% in 1989. Though 16% of teens had used medical opioids in 1976, prevalence rose to 20% in 1989, then dropped to 13% in 1997 and remained stable. Rates sharply increased to 20% in 2002 – the year Vicodin, OxyContin, and Percocet were included in the questions – and then began declining again in 2013.
Nonmedical use correlated with medical use though remained less prevalent throughout the study period. This correlation was stronger for males, who are more likely to use opioids recreationally, than for females, who are more likely to use them to self-treat pain, the authors wrote.
Both medical and nonmedical use were more prevalent among white students than black students, in line with previous research showing “health disparities for receiving prescription opioids among racial minority patients,” the authors wrote.
Black teens are more often motivated to use opioids for pain relief, suggesting that their lower exposure rates “could result from a lack of adequate treatment, insufficient availability, overprescribing among white populations or underprescribing among nonwhite populations,” they wrote.
One limitation of the study was that absent students or those who had dropped out have a higher risk of opioid use, thereby possibly contributing to underreporting.
The National Institute on Drug Abuse and the National Institutes of Health funded the research. The researchers had no disclosures.
This research is important because nonmedical use of prescribed opiates is believed to be a major cause of morbidity and mortality associated with opiates. The consistency of the Monitoring the Future survey provides a high-level view of opiate use across the country from 1975 to 2015. Although helpful, this perspective can obscure critically important changes in local areas or within specific populations.
It is important to recognize the strong relationship between opioid prescription and nonmedical opioid use. These findings support the policy recommendations to prescribe opioids only when patients have strong indications for opioids and no better treatment options are available.
We view the recent decrease in the medical use of prescription opioids and nonmedical opioid use as an important finding, but there are significant small-area variations that would not appear in a national study. The epidemic of opioid use disproportionately affects some urban and more rural areas. Nonmedical use of prescribed opiates in general has become more common in rural areas. West Virginia, a predominantly rural state, has the highest rate of opioid overdose fatality in the country at 41.5 deaths per 100,000 in 2015. The state also has the second highest rate of opioid prescriptions per capita.
We are heartened to see a recent decrease, but we see it as a measured improvement. We understand that the appropriate use of opioids to manage pain can be helpful for our patients, but we must continue to search for solutions to the current crisis. Possible interventions include better education of our patients and families when we prescribe these drugs, better drug regulation, development of new affordable approaches to pain management that have lower potential for abuse, and accessible and affordable treatment programs for those already afflicted.
These comments were taken from an editorial published in Pediatrics by David A. Rosen, MD, FAAP, and Pamela J. Murray, MD, MHP, FAAP, both of West Virginia University in Morgantown. They reported having no disclosures or external funding.
This research is important because nonmedical use of prescribed opiates is believed to be a major cause of morbidity and mortality associated with opiates. The consistency of the Monitoring the Future survey provides a high-level view of opiate use across the country from 1975 to 2015. Although helpful, this perspective can obscure critically important changes in local areas or within specific populations.
It is important to recognize the strong relationship between opioid prescription and nonmedical opioid use. These findings support the policy recommendations to prescribe opioids only when patients have strong indications for opioids and no better treatment options are available.
We view the recent decrease in the medical use of prescription opioids and nonmedical opioid use as an important finding, but there are significant small-area variations that would not appear in a national study. The epidemic of opioid use disproportionately affects some urban and more rural areas. Nonmedical use of prescribed opiates in general has become more common in rural areas. West Virginia, a predominantly rural state, has the highest rate of opioid overdose fatality in the country at 41.5 deaths per 100,000 in 2015. The state also has the second highest rate of opioid prescriptions per capita.
We are heartened to see a recent decrease, but we see it as a measured improvement. We understand that the appropriate use of opioids to manage pain can be helpful for our patients, but we must continue to search for solutions to the current crisis. Possible interventions include better education of our patients and families when we prescribe these drugs, better drug regulation, development of new affordable approaches to pain management that have lower potential for abuse, and accessible and affordable treatment programs for those already afflicted.
These comments were taken from an editorial published in Pediatrics by David A. Rosen, MD, FAAP, and Pamela J. Murray, MD, MHP, FAAP, both of West Virginia University in Morgantown. They reported having no disclosures or external funding.
This research is important because nonmedical use of prescribed opiates is believed to be a major cause of morbidity and mortality associated with opiates. The consistency of the Monitoring the Future survey provides a high-level view of opiate use across the country from 1975 to 2015. Although helpful, this perspective can obscure critically important changes in local areas or within specific populations.
It is important to recognize the strong relationship between opioid prescription and nonmedical opioid use. These findings support the policy recommendations to prescribe opioids only when patients have strong indications for opioids and no better treatment options are available.
We view the recent decrease in the medical use of prescription opioids and nonmedical opioid use as an important finding, but there are significant small-area variations that would not appear in a national study. The epidemic of opioid use disproportionately affects some urban and more rural areas. Nonmedical use of prescribed opiates in general has become more common in rural areas. West Virginia, a predominantly rural state, has the highest rate of opioid overdose fatality in the country at 41.5 deaths per 100,000 in 2015. The state also has the second highest rate of opioid prescriptions per capita.
We are heartened to see a recent decrease, but we see it as a measured improvement. We understand that the appropriate use of opioids to manage pain can be helpful for our patients, but we must continue to search for solutions to the current crisis. Possible interventions include better education of our patients and families when we prescribe these drugs, better drug regulation, development of new affordable approaches to pain management that have lower potential for abuse, and accessible and affordable treatment programs for those already afflicted.
These comments were taken from an editorial published in Pediatrics by David A. Rosen, MD, FAAP, and Pamela J. Murray, MD, MHP, FAAP, both of West Virginia University in Morgantown. They reported having no disclosures or external funding.
About a quarter of high school seniors have taken prescription opioids, medically or nonmedically, but exposures have declined over the past 2 years, according to a study.
“The recent declines in medical use of prescription opioids and nonmedical use of prescribed opioids from 2013 through 2015 found in the current study coincide with similar recent declines in U.S. opioid analgesic prescribing,” reported Sean Esteban McCabe, PhD, of the University of Michigan, Ann Arbor, and his associates (Pediatrics 2017 March 20. doi: 10.1542/peds.2016-2387). “Among adolescents who report both medical use of prescription opioids and nonmedical use of prescribed opioids, medical use before initiating nonmedical use of prescribed opioids tended to be most prevalent, and this pattern may be driven by the one-third of adolescents who report nonmedical use of prescribed opioids involving leftover opioid medications from their own previous prescriptions.”
The researchers analyzed data from the Monitoring the Future study from 1976 through 2015, an annual cross-sectional survey of high school seniors from 135 public and private high schools in the United States. Cohorts were nationally representative and varied in size from 2,181 to 3,791 students.
Students were asked whether they had ever been prescribed opioids by a doctor and how often they had ever taken opioids nonmedically. The list of opioids included all the ones available that year, including Vicodin, OxyContin, Percodan, Percocet, Demerol, Ultram, methadone, morphine, opium, and codeine.
Use of opioids for any reason ranged from 16.5% to 24% over the 4 decades, with medical use ranging from a low of 8.5% in 2000 to a peak of 14.4% in 1989. Though 16% of teens had used medical opioids in 1976, prevalence rose to 20% in 1989, then dropped to 13% in 1997 and remained stable. Rates sharply increased to 20% in 2002 – the year Vicodin, OxyContin, and Percocet were included in the questions – and then began declining again in 2013.
Nonmedical use correlated with medical use though remained less prevalent throughout the study period. This correlation was stronger for males, who are more likely to use opioids recreationally, than for females, who are more likely to use them to self-treat pain, the authors wrote.
Both medical and nonmedical use were more prevalent among white students than black students, in line with previous research showing “health disparities for receiving prescription opioids among racial minority patients,” the authors wrote.
Black teens are more often motivated to use opioids for pain relief, suggesting that their lower exposure rates “could result from a lack of adequate treatment, insufficient availability, overprescribing among white populations or underprescribing among nonwhite populations,” they wrote.
One limitation of the study was that absent students or those who had dropped out have a higher risk of opioid use, thereby possibly contributing to underreporting.
The National Institute on Drug Abuse and the National Institutes of Health funded the research. The researchers had no disclosures.
About a quarter of high school seniors have taken prescription opioids, medically or nonmedically, but exposures have declined over the past 2 years, according to a study.
“The recent declines in medical use of prescription opioids and nonmedical use of prescribed opioids from 2013 through 2015 found in the current study coincide with similar recent declines in U.S. opioid analgesic prescribing,” reported Sean Esteban McCabe, PhD, of the University of Michigan, Ann Arbor, and his associates (Pediatrics 2017 March 20. doi: 10.1542/peds.2016-2387). “Among adolescents who report both medical use of prescription opioids and nonmedical use of prescribed opioids, medical use before initiating nonmedical use of prescribed opioids tended to be most prevalent, and this pattern may be driven by the one-third of adolescents who report nonmedical use of prescribed opioids involving leftover opioid medications from their own previous prescriptions.”
The researchers analyzed data from the Monitoring the Future study from 1976 through 2015, an annual cross-sectional survey of high school seniors from 135 public and private high schools in the United States. Cohorts were nationally representative and varied in size from 2,181 to 3,791 students.
Students were asked whether they had ever been prescribed opioids by a doctor and how often they had ever taken opioids nonmedically. The list of opioids included all the ones available that year, including Vicodin, OxyContin, Percodan, Percocet, Demerol, Ultram, methadone, morphine, opium, and codeine.
Use of opioids for any reason ranged from 16.5% to 24% over the 4 decades, with medical use ranging from a low of 8.5% in 2000 to a peak of 14.4% in 1989. Though 16% of teens had used medical opioids in 1976, prevalence rose to 20% in 1989, then dropped to 13% in 1997 and remained stable. Rates sharply increased to 20% in 2002 – the year Vicodin, OxyContin, and Percocet were included in the questions – and then began declining again in 2013.
Nonmedical use correlated with medical use though remained less prevalent throughout the study period. This correlation was stronger for males, who are more likely to use opioids recreationally, than for females, who are more likely to use them to self-treat pain, the authors wrote.
Both medical and nonmedical use were more prevalent among white students than black students, in line with previous research showing “health disparities for receiving prescription opioids among racial minority patients,” the authors wrote.
Black teens are more often motivated to use opioids for pain relief, suggesting that their lower exposure rates “could result from a lack of adequate treatment, insufficient availability, overprescribing among white populations or underprescribing among nonwhite populations,” they wrote.
One limitation of the study was that absent students or those who had dropped out have a higher risk of opioid use, thereby possibly contributing to underreporting.
The National Institute on Drug Abuse and the National Institutes of Health funded the research. The researchers had no disclosures.
FROM PEDIATRICS
Key clinical point: Teen opioid use began to decline from 2013 through 2015 but remains common.
Major finding: Prevalence of teens’ medical or nonmedical use of prescription opioids ranged from 16.5% to 24% between 1976 and 2015.
Data source: Analysis of 40 annual surveys of U.S. high school seniors from 1976 through 2015.
Disclosures: The National Institute on Drug Abuse and the National Institutes of Health funded the research. The researchers had no disclosures.