Prescription Opioid Use and Misuse Among Adolescents and Young Adults in the U.S.

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  • Joel D. Hudgins – Division of Emergency Medicine, Boston Children’s Hospital | Depts. of Pediatrics and Emergency Medicine, Harvard Medical School
  • John J. Porter – Division of Emergency Medicine, Boston Children’s Hospital
  • Michael C. Monuteaux – Division of Emergency Medicine, Boston Children’s Hospital
  • Florence T. Bourgeois – Division of Emergency Medicine, Boston Children’s Hospital | Depts. of Pediatrics and Emergency Medicine, Harvard Medical School

Published: Nov. 5, 2019

Report Intro/Brief:
“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.

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 who used prescription opioids in the previous year, including 21.0% of adolescents and 32.2% of young adults. Significantly more females than males reported using any prescription opioid, and non-Hispanic whites and blacks were more likely to have had any opioid use compared to Hispanics. Opioid misuse was reported by 1,050 adolescents and 2,207 young adults.

Male respondents using opioids were more likely to have opioid misuse without use disorder compared with females, 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.”

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