First opioids for teens may not up drug abuse risk by much

Young adults who receive an opioid prescription for the first time may have a slightly greater risk of a substance-related problem later, but that risk might not be as high as previously thought, according to a new study.

The findings show that, compared with people not prescribed an opioid, 1 to 2% more of those prescribed an opioid for the first time developed a substance use disorder or other substance-related issue such an overdose or criminal conviction within five years of receiving the prescription.

The researchers caution, however, that further studies are needed to determine how much of that risk is truly caused by opioid prescriptions.

Researchers looked at the health and other national records of Swedish individuals age 13 to 29, from 2007 to 2013, who received an opioid prescription for the first time. They wanted to further investigate whether prescribing opioids, such as codeine or oxycodone during adolescence and young adulthood leads to a greater risk of substance-related problems.

“By using several rigorous research designs, we found that there was not a huge difference—in fact, the difference was smaller than some previous research has found. But the study still shows that even a first opioid prescription may lead to some risk,” says Patrick Quinn, an assistant professor at the Indiana University School of Public Health-Bloomington and coauthor of the paper, published in JAMA Pediatrics.

“Our findings highlight the importance of screening for substance use disorders and other mental health conditions among patients with pain, including those receiving opioid therapy.”

Quinn and his team used health data from Sweden because the country has nationwide records, which makes it easier to document people’s prescriptions. They conducted a number of tests, including comparing youth and adolescents who were prescribed opioids with those whose pain was treated with a non-opioid pain medication. They also compared twins and other siblings of multiple births, one who was prescribed opioids and others who were not.

The opioid epidemic in the US has brought about welcome prescription policy changes, Quinn says, but it is important to have solid data that can help guide these decisions.

“Our goal is help patients and doctors understand the risks of opioid treatment for pain,” he says. “We need to have a good understanding of what those risks might be in order for patients and doctors to make informed decisions.”

Additional coauthors are from Indiana University, Örebro University, and the Karolinska Institute. The National Institute on Drug Abuse of the National Institutes of Health, the Indiana Clinical and Translational Sciences Institute, the Swedish Research Council, and the National Science Foundation supported the work.

Source: Indiana University

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