Adolescent painkiller use may impact later drug abuse

Wednesday, October 28, 2015 - 6:22pm

Adolescents who reported receiving a prescription from a doctor for a pain reliever are nearly 33 percent more likely to misuse pain relievers compared to those who never received a doctor-prescribed opioid, according to recent University study.

The subjects of the study’s focus group, 12th grade students, were asked to report whether or not a doctor prescribed them a pain reliever and if they used it. Researchers then provided the same students with follow-up questions between the ages of 19 and 23 to see if the students who had been prescribed pain relievers were more likely to misuse them when they get older than those who never used an opioid.

Conducted by the University’s Institute for Social Research, the study also determined whether a student’s previous experience with drugs — including drugs other than opioids, such as marijuana and alcohol — played a role in a student’s continued misuse of a prescription medication throughout their college years.

Richard Miech, professor at the University’s Institute for Social Research and the study’s lead author, said some of the students participating in the study had a lot of experience with drugs, and reported they had used marijuana. Others reported by 12th grade, they had had no experience at all with drugs.

“The surprising finding to come out of the study, is this effect that I found overall was concentrated among the drug-naïve adolescents, the ones that had very little experience with drugs,” he said.

However, drug-naïve students are about three times more likely to misuse drugs than those who have experience with other drugs. According to Miech, there is no effect among adolescents who had already had experience with drugs by 12th grade.

“What we speculate, is that the drug-naïve adolescents, when they’re taking a prescription opioid, it’s really something quite different than they’ve ever experienced before,” Miech said. “It’s a safe experience, because it’s under the doctor’s guidance … For those adolescents, the pain relievers are really quite powerful and pleasurable. Whereas the adolescents who get a doctor’s prescription for an opioid who already have other drug experience, the whole opioid experience, relatively speaking, will not produce a big thrill.”

Miech said when a celebrity dies from prescription drug overdose, the media often claims those individuals turned to harder drugs after using prescription drugs legitimately prescribed by a doctor.

“They make it sound like prescription drugs are a gateway to harder drugs like heroin,” he said. “What my findings show is that there are people that use prescription drugs and then go on to use heroin, but I don’t think their introduction to heroin was through prescription drugs. They were already using all kinds of other drugs … I don’t think that was the cause of harder drug use.”

Though ­­­­­­­the study did not go into the developmental effects that accompany prescription pain medication abuse, Miech said at the ages of the students that were studied, the brain is still developing, making it more sensitive to these external drugs that enter the system.

Kennon Heard, professor of emergency medicine at the University of Colorado School of Medicine, also provided clinical interpretation of the data for the study.

“We see many (Emergency Department) visits related to opioid abuse,” Heard wrote in an e-mail to The Michigan Daily. “The most common medications are oxycodone, hydrocodone and morphine. We also often see heroin use by patients who started abusing prescription opioids and then moved to heroin because it is cheaper.”

Heard said the most common effects of opioid use are sedation and respiratory depression.

“There is research suggesting that early exposure to addictive drugs increases the risk of abuse as an adult,” he added.

The research studied high school seniors until they reached age 23, which Heard said is an age where drug abuse tends to start. The rates of prescription drug abuse are higher in older adolescent age groups. However, he said the most extreme cases that result in needing medical attention in the emergency room are older than the age range considered in the study.

Though opioids are such a common concern because of abuse that can occur as a result, Heard said the medical field does not have alternatives to these medications.

“At this time opioids are the most effective pain medications we have,” Heard said. “Unfortunately there are not great alternatives with less addictive potential. Safe use requires thoughtful prescribing and continual reassessment for efficacy and safety.”

LSA junior Erin Dunne, co-director of the Students for Sensible Drug Policy organization on campus, said the main goal of the organization is to promote harm reduction and inform the campus dialogue. She said members are ultimately interested in what is best for individuals, families and communities.

Earlier this fall, SSPD hosted an event focused on opioids. The organization met with a Detroit emergency room physician who presented various concerns with opioid use in the United States. He also talked about methods to deal with opioid overdose, and ways people can become hooked on the drugs.

Dunne pointed to a lack of specialized pain counseling in the United States, causing people to take painkillers when they do not necessarily need them and end up staying on them longer than they should.

Dunne mentioned a drug called Naloxone — commonly referred to as Narcan — which counteracts the effect of opioid overdose by blocking receptors in the body that opioids bind to and instigate an overdose.

The organization also supports proposals to extend medical amnesty policies to those suffering from prescription drug overdose.

“There’s still a lot of stigma on drug use and there is still a lot of fear around going to authorities and having to deal with someone who is suffering from overdose, especially if the other people around were using drugs themselves,” Dunne said. “We as an organization find this to be incredibly alarming. We want people to be able to seek the help they need for themselves and for their friends without these barriers.”