Nearly two million Americans are addicted to prescription opioids, a family of drugs that includes the commonly prescribed Vicodin and OxyContin. Two recent University studies further demonstrate the prevalence of these painkillers among adolescents and their potential for leading to chronic substance abuse.
University of Washington professor Lauren Whiteside — who was the primary researcher in one of the studies during her postdoctoral research fellowship at the University Injury Center — said while adults are more likely to be addicted to prescription opioids, teens were a key group to examine for prevention.
“What makes this age group so important is that it’s the highest initiation of nonmedical use of opioids,” Whiteside said. “This age group is important to target for primary prevention before they start nonmedical use.”
Whiteside emphasized that teen prescription painkiller misuse is a public health problem. Conducted by a team from the University Medical School and Injury Center, the study led by Whiteside showed that one in 10 teens in the University of Michigan Hospital’s emergency department had used prescriptions for nonmedical reasons. Prescription painkillers were the focus of the study.
Most of the admitted emergency-room patients were seeking help for a sprained ankle, a fever or another routine, non-drug-related ailment. Notably, only 15 percent of the patients misused drugs that a doctor prescribed; Whiteside said this may indicate they used their parents’ or friends’ leftover medications. A negligible amount of teens purchased the pills online.
Data on prescription drug abuse is typically gathered in schools, and most often reflects that about eight percent of teens have misused prescription drugs. This recent survey shows a slight increase at 10 percent.
A study from the University’s Institute for Social Research demonstrated that prescription drug abuse starting in adolescence can lead to long-term abuse. About a third of the opioid-abusing 18-year-olds studied continued misuse into their early- to mid-20s. Twelve percent of those aged 18 to 24 reported non-medical use of opioids.
Both Whiteside and Sean McCabe, a research associate professor in the University’s Substance Abuse Research Center who led the latter study, found that teens mostly used these drugs to experiment or get high.
However, young adults who continually use prescription drugs non-medically often engage in other destructive behaviors.
Compared to those who never reported nonmedical use of opioids, those surveyed were four times as likely to engage in binge drinking in the two-week period prior to their engagement in the survey and 17 times more likely to report marijuana usage in the year prior to the survey, McCabe wrote in an email.
There’s a slightly higher likelihood for those on public assistance to use these drugs non-medically, Whiteside said. Suburban and rural teens are also more likely than inner-city teens to misuse prescription drugs.
The longitudinal study McCabe led included responses over a four-year period from 27,268 young adults from the national Monitoring the Future study, which has been conducted annually by the University since 1975 to survey trends in illicit drug use. It will be published in an upcoming issue of Addiction.
The explosion in use — and misuse — of prescription painkillers is often publicized and Whiteside cites a move by the Institute of Health in 2003 as a major contributor to the surge in use.
In 2003, the Institute of Health began to emphasize more aggressive treatment of pain 10 years ago. One result of this was leftover medication, which allows, for instance, teens to scavenge through their family medicine cabinets for unused pills.
Since 2007, the IMS Institute for Healthcare Informatics has reported that hydrocodone — more commonly known as Vicodin — is the most-prescribed drug in the United States.
Since then, however, Whiteside said both the medical and political communities are regulating prescriptions. Every state now has automated prescribing systems, which ensures that patients receive potentially addicting prescriptions only when needed. Doctors, she added, are becoming increasingly aware of the problem.
Whiteside expressed the importance of screening interventions, especially for teenage boys, who are particularly unlikely to get annual check-ups.
“I think that primary care is a good place to talk about substance use, but I don’t think that regular primary care alone would solve the problem,” Whiteside said.
McCabe added that prescribers play a key role in limiting painkiller abuse. He stressed the need for careful prescription of medication, monitoring of patients’ usage and, when needed, referral for substance-abuse treatment.
“Indeed, an evidence-based protocol for assessment and education among prescribers is needed: one aimed at preventing non-medical use, ensuring safe/secure storage and dictating safe disposal.”