A recentstudy has identified why some young people could be at greater risk for developing opioid use disorder and found that those at the highest risk also struggled with mental health issues like depression.
Dr. Deanna Wilson, an assistant professor of medicine and pediatrics at the University of Pittsburgh School of Medicine, led the analysis. She said the bulk of existing research on opioid use disorder focuses on older adults, even though “many of those adults say that their first opiate exposure was actually as an adolescent or young adult.”
“We know that for many young people, the first opiate exposure actually comes from a physician or provider,” Wilson said. “We really wanted to explore with this group what happens during that first year and after you receive your first opioid prescription.”
The UPMC analysis used state Medicaid data to look at prescription use for nearly 200,000 patients between the ages of 10 and 21. The study also found that people who had stronger prescriptions were more likely to experience use disorder. Researchers hoped the analysis would help experts understand how early opioid use could lead to long-term risks.
According to Wilson, the “vast majority” of participants who were prescribed opioids did not develop complications from them. But for about 25% of participants, Wilson said “there truly are significant risks.” This portion of the population, which the study divided into “high risk” and “low risk” trajectories, included people who received two or more opioid prescriptions within one year of their initial prescription.
“We know that ongoing opioid prescriptions put you at increased risk for misuse, for problematic use of opioids, or for developing an opiate addiction or what we call an opiate use disorder. And so, the risk of developing that in the high-risk group was about threefold higher than that in the lower risk group,” Wilson said.
People in the higher-risk group tended to be older teens or in their early twenties when they were first prescribed opioids. They were also more likely to have longer and more potent prescriptions, and reported other conditions, like depression, which Wilson said, “might increase their risks for developing persistent or chronic use of opioids.” Thirty-percent of patients in the high-risk trajectory went on to develop opioid use disorder after the first year.
Wilson said the results of the study have influenced how she practices medicine and hopes they will encourage physicians and parents to have conversations with young patients about the risks of opioids before they are prescribed.
“I think what’s been hard with some of the opioid discussion is we didn’t have sufficient data to know how to counsel parents about the risks. You know, sometimes I think the message people get is that all opiates are bad. We’re not saying that.” said Wilson. “What we’re saying is we need to have greater monitoring and education around the risks, and around risk factors like co-mordant depression that can complicate the ability of young people to stop using opioids, or that may increase their risk for going on to develop problems later.”
