Most teens abusing prescription opioids previously used them for medical reasons, according to a new study.
The report is one of two released Monday in Pediatrics looking at prescription opioids. The other explored poison center calls related to opioid exposure.
Doctors wrote about 259 million prescriptions for opioids in 2012, and roughly 1,000 people a day are treated in emergency departments for misusing them, according to the Centers for Disease Control and Prevention (CDC).
Using data from the Monitoring the Future study, researchers from the University of Michigan explored prescription opioid use among high school seniors from 1976-2015.
During that time, prevalence of any type of use ranged from 16.5% to 24.1%. Medical use only was most common, ranging from 8.5% to 14.4%, according to the study “Trends in Medical and Nonmedical Use of Prescription Opioids among US Adolescents: 1976-2015” (McCabe SE, et al. Pediatrics. March 20, 2017, https://doi.org/10.1542/peds.2016-2387).
Among those who have used both, the most common pattern was medical use before nonmedical, which ranged from 2.6% to 5.4%.
While males and females had similar rates of nonmedical use of prescription opioids (NUPO), the correlation between medical and nonmedical uses was stronger for males. Researchers said this may be due to accessibility because males tend to get opioids from peers while females often get them from family members. In addition, male nonmedical use tends to be for getting high while females are trying to relieve pain, according to the study.
The authors said physicians should monitor prescription drug use, discuss risks and benefits of prescription opioids with patients and parents, screen for NUPO, substance use and other mental health disorders, and prescribe carefully.
“Prescribing practices that enhance vigilance and monitoring of prescription opioids among adolescents, including education regarding proper disposal when medical use has concluded, warrant further investigation,” they wrote.
The authors of a related commentary called for additional ways to curb the opioid crisis.
“Possible interventions include better education of our patients and families when we prescribed these drugs, better drug regulation, development of new affordable approaches to pain management that have lower potential for abuse, and accessible and affordable treatment programs for those already afflicted,” they wrote.
Another study explored the toll of pediatric exposure to prescription opioids using data from U.S. Poison Control Centers.
Researchers found 188,468 pediatric (under 20 years) prescription opioid exposures from 2000-’15. The annual rates increased significantly from 2000-’09 and then declined, according to the study “Prescription Opioid Exposures among Children and Adolescents in the United States: 2000-2015” (Allen JD, et al. Pediatrics. March 20, 2017, https://doi.org/10.1542/peds.2016-3382).
About 56.1% of all exposures were deemed unintentional-general, 22.5% were intentional and 18.1% were unintentional-therapeutic error.
Nearly 60% of the exposures occurred in children 5 years and under, often stemming from exploratory behaviors, according to the study.
For teens, the majority (71.5%) were intentional, including suspected suicide (34.2%), abuse (20.8%) and misuse (11.2%). The rate of suspected suicides increased by more than 50% for this group throughout the study period.
Among children of any age experiencing exposure-related symptoms, the most common were drowsiness/lethargy (17.6%) and vomiting 6%. Roughly 6.6% of children experienced serious medical issues, which occurred in greater rates in teens. There were 175 deaths.
Hydrocodone was the most common medication involved for any age group, but the authors also noted the impact of buprenorphine. Most buprenorphine exposures impacted children 5 and under, and more than half of those children were admitted to a health care facility.
To prevent exposure, the authors suggested using unit-dosing packaging, alternate drug formulations, education on safe storage and disposal, and prescription drug monitoring programs.