There is no question that adult prescription opioid misuse in the United States are at epidemic levels. More than 32,000 opioid-related deaths occurred in 2016. This is the equivalent of 89 cases per day and represents a more than 40 percent increase over 2015.
Even more concerning, opioid misuse may be even higher among adolescents, but less easy to detect, says Sarah Feldstein Ewing, Ph.D., professor of psychiatry (child and adolescent psychiatry) in the OHSU School of Medicine and director of the Adolescent Behavioral Health Clinic at OHSU Doernbecher Children’s Hospital.
“Whether it’s alcohol, cannabis or other substances, this age group tends to have elevated levels of substance exploration and misuse during a crucial developmental period. Therefore, access to legitimately prescribed substances, like opioids, may create an increased risk for misuse, or abuse, later in life,” she said.
To help assess this risk, Feldstein Ewing and Anna Wilson, Ph.D., have been awarded a $3 million research grant from the National Institute on Drug Abuse (1 R01 DA044778-01A1), part of the National Institutes of Health.
The first-of-its-kind study will evaluate the utilization patterns of nearly 500 Oregon-based adolescents, aged 14 to 18, receiving opioid prescriptions for non-cancer pain management in outpatient medical, dental and emergency settings. Every six months, over the course of two years, the teens will report on pain characteristics, opioid and other substance use, as well as important psychological factors such as depression or anxiety.
Non-medication pain management strategies, peer behaviors, family history of chronic pain and opioid use, as well as attitudes about pain medications will also be examined.
“By identifying and understanding the triggers that may impact long-term opioid use in adolescents, we will be able to directly inform the development of preventive interventions, and alternate therapies for youth at increased risk for substance abuse,” said Wilson, an associate professor of pediatrics in the OHSU School of Medicine and OHSU Doernbecher Children’s Hospital. “Physicians are currently operating on very little understanding of these factors. This needs to change in order to ensure the health of future generations.”
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