Friday, April 9, 2021

Study Identifies Risk Factors for Opioid Use Disorder, Overdose in Youth

Opioid use disorder (OUD) and overdose among young people who fill an initial opioid prescription are rare but more likely to occur in those who have other substance use disorders or who have mood or anxiety disorders, a study in Addiction has found.

Scott E. Hadland, M.D., M.P.H., M.S., of Boston University School of Medicine and colleagues analyzed data from the health insurance claims of more than 3.2 million youth aged 11 to 25 years who filled an initial opioid prescription between 2006 and 2016.

Within 12 months of first filling their opioid prescriptions, 0.3% of the patients either developed OUD or overdosed. Patients who had other substance use disorders were more than 20 times more likely to develop these complications than their peers who did not have a substance use disorder. Roughly 73% of those who developed OUD or overdosed had a comorbid substance use disorder. and of these, 33.4% used alcohol, 33% used cannabis, and 43.2% used nicotine.

Patients who had mood or anxiety disorders were 4.45 times more likely to develop either of these opioid-related complications than their peers who did not have the disorders.

“We do not advocate for withholding opioid prescriptions from youth with comorbid mental health conditions or substance use; however, clinicians might consider ensuring close follow-up … for youth identified as having comorbid mental health conditions or substance use to minimize the risk [of OUD or overdose],” the researchers wrote.

The researchers also found a link between formulations of opioids and increased risk of opioid-related complications. Taking long‐acting opioids more than doubled the risk of OUD or overdose compared with taking short-acting formulations. Similarly, taking opioids for 15 days or more doubled the risk compared with taking opioids for three or fewer days.

The researchers concluded that consistent with U.S. opioid prescribing guidelines for adults, opioid prescriptions for young people should be for short-acting formulations at the lowest dose and for a short duration.

For related information, see the Psychiatric News article “Polysubstance Use Common in SUD Patients.”

(Image: iStock/Chinnapong)

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