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Study: Longer, higher-dose opioid prescriptions for teens increase misuse risk

Teens and young adults prescribed opioids for pain may be more likely to misuse the drugs based on the length of time they take them, a new study has found. File Photo by iminwon/Shutterstock
Teens and young adults prescribed opioids for pain may be more likely to misuse the drugs based on the length of time they take them, a new study has found. File Photo by iminwon/Shutterstock

April 22 (UPI) -- Teens and young adults at high risk for abusing opioid painkillers often are prescribed the drugs for longer periods and at higher doses, a study published Thursday by JAMA Network Open found.

The risk for abuse and misuse of these medications among this age group is high, however, even when the opioids are prescribed initially for a shorter duration and at lower doses, the researchers said.

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In the analysis of nearly 190,000 Medicaid beneficiaries age 10 to 21 in Pennsylvania who were prescribed an opioid between 2010 and 2016, 65% of those considered at high risk for abusing the drug still were requesting new prescriptions one year later.

These "high-risk" recipients initially were prescribed the drugs at higher doses and for longer periods, five days, on average, versus four days among those considered at low risk, according to the researchers.

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They also tended to be slightly older, average age 19 versus 18; 15% more likely to have depression; and three times as likely to have some form of cancer compared to those in the low-risk group.

Still, just over 13% of those in the low-risk group requested a new opioid prescription one year after receiving their first, the data showed.

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"Even short, fairly low-dose opioid prescriptions are not without risks for some youth," study co-author Dr. J. Deanna Wilson told UPI in an email.

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"This does not mean that providers should not prescribe pain medication to patients who need it, but it does mean that providers need to have thoughtful conversations with patients and their families about risks and who may be more vulnerable to these risks," said Wilson, an assistant professor of medicine and pediatrics at the University of Pittsburgh.

For young people prescribed opioids to treat pain, this could mean more frequent check-ups to ensure proper use of the drugs, she said.

Despite the ongoing opioid "epidemic" in the United States, and increasing rates of addiction to prescription painkillers and related illegal drugs such as heroin, nearly 15% of teens and young adults are prescribed these medications after emergency room visits, according to earlier research.

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In addition, an estimated one in 10 deaths among adolescents, teens and young adults nationally has been linked with the drugs.

Among the nearly 190,000 people in Pennsylvania age 10 to 21 in the study who were prescribed an opioid pain medication between 2010 and 2016, 901, or less than 1%, were considered at high risk for future abuse or misuse, Wilson and her colleagues said.

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Nearly two-thirds of them still were filling opioid prescriptions 12 months after receiving their first one.

Of these high-risk young people, 73% were White, 27% had been diagnosed with depression and just under 8% had cancer, the researchers said.

In the low-risk group, 63% were White, 18% had depression and less than 3% had cancer.

"Our study shows that those in the 'high-risk' trajectory are often those with co-occurring depression or anxiety," Wilson said.

"Persistent use of opioids following the initial exposure may suggest the development of chronic pain or worsening of mood symptoms or even problematic opioid use, but none of these things can be teased out without having physicians take time to meet with patients and their families," she said.

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