Trends in personal and family member opioid prescriptions prior to a diagnosis of an opioid-related problem among adolescents and young adults

Abstract

Background: Efforts to reduce the risk of opioid misuse are often focused on reducing unnecessary prescriptions for opioid medications or reducing the dose prescribed; however, not all misuse occurs in individuals with a personal prescription. This study examined trends in the proportion of adolescents and young adults (AYAs) who had an opioid-related problem (ORP) and who also had a personal opioid prescription drug claim or had a family member with an opioid prescription drug claim prior to the ORP diagnosis. Methods: A retrospective cohort design was used to analyze longitudinal claims data. We identified individuals aged 12 to 25 years who had a newly diagnosed ORP in the years 2006 to 2014. Trends over time in personal or family opioid prescription drug claims within 1 year prior to ORP diagnosis were examined. Results: We identified 53,560 AYAs with an ORP diagnosis. Over the entire study period, 40% of AYAs with an ORP diagnosis had a personal opioid prescription in the year prior to diagnosis, and 48% had a family member with an opioid prescription in the prior year. While the proportion of AYAs with a family prescription remained constant, the proportion with a personal prescription fell from 77.1% in 2006 to 27.3% in 2014. Conclusions: The number of AYAs with an ORP increased over time, yet the proportion with a personal opioid prescription claim prior to their diagnosis decreased over time. This suggests that providers are paying greater attention to prescribing opioids to AYAs directly, although prescriptions to family members may still remain a point of access.

Keywords:

• Adolescent health
• adolescent medicine
• substance abuse

Disclosure statement

RP reports funding from the National Institute on Drug Abuse, the National Institute of Mental Health, and the Centers for Disease Control. AD reports funding from the National Institute of Mental Health, National Institute on Drug Abuse, and the Agency for Healthcare Research and Quality. BS reports funding from the National Institute on Drug Abuse, National Institute of Mental Health, National Institute of Dental and Craniofacial Research, Substance Abuse and Mental Health Services Administration, Pew Charitable Trusts, Glade Run Lutheran Foundation, and Brookings Institution. DL reports funding from the National Institute of Mental Health, the Agency for Healthcare Research and Quality, Department of Health and Human Services/Substance Abuse and Mental Health Services Administration, Eglet Adams, and Simon Greenstone Panatier. BD and AC has no conflicts to disclose.

Author contributions

AC and DL conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. AC collected data and carried out the initial analyses. DL supervised data collection and analysis. All authors, AC, RP, AD, BS, BD, and DL, assisted with data interpretation, reviewed the manuscript for important intellectual content and approved the final manuscript as submitted.

Additional information

Funding

All phases of this study were supported by a grant [R01DA047396] from the National Institute on Drug Abuse (NIDA). NIDA had no further role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.