Misuse of prescription opioids among adolescents and young adults has generated significant media coverage, but less attention has been given to differentiating the underlying motives for opioid misuse. A study published in The Journal of Pain showed that pain relief, not getting high, was the most prevalent motive for medical misuse of opioids among adolescents. This factor alone motivated 4 in 5 adolescents who misused their prescribed pain medications.
Medical misuse is defined as use of a prescribed opioid medication in a manner not intended by the prescriber, such as taking higher than prescribed doses. Nonmedical misuse is use of someone else's prescription drugs.
Previous studies have reported that the majority of adolescents who are prescribed opioids use them properly, but there are subgroups of adolescents who do not. The objectives of this study, conducted by researchers at the University of Michigan, were to determine past-year prevalence of motives for medical misuse of prescription opioids among adolescents in two school districts in Detroit, and to assess the association of motives for medical misuse with gender, race, ethnicity, substance abuse and diversion behaviors. Some 3,000 adolescents were surveyed in 2011 and 2012.
The authors found that even though the majority of medical misusers said they were motivated by their need for pain relief, 30 percent of medical misusers and 47 percent of nonmedical misusers said they were also motivated by non-pain relief choices, such wanting "to get high."
The study also showed that females were almost twice as likely as males to report past-year medical misuse of opioids. but there were no gender differences seen in the prevalence of motives. African Americans were more likely than whites to medically misuse opioids, and 3 in 4 said they were motivated by pain relief. The authors noted that racial differences observed in this study could be related to inadequate pain management, poor communication, insufficient opioid availability, and under prescribing among black patients.
Medical misuse for non-pain relief motives was linked with significantly greater probability for substance abuse. This group of adolescents also is more likely to divert their medications.
Overall, the findings of this study indicate a need for close monitoring of opioid medications among adolescents and underscore the importance of detecting unusual patterns of opioid medication use.
- Sean Esteban McCabe, Brady T. West, Carol J. Boyd. Motives for Medical Misuse of Prescription Opioids Among Adolescents. The Journal of Pain, 2013; 14 (10): 1208 DOI: 10.1016/j.jpain.2013.05.004
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