Patterns of Prescription Opioid Misuse among Adolescents and Young Adults

Background: Prescription opioids are a primary drug of abuse among youth. In 2008, prescription opioids were the second leading drug of abuse after marijuana. Despite health problems associated with prescription opioid misuse, such as dependence and overdose, few studies has examined patterns of initiation into prescription opioid misuse drugs among adolescents and young adults.

Methods: A sample of 150 youth aged 18 to 25 reporting current prescription drug misuse were recruited in Los Angeles and New York in 2008-09. Three subgroups of high-risk youth were targeted: polydrug users; homeless youth; and injection drug users. Both qualitative and quantitative data were collected on several aspects of initiation events: drug type; mode of administration; drug source; rationale; and history of prescribed use.

Findings: 94% reported lifetime misuse of prescription opioids, which followed marijuana (98.7%) as the second most commonly misused substance. The average age of initiation for misuse of prescription opioid equaled 15.6 years old, which was second only to marijuana (13.7 years old). A majority had been prescribed opioids (72%), and most (52.7%) had misused their prescription. Additionally, a majority of youth's parents had been prescribed opioids (68%), while a minority (40.2%) had misused their parent's medication. Age at first opioid misuse was lower among youth who both had been prescribed opioids and whose parents had been prescribed opioids.

Conclusions: Prescription opioid misuse was common and occurred at an early age relative to other substances. Initiation into prescription opioid misuse was often facilitated by drug availability within households. Prevention efforts should focus on reducing availability of prescription opioids within households.