219041 Assessing problematic opioid misuse among high-risk youth

Tuesday, November 9, 2010 : 12:47 PM - 1:04 PM

Stephen E. Lankenau, PhD , Community Health and Prevention, Drexel University, School of Public Health, Philadelphia, PA
Michelle Teti, MPH, DrPh , Community Health and Prevention, Drexel University, School of Public Health, Philadelphia, PA
Jennifer Jackson Bloom, MPH , Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, CA
Alexandra Harocopos, MSC , Institute for International Research on Youth At Risk, National Development and Research Institutes, Inc., New York, NY
Meghan Treese , Division of Research on Children, Youth and Families, Childrens Hospital Los Angeles, Hollywood, CA
Karol Silva, MPH , Community Health and Prevention, Drexel University, School of Public Health, Philadelphia, PA
Background: Despite emerging public health problems associated with prescription opioid misuse, few studies have examined how to assess problematic opioid misuse particularly among a sample of high-risk youth.

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 (IDUs). Ten questions modeled after the Drug Abuse Screening Test (DAST-10) assessed histories of problematic opioid misuse. Qualitative probes followed affirmative response to each item.

Findings: Responses to 10 items pertaining to lifetime opioid misuse were as follows: sniffed (62%); injected (30%); polydrug combination (88%); everyday use for one or more weeks (46%); overdosed or blacked out (19%); family problems (26.7%); engaged in illegal activities (17.3%); sold (51.3%); withdrawal symptoms (36.7%); and medical problems (15%). The average number of affirmative responses (score) for the 10 questions equaled 3.9. IDUs registered the highest score (5.6) followed by homeless (3.8) and polydrug (2.5). Qualitative data revealed variability within certain questions, i.e., family problems, overdose, and medical problems, which contextualized particular affirmative responses.

Conclusions: High-risk youth reported extensive histories of prescription opioid misuse. Adapting aspects of the DAST-10 to focus on specific histories of opioid misuse identified particular patterns of misuse. However, all types of misuse were not equally problematic, which was revealed by qualitative data. Problematic opioid misuse is a multifaceted construct that can be best understood utilizing both quantitative and qualitative data.

Learning Areas:
Epidemiology

Learning Objectives:
1) describe different patterns of opioid misuse among high-risk youth; 2) evaluate how problematic opioid misuse can be assessed; 3) explain the utility of qualitative and quantitative data in assessing problematic opioid misuse.

Keywords: Prescription Drug Use Patterns, Adolescent Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator on the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.