259417 Correlates and consequences of opioid misuse trajectories among high-risk prescription drug users

Monday, October 29, 2012 : 10:30 AM - 10:50 AM

Sheree M. Schrager, MS, PhD , Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, CA
Jennifer Jackson Bloom, MPH , Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, CA
Ellen Iverson, MPH , Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, CA
Stephen E. Lankenau, PhD , Community Health and Prevention, Drexel University, School of Public Health, Philadelphia, PA
Background: Prescription drug misuse is most prevalent among young adults aged 18-25, and opioids are the most frequently misused class of prescription drug among youth. Longitudinal research indicates that youth attenuate, maintain, or escalate opioid misuse over time, suggesting that misuse follows different temporal trajectories. However, no studies have articulated trajectories of opioid misuse among youth that include both duration of use and other indicators of escalated opioid use. Methods: 596 young adults age 16-25 who had misused one or more prescription drugs at least 3 times in the last 90 days were interviewed in Los Angeles and New York between October 2009 and March 2011. Latent class analysis on a subsample of opioid misusers (N=575) described opioid misuse trajectories based on years of use and indicators of misuse and drug form alteration within the past 12 months, 3 months, and 30 days. Results: The best-fitting solution yielded four latent classes: “intensive” (consistent high use), “active” (slight 3-month declines), “reduced” (recent use but no recent form alteration), and “limited” (3-month cessation). Latent classes differentially predicted the likelihood of heroin use, tranquilizer misuse, daily opioid use, and opioid withdrawal. Using latent class regression, socio-demographic variables, housing status, prescription history, and parental drug use were significantly associated with opioid misuse trajectories. Conclusions: Youth who misuse prescription opioids show different trajectories of historical and recent use. Data on decisions to use and alter a drug's form can be combined to describe patterns of misuse over time and predict important risk outcomes.

Learning Areas:
Public health or related research

Learning Objectives:
Describe opioid misuse trajectories in a sample of high-risk youth Identify other drug use outcomes associated with opioid misuse trajectories List predictors associated with the development of opioid misuse trajectories

Keywords: Drug Abuse, Youth

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Administrator of Behavioral Research in the Division of Adolescent Medicine at Children's Hospital Los Angeles; I hold a PhD in psychology and an MS in statistics, both from the University of Wisconsin-Madison. I served as an expert statistical consultant; in this context, I personally conducted the analysis presented in the abstract. I wrote the draft of the abstract and am first author on the associated manuscript in development.
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.