Risk Factors Associated With Prescription Opioid Use Disorder Among Youth In an Outpatient Substance Abuse Treatment Program

The significant increase in prescription opioid use disorders has become a major public health problem.  It is imperative that treatment professionals understand the risk factors associated with this problem.  As such, the purpose of this study is to examine risk factors associated with prescription opioid use in standard clinical substance abuse treatment. 

Retrospective chart abstraction data was collected from a sample (n=332) of youth ages 16-24 who completed an intake assessment at a community outpatient treatment program in a large urban setting. Subjects were grouped according to baseline self-reported substance of abuse (primary prescription opioid (n=103) vs other primary substance (n=229)).  Baseline intake assessment was gathered on current use as well as previous use history in addition to demographic and other psychosocial factors. 

Individuals who used prescription opioids were older but indicated earlier onset of substance use problems with alcohol and marijuana (12.9 vs 14.2).  Additionally, those with prescription opioid use had an increased likelihood of using other medications (57.8% vs 21.6%). Those who used prescription opioids had higher frequencies of delinquency, diagnosis of externalizing behavior, and psychiatric diagnosis (62.6% vs 36.7%).  A stepwise logistic regression identified significant risk factors, youth who identified prescription opioid use as primary were significantly more likely to be non-Hispanic white (OR: 0.56 95% CI: 0.50-0.64), have a history of non-violent criminal involvement (OR: 1.21 95% CI: 1.17-1.24), and have a co-occurring psychiatric diagnosis (OR: 2.57 95%CI: 2.12-2.79) compared to those who used other substances.

Youth who identify prescription opioids as their substance of choice have higher rates of substance use in addition to compounding psychosocial dysfunction.  It is imperative that additional research be conducted to understand contributing factors related to these differences in order to better inform treatment approaches and better equip providers with the necessary tools to effect positive change in treatment outcomes.