Certain Teens More Likely to Get Hooked on Opioids

From Drugs.com - March 12, 2018

Certain Teens More Likely to Get Hooked on Opioids

MONDAY, March 12, 2018 -- Teenagers with any mental health problem are more prone to painkiller dependence after receiving a prescription opioid, a new study finds.

The odds of progressing to long-term opioid therapy can double, triple or more, depending on the kid's diagnosis and the other drugs prescribed to treat their disorder, the researchers said.

The findings mirror earlier studies showing that adults with mental health conditions are more likely to take prescription opioids on a long-term basis, said study author Patrick Quinn.

Doctors prescribing drugs like oxycodone (OxyContin) or hydrocodone (Vicodin) for chronic pain might want to screen for mental disorders, said Quinn, a postdoctoral fellow with Indiana University, in Bloomington. If there's a deeper psychiatric problem driving their pain, it might be addressed without resorting to addictive narcotics.

This study highlights that these patients "might be already carrying some risk for [addiction] problems, even before they start taking opioids," Quinn added.

Faced with an epidemic of opioid addiction in the United States, researchers are trying to determine who is most vulnerable. Quinn and his colleagues analyzed commercial health insurance records for more than 1.2 million teens, aged 14 to 18, who had been prescribed an opioid.

The researchers looked to see if the teen had a previous diagnosis of a mental condition, including anxiety, mood disorders, attention-deficit/hyperactivity disorder, psychosis, sleep disorders or substance abuse problems.

The investigators then looked past the initial prescription to see whether these teens were more likely to end up taking opioids on a long-term basis.

Overall, about three out of every 1,000 teenagers prescribed opioids wound up taking them long-term, Quinn said.

But those numbers were consistently higher for teens struggling with mental disorders:

Kids already taking a psychoactive medication for their mental health problem were even more likely to wind up on opioids long-term. For example, odds rose higher for teens with anxiety who take benzodiazepines (such as Xanax); kids with mood disorders who take an SNRI (such as Cymbalta); and those taking antipsychotics for schizophrenia (such as Abilify).

The study, published online March 12 in JAMA Pediatrics, did not examine the reasons for the higher odds of painkiller dependence.

But it might be that their underlying mental disorder makes them more likely to feel their pain more intensely or persistently, Quinn said.

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