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Prescription opioid use and misuse among adolescents and young adults in the United States: A national survey study.
PLOS Medicine ( IF 15.8 ) Pub Date : 2019-11-05 , DOI: 10.1371/journal.pmed.1002922
Joel D Hudgins 1, 2 , John J Porter 1 , Michael C Monuteaux 1 , Florence T Bourgeois 1, 2, 3
Affiliation  

BACKGROUND Prescription opioid misuse has become a leading cause of unintentional injury and death among adolescents and young adults in the United States. However, there is limited information on how adolescents and young adults obtain prescription opioids. There are also inadequate recent data on the prevalence of additional drug abuse among those misusing prescription opioids. In this study, we evaluated past-year prevalence of prescription opioid use and misuse, sources of prescription opioids, and additional substance use among adolescents and young adults. METHODS AND FINDINGS This was a retrospective analysis of the National Survey on Drug Use and Health (NSDUH) for the years 2015 and 2016. Prevalence of opioid use, misuse, use disorder, and additional substance use were calculated with 95% confidence intervals (CIs), stratified by age group and other demographic variables. Sources of prescription opioids were determined for respondents reporting opioid misuse. We calculated past-year prevalence of opioid use and misuse with or without use disorder, sources of prescription opioids, and prevalence of additional substance use. We included 27,857 adolescents (12-17 years of age) and 28,213 young adults (18-25 years of age) in our analyses, corresponding to 119.3 million individuals in the extrapolated national population. There were 15,143 respondents (27.5% [95% CI 27.0-28.0], corresponding to 32.8 million individuals) who used prescription opioids in the previous year, including 21.0% (95% CI 20.4-21.6) of adolescents and 32.2% (95% CI 31.4-33.0) of young adults. Significantly more females than males reported using any prescription opioid (30.3% versus 24.8%, P < 0.001), and non-Hispanic whites and blacks were more likely to have had any opioid use compared to Hispanics (28.9%, 28.1%, and 25.8%, respectively; P < 0.001). Opioid misuse was reported by 1,050 adolescents (3.8%; 95% CI 3.5-4.0) and 2,207 young adults (7.8%; 95% CI 7.3-8.2; P < 0.001). Male respondents using opioids were more likely to have opioid misuse without use disorder compared with females (23.2% versus 15.8%, respectively; P < 0.001), with similar prevalence by race/ethnicity. Among those misusing opioids, 55.7% obtained them from friends or relatives, 25.4% from the healthcare system, and 18.9% through other means. Obtaining opioids free from friends or relatives was the most common source for both adolescents (33.5%) and young adults (41.4%). Those with opioid misuse reported high prevalence of prior cocaine (35.5%), hallucinogen (49.4%), heroin (8.7%), and inhalant (30.4%) use. In addition, at least half had used tobacco (55.5%), alcohol (66.9%), or cannabis (49.9%) in the past month. Potential limitations of the study are that we cannot exclude selection bias in the study design or socially desirable reporting among participants, and that longitudinal data are not available for long-term follow-up of individuals. CONCLUSIONS Results from this study suggest that the prevalence of prescription opioid use among adolescents and young adults in the US is high despite known risks for future opioid and other drug use disorders. Reported prescription opioid misuse is common among adolescents and young adults and often associated with additional substance abuse, underscoring the importance of drug and alcohol screening programs in this population. Prevention and treatment efforts should take into account that greater than half of youths misusing prescription opioids obtain these medications through friends and relatives.

中文翻译:

美国青少年和年轻人处方阿片类药物的使用和滥用:一项全国调查研究。

背景技术处方阿片类药物滥用已成为美国青少年和年轻人意外伤害和死亡的主要原因。然而,关于青少年和年轻人如何获得处方阿片类药物的信息有限。关于滥用处方阿片类药物的人中额外药物滥用发生率的最新数据也不足。在这项研究中,我们评估了过去一年青少年和年轻人中处方阿片类药物使用和滥用的流行率、处方阿片类药物的来源以及其他物质使用情况。方法和结果 这是对 2015 年和 2016 年国家药物使用与健康调查 (NSDUH) 的回顾性分析。阿片类药物使用、误用、使用障碍和其他物质使用的流行率采用 95% 置信区间 (CI) 进行计算),按年龄组和其他人口变量分层。针对报告阿片类药物滥用的受访者确定了处方阿片类药物的来源。我们计算了去年阿片类药物使用和误用(伴或不伴使用障碍)的流行率、处方阿片类药物的来源以及额外物质使用的流行率。我们的分析包括 27,857 名青少年(12-17 岁)和 28,213 名年轻人(18-25 岁),相当于推断的全国人口中的 1.193 亿人。有 15,143 名受访者(27.5% [95% CI 27.0-28.0],相当于 3280 万人)在上一年使用过处方阿片类药物,其中包括 21.0% (95% CI 20.4-21.6) 的青少年和 32.2% (95% CI 20.4-21.6) 的青少年。年轻人的 CI 31.4-33.0)。报告使用任何处方阿片类药物的女性明显多于男性(30.3% 对比 24.8%,P < 0.001),与西班牙裔相比,非西班牙裔白人和黑人更有可能使用任何阿片类药物(28.9%、28.1% 和 25.8) %,分别;P < 0.001)。1,050 名青少年(3.8%;95% CI 3.5-4.0)和 2,207 名年轻人(7.8%;95% CI 7.3-8.2;P < 0.001)报告阿片类药物滥用。与女性相比,使用阿片类药物的男性受访者更有可能在没有使用障碍的情况下滥用阿片类药物(分别为 23.2% 和 15.8%;P < 0.001),不同种族/民族的患病率相似。在滥用阿片类药物的人中,55.7%是从朋友或亲戚那里获得的,25.4%是从医疗系统获得的,18.9%是通过其他途径获得的。对于青少年(33.5%)和年轻人(41.4%)来说,从朋友或亲戚那里免费获取阿片类药物是最常见的来源。那些滥用阿片类药物的人报告称,之前曾使用可卡因(35.5%)、致幻剂(49.4%)、海洛因(8.7%)和吸入剂(30.4%)。此外,至少一半人在过去一个月内吸食过烟草(55.5%)、酒精(66.9%)或大麻(49.9%)。该研究的潜在局限性是,我们不能排除研究设计中的选择偏差或参与者的社会期望报告,并且无法获得对个人进行长期随访的纵向数据。结论 这项研究的结果表明,尽管已知未来阿片类药物和其他药物使用障碍的风险,但美国青少年和年轻人中处方阿片类药物使用的流行率很高。据报道,处方阿片类药物滥用在青少年和年轻人中很常见,并且往往与其他药物滥用有关,这凸显了药物和酒精筛查计划在这一人群中的重要性。预防和治疗工作应考虑到一半以上滥用处方阿片类药物的青少年是通过朋友和亲戚获得这些药物的。
更新日期:2019-12-03
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